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Nivolumab-refractory patients with advanced non-small-cell lung cancer

A Costantini1, V Fallet1, J Corny2

  • 1AP-HP, Hôpital Tenon et Sorbonne Université, 4 Rue de la Chine 75020, Paris, France.

Lung Cancer (Amsterdam, Netherlands)
|March 20, 2019
PubMed
Abstract

Insights

Immune checkpoint inhibitors (ICIs) like nivolumab can lead to refractory disease in up to 20% of advanced non-small cell lung cancer patients. This refractory disease is associated with worse survival outcomes, necessitating further research into its mechanisms and management.

Area of Science:

  • Oncology
  • Immunotherapy
  • Lung Cancer Research

Background:

  • Immune checkpoint inhibitors (ICIs) have transformed cancer treatment, particularly for lung cancer.
  • New response patterns, including pseudo-progression and hyper-progressive disease (HPD), are observed with ICIs.
  • A consensus definition for HPD is still lacking.

Purpose of the Study:

  • To propose a clinical definition for nivolumab-refractory patients.
  • To identify factors associated with nivolumab-refractory disease in advanced non-small cell lung cancer (NSCLC).

Main Methods:

  • A multi-centric retrospective study was conducted.
  • Patients included received nivolumab for advanced NSCLC during the French temporary authorization in 2015.
  • Data from 303 patients were analyzed.

Main Results:

  • 20% (57 out of 303) of patients exhibited nivolumab-refractory disease.
  • Refractory patients had worse performance status (PS) at nivolumab initiation (p < 0.0001).
  • Shorter treatment duration before nivolumab (p = 0.028) and significantly shorter overall survival (p < 0.0001) were observed in refractory patients.

Conclusions:

  • Nivolumab-refractory disease impacts up to 20% of advanced NSCLC patients, leading to drastically reduced survival.
  • Further investigation is required to elucidate the mechanisms underlying refractory disease and to establish effective management strategies.
Keywords:
NivolumabNon-small-cell lung cancerRefractoryTreatment

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