Nivolumab vs. Chemotherapy for Advanced Chemo-Naive NSCLC

In prior studies of first-line treatment for patients with advanced non–small-cell lung cancer (NSCLC), survival was prolonged with PD-1 inhibitor pembrolizumab versus platinum-based chemotherapy (NEJM JW Oncol Hematol Jan 2017).

To determine whether the PD-1 inhibitor nivolumab also improves survival in this setting, investigators have conducted an industry-funded, international, randomized, open-label, phase III trial (CheckMate 026), in which 423 patients with untreated stage IV or recurrent NSCLC and ≥1% PD-L1 immunohistochemical (IHC) expression received nivolumab or platinum-based chemotherapy. Chemotherapy recipients were allowed to cross over to nivolumab upon disease progression.

In patients with ≥5% PD-L1 expression, median progress…