First-Line Nivolumab Plus Ipilimumab Versus Chemotherapy in Advanced NSCLC With 1% or Greater Tumor PD-L1 Expression:...

Area of Science:

• Oncology
• Immunotherapy
• Patient-Reported Outcomes

Background:

• CheckMate 227 demonstrated improved overall survival with nivolumab plus ipilimumab versus chemotherapy in treatment-naive advanced NSCLC patients with PD-L1 expression ≥1%.
• Patient-reported outcomes (PROs) are crucial for assessing treatment impact on quality of life.

Purpose of the Study:

• To present the patient-reported outcomes (PROs) from the CheckMate 227 trial.
• To compare the impact of nivolumab plus ipilimumab versus chemotherapy on symptom burden and health-related quality of life in advanced NSCLC.

Main Methods:

• Exploratory analysis of PROs including Lung Cancer Symptom Scale (LCSS) and EQ-5D measures.
• 1189 patients with treatment-naive advanced NSCLC and PD-L1 ≥1% were randomized to nivolumab plus ipilimumab, nivolumab, or chemotherapy.
• Statistical analyses included mixed-effect model repeated measures and time-to-first deterioration/improvement.

Main Results:

• PRO completion rates exceeded 80% across treatment arms.
• Nivolumab plus ipilimumab demonstrated clinically meaningful improvements in LCSS symptom burden and global health status, generally exceeding the minimal important difference.
• This combination also showed delayed time-to-first deterioration and a trend for more rapid time-to-first improvement compared to chemotherapy.

Conclusions:

• Nivolumab plus ipilimumab demonstrated delayed deterioration and numerical improvements in symptoms and health-related quality of life versus chemotherapy.
• These findings support the efficacy of nivolumab plus ipilimumab in improving patient outcomes beyond overall survival in advanced NSCLC.