- Real-world survival outcomes for patients with cancer receiving immune checkpoint inhibitors (ICIs) are inferior to outcomes reported in patients in clinical trials of ICIs.
Why this matters
- Authors: “patients receiving ICIs in real-world practice differ from those enrolled in trials in a variety of ways, including age, race, performance status, and comorbidity burden.”
- Study of 11,888 patients with cancer who received ICIs.
- Funding: VA Office of Research and Development.
- The patients were treated for NSCLC (51.1%), melanoma (14.4%), renal cell carcinoma (RCC; 8.1%), squamous cell carcinoma of the head and neck (6.8%), urothelial cancer (6.4%), hepatocellular carcinoma (4.5%), and other less common cancer types (8.8%).
- Median real-world OS was inferior to median clinical trial OS for:
- Second line or higher (2L+): 16.3 months.
- First-line ipilimumab and nivolumab: 14 months.
- First-line pembrolizumab: 10.6 months.
- First-line pembrolizumab and platinum-based chemotherapy: 9.1 months.
- Urothelial cancer (2L+ ICIs): 6.7 months.
- The following settings showed similar OS between the real-world and trial data.
- Melanoma: first-line nivolumab in melanoma, 25.5 months.
- NSCLC: 2L+ pembrolizumab or nivolumab, 9.9 months.