Neoadjuvant nivolumab with or without relatlimab in resectable non-small-cell lung cancer: a randomized phase 2 trial
Research output: Contribution to journal › Research article › Contributed › peer-review
Contributors
Abstract
Antibodies targeting the immune checkpoint molecules PD-1, PD-L1 and CTLA-4, administered alone or in combination with chemotherapy, are the standard of care in most patients with metastatic non-small-cell lung cancers. When given before curative surgery, tumor responses and improved event-free survival are achieved. New antibody combinations may be more efficacious and tolerable. In an ongoing, open-label phase 2 study, 60 biomarker-unselected, treatment-naive patients with resectable non-small-cell lung cancer were randomized to receive two preoperative doses of nivolumab (anti-PD-1) with or without relatlimab (anti-LAG-3) antibody therapy. The primary study endpoint was the feasibility of surgery within 43 days, which was met by all patients. Curative resection was achieved in 95% of patients. Secondary endpoints included pathological and radiographic response rates, pathologically complete resection rates, disease-free and overall survival rates, and safety. Major pathological (≤10% viable tumor cells) and objective radiographic responses were achieved in 27% and 10% (nivolumab) and in 30% and 27% (nivolumab and relatlimab) of patients, respectively. In 100% (nivolumab) and 90% (nivolumab and relatlimab) of patients, tumors and lymph nodes were pathologically completely resected. With 12 months median duration of follow-up, disease-free survival and overall survival rates at 12 months were 89% and 93% (nivolumab), and 93% and 100% (nivolumab and relatlimab). Both treatments were safe with grade ≥3 treatment-emergent adverse events reported in 10% and 13% of patients per study arm. Exploratory analyses provided insights into biological processes triggered by preoperative immunotherapy. This study establishes the feasibility and safety of dual targeting of PD-1 and LAG-3 before lung cancer surgery. ClinicalTrials.gov Indentifier: NCT04205552.
Details
Original language | English |
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Pages (from-to) | 1602-1611 |
Number of pages | 10 |
Journal | Nature medicine |
Volume | 30 |
Issue number | 6 |
Publication status | Published - Jun 2024 |
Peer-reviewed | Yes |
External IDs
PubMed | 38689060 |
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Keywords
Sustainable Development Goals
ASJC Scopus subject areas
Keywords
- Humans, Carcinoma, Non-Small-Cell Lung/drug therapy, Nivolumab/therapeutic use, Female, Male, Middle Aged, Lung Neoplasms/drug therapy, Neoadjuvant Therapy, Aged, Antineoplastic Combined Chemotherapy Protocols/therapeutic use, Lymphocyte Activation Gene 3 Protein, Adult, Antibodies, Monoclonal, Humanized/therapeutic use, Antigens, CD, Aged, 80 and over