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Multicenter Study
. 2024 Jan 4;73(1):4.
doi: 10.1007/s00262-023-03583-4.

Real-world outcomes of nivolumab plus ipilimumab and pembrolizumab with platinum-based chemotherapy in advanced non-small cell lung cancer: a multicenter retrospective comparative study

Kinnosuke Matsumoto  1 , Takayuki Shiroyama  2 , Motohiro Tamiya  3 , Toshiyuki Minami  4 , Yuhei Kinehara  5 , Akihiro Tamiya  6 , Yasuhiko Suga  7 , Tomoki Kuge  1   8 , Masahide Mori  8 , Hidekazu Suzuki  9 , Satoshi Tobita  10 , Kiyonobu Ueno  10 , Yoshinobu Namba  11 , Satoshi Tetsumoto  12 , Toshie Niki  13 , Osamu Morimura  14 , Akio Osa  15 , Kazumi Nishino  3 , Izumi Nagatomo  1 , Yoshito Takeda  1 , Takashi Kijima  4 , Atsushi Kumanogoh  1   16   17   18   19   20
Affiliations
Multicenter Study

Real-world outcomes of nivolumab plus ipilimumab and pembrolizumab with platinum-based chemotherapy in advanced non-small cell lung cancer: a multicenter retrospective comparative study

Kinnosuke Matsumoto et al. Cancer Immunol Immunother. .

Abstract

Introduction: Nivolumab plus ipilimumab with chemotherapy (NICT) and pembrolizumab with chemotherapy (PCT) are commonly used in patients with advanced non-small cell lung cancer (NSCLC). Compared with immune checkpoint inhibitor (ICI) monotherapy, ICI combination therapy can increase immune-related toxicity instead of prolonging survival. This study aimed to compare the efficacy and safety of NICT and PCT to decide on the favorable treatment.

Methods: We conducted a multi-center retrospective cohort study on patients who underwent NICT or PCT between December 2018 and May 2022. Propensity score matching (PSM) was performed with the variables age, sex, smoking status, performance status, stage, histology, and programmed cell death ligand-1 (PD-L1). The Kaplan-Meier method was used to compare survival for the matched patients.

Results: Six hundred consecutive patients were included. After PSM, 81 and 162 patients were enrolled in the NICT and PCT groups, respectively. The baseline characteristics were well-balanced. The median progression-free survival was equivalent (11.6 vs. 7.4 months; P = 0.582); however, the median overall survival (OS) was significantly longer in the NICT group than in the PCT group (26.0 vs. 16.8 months; P = 0.005). Furthermore, OS was better in PD-L1-negative patients who underwent NICT than in those who underwent PCT (26.0 vs. 16.8 months; P = 0.045). Safety profiles did not differ significantly in terms of severe adverse event and treatment-related death rates (P = 0.560, and 0.722, respectively).

Conclusions: Real-world data suggests that NICT could be a favorable treatment option compared with PCT for patients with advanced NSCLC. Further follow-up is needed to determine the long-term prognostic benefit.

Keywords: Ipilimumab; Nivolumab; Non-small-cell Lung cancer; Pembrolizumab; Propensity score; Real-world.

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Conflict of interest statement

Dr. A. Tamiya reports receiving grants from AstraZeneca, BeiGene, and Daiichi-Sankyo; and honoraria for lectures from AstraZeneca, Boehringer Ingelheim, Eli Lilly, Pfizer, Amgen, Kyowa Kirin, Merck BioFarma, Novartis, Ono Pharmacaceutical, Chugai Pharmacaceutical, Bristol-Myers Squibb, Taiho Pharmaceutical, Merck Sharp & Dohme, Takeda Pharmaceutical, Nihon-Kayaku, and Thermo Fischer Scientific outside of the submitted work. Dr. M. Tamiya reports receiving grants from Ono Pharmaceutical, Japan, Bristol-Myers Squibb, and Boehringer Ingelheim; and honoraria for lectures from Taiho Pharmaceutical, Japan, Eli Lilly, Asahi Kasei Pharmaceutical, Merck Sharp & Dohme, Boehringer Ingelheim, AstraZeneca, Chugai Pharmaceutical, Ono Pharmaceutical, and Bristol-Myers Squibb outside of the submitted work. Dr. Nishino reports receiving grants from Ono Pharmaceutical, Taiho Pharmaceutical, Merck Sharp & Dohme, AbbVie, Daiichi-Sankyo, Amgen, Eisai, Sanofi, Janssen Pharmaceutical, Novartis, Pfizer, Eli Lilly Japan, Merck Biopharma, Takeda Pharmaceutical, Chugai Pharmaceutical, Merus; and honoraria for lectures from AstraZeneca, Chugai pharmaceutical, Nippon Boehringer Ingelheim, Eli Lilly Japan, Roche Diagnostics, Novartis, Pfizer, Merk, Janssen Pharmaceutical, Bristol-Myers Squibb, Nippon Kayaku outside of the submitted work. Dr. Mori. reports receiving grants from Ono Pharmaceutical, Merck Sharp & Dohme, Delt-Fly Pharma, Chugai Pharmaceutical; and honoraria for lectures from AstraZeneca, Chugai pharmaceutical, Nippon Boehringer Ingelheim, Eli Lilly Japan, Novartis, Pfizer, Merck Sharp & Dohme, Bristol-Myers Squibb, Ono Pharmaceutical, Taiho Pharmaceutical, Takeda Pharmaceutical, Nippon Kayaku, Kyowa Kirin, Daiichi-Sankyo, Otsuka Pharmaceutical, Shionogi Pharmaceutical outside of the submitted work. Dr. Kijima. reports receiving honoraria for lectures from Chugai pharmaceutical, Bristol-Myers Squibb, Ono Pharmaceutical outside of the submitted work. The other authors declare no conflicts of interest.

Figures

Fig. 1
Fig. 1
Kaplan–Meier survival curves of TTD (A), PFS (B), and OS (C) in the NICT and PCT groups after propensity score matching. Abbreviations: NICT, nivolumab plus ipilimumab with chemotherapy; PCT, pembrolizumab with chemotherapy; mTTD, median time to treatment discontinuation; mPFS, median progression-free survival; mOS, median overall survival; HR, hazard ratio
Fig. 2
Fig. 2
Subgroup analyses for OS in the NICT and PCT groups after a propensity score matching method according to age (A1: <65 years, A2: ≥65 years), ECOG-PS (B1: PS 0–1, B2: PS 2–4), histology (C1: adenocarcinoma, C2: squamous cell carcinoma), and PD-L1 TPS (D1: TPS ≥ 50%, D2: TPS 1–49%, D3: TPS < 1%). Abbreviations: NICT, nivolumab plus ipilimumab with chemotherapy; PCT, pembrolizumab with chemotherapy; mOS, median overall survival; HR, hazard ratio; NR, not reached; ECOG-PS, Eastern Cooperative Oncology Group Performance Status; PD-L1 TPS, programmed cell death ligand-1 tumor proportion score
Fig. 3
Fig. 3
The frequency of pneumonitis development in patients was stratified according to grade within 12 months of NICT or PCT initiation (A); time from NICT and PCT initiation to the onset of any grade pneumonitis (B). Abbreviations: NICT, nivolumab plus ipilimumab with chemotherapy; PCT, pembrolizumab with chemotherapy
See this image and copyright information in PMC

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