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What kind of lung cancer patients benefit the most from immunotherapy?
The biggest highlight of immunotherapy, in addition to its different safety from chemotherapy, can also bring long-term survival benefits to some patients. Recently, the full text of CA209-003 research was published online in JCO magazine. In this issue, Professor Yang Nong, assistant dean of Hunan Cancer Hospital and member of CSCO immunotherapy expert committee, was invited to comment on this research.

abstract of a thesis

Research purposes

In two phase III clinical studies, nivolumab significantly improved the overall survival of patients with advanced non-small cell lung cancer (NSCLC) compared with docetaxel. This study reports the follow-up results of a phase I clinical study of patients with advanced non-small cell lung cancer treated with nivolumab, and describes the characteristics of patients who have survived for 5 years.

research method

Patients with non-small cell lung cancer who had previously received multi-line systemic therapy were treated with 1mg/kg, 3mg/kg and 10mg/kg, once every two weeks, with a treatment cycle of 8 weeks, and the longest treatment time was 96 weeks. From the first administration, the OS of patients was evaluated by KM method.

research results

The 5-year survival rate of all patients treated with nivolumab was 16% (n = 129). The survival rate of squamous cell carcinoma (16%) is similar to that of adenocarcinoma (15%). Most of the 16 patients who survived for 5 years were former smokers or current smokers. Among the patients with quantifiable expression level of PD-L 1 0, the expression level of PD-L 1 at baseline was ≥ 1%. According to the criteria of RECIST v 1.0, 12 cases (75%) who survived for 5 years reached PR, and 2 cases in each group had the best curative effect. Nine patients completed the treatment for 96 weeks, four patients (25%) stopped treatment due to toxic side effects, and three patients (19%) stopped treatment due to PD. By the end of 20 16, 1 1 2 patients (75%) had not received follow-up treatment, and no evidence of disease progression was found at the last follow-up.

Research conclusion

Some patients with advanced non-small cell lung cancer can get long-term and sustained curative effect after treatment with nivolumab. Long-term survivors have different baseline and treatment characteristics.