Nivolumab improves lung cancer survival in 80%

Researchers tracking the long-term effects of the immunotherapy drug nivolumab on early-stage lung cancer found that 80% of patients who received the drug before surgery were still alive after five years. The rate far exceeds the typical 36% to 68% range seen with standard treatments, according to a new study.

Lung cancer is the leading cause of cancer death worldwide. Around 80% to 85% of cases are non-small cell lung cancer (NSCLC), a group of cancers that respond to similar therapies. While treatments for advanced NSCLC have improved in recent years, progress for early-stage disease has been slower to arrive.

The study followed 21 patients with stage 1 to 3 NSCLC. About half were women, with an average age of 67.

They received two intravenous doses of nivolumab two weeks apart, then underwent surgery four weeks after the first dose. One person could not have surgery because the disease progressed. The remaining 20 were tracked for an average of 63 months.

The team also noted that nivolumab caused few side effects and did not delay surgery.

“To our knowledge, this is the longest follow-up to date for a PD-1/ PD-L1 inhibitor in the neoadjuvant setting- before surgery- for any solid tumor,” said Dr. Patrick Forde, the study’s senior author and an associate professor of oncology at Johns Hopkins University.

Nivolumab is an anti-programmed-cell death protein-1 (PD-1) therapy. It blocks PD-1 proteins on cancer cells, which allows immune T cells to kill those cells more effectively.

Dr. Chao Huang, an associate professor of medical oncology at the University of Kansas Medical Center not involved in the research, explained it this way: “I usually explain to the patient using the analogy that the drug removes the ‘cloak of invisibility’ of the cancer cells, so that T cells can ‘see’ them.”

Dr. Irina Sachelarie, a board-certified hematologist and medical oncologist at MemorialCare Cancer Institute in Fountain Valley, CA, also not involved in the study, said immunotherapy has proven effective in treating NSCLC, improving response rates, lowering relapse rates, and improving survival.

She noted that it is now used for metastatic NSCLC and also for early-stage disease after surgery (adjuvant setting) or before surgery (neoadjuvant setting).