Neoadjuvant Nivolumab for Resectable Lung Cancer

PD-1 inhibitors have been shown to improve survival in patients with advanced non–small-cell lung cancer (NSCLC; e.g., NEJM JW Oncol Hematol Jun 2018 and N Engl J Med 2018 Apr 16; [e-pub] and NEJM JW Oncol Hematol Mar 2017 and Lancet 2017; 389:255).

To determine its effectiveness for early NSCLC, investigators conducted a window-of-opportunity neoadjuvant pilot trial in which 21 patients with untreated, resectable disease (stage I–IIIA; 81% were stage II or IIIA) received the anti–PD-1 checkpoint inhibitor nivolumab (2 preoperative doses every 2 weeks); 20 of 21 tumors were completely resected at week 4.

Results were as follows:

• A major pathologic response (MPR) was identified in 45% of patients.

• MPR was seen in both PD-L1—positive and PD-L1—ne…