Citation: European Journal of Cancer. 2020, 127, 160-172
Author: Enriqueta Felip, Andrea Ardizzoni, Tudor Ciuleanu, Manuel Cobo, Konstantin Laktionov, Maria Szilasi, Raffaele Califano, Enric Carcereny, Richard Griffiths, Luis Paz-Ares, Renata Duchnowska, Miriam Alonso Garcia, Dolores Isla, Jacek Jassem, Wiebke Appel, Janusz Milanowski, Jan P Van Meerbeeck, Juergen Wolf, Ang Li, Angelic Acevedo, Sanjay Popat
Abstract: Background: CheckMate 171 (NCT02409368) is an open-label, multicentre, phase 2 trial of nivolumab in previously treated advanced squamous non-small cell lung cancer (NSCLC), conducted as part of a post-approval commitment to the European Medicines Agency (EMA). We report outcomes from this trial.
Methods: Patients with Eastern Cooperative Oncology Group performance status (ECOG PS) 0-2 and disease progression during/after ≥1 systemic treatment (≥1 being platinum-based chemotherapy) for advanced or metastatic disease were treated with nivolumab 3 mg/kg every 2 weeks until progression or unacceptable toxicity. The primary end-point was incidence of grade 3-4 treatment-related select adverse events (AEs). Other end-points included overall survival (OS) and safety.
Results: Of 811 patients treated, 103 had ECOG PS 2; 278 were aged ≥70 years and 125 were ≥75 years of age. Minimum follow-up was ~18 months. Safety was similar across populations; the most frequent grade 3-4 treatment-related select AEs in all treated patients were diarrhoea (1%), increased alanine aminotransferase (ALT, 1%), pneumonitis (0.7%), colitis (0.6%) and increased aspartate aminotransferase (AST, 0.5%). Median OS was similar in all treated patients and those aged ≥70 and ≥75: 10.0 months, 10.0 months and 11.2 months, respectively. Median OS was 5.2 months in patients with ECOG PS 2.
Conclusion: These results suggest that nivolumab is well tolerated and active in patients with advanced, relapsed squamous NSCLC, including the elderly, with OS outcomes consistent with phase 3 data. In patients with ECOG PS 2, nivolumab had similar tolerability, but outcomes were worse, as expected in this difficult-to-treat, poor prognosis population.
Clinical trial registration: NCT02409368.
Keywords: Comorbidity; Elderly; Health status indicators; Nivolumab; Non-small cell lung cancer.
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