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Nivolumab Effective for Advanced NSCLC in Real-World Practice

March 02, 2021

Nivolumab monotherapy is effective for previously treated advanced non-small cell lung cancer in real-world practice, according to results from a study published in Clinical Lung Cancer (2021;22[1]:e35-e47. doi: 10.1016/j.cllc.2020.07.009. Epub 2020 Jul 29).

“In phase 3 clinical trials, nivolumab prolonged overall survival (OS) compared to chemotherapy in patients with previously treated advanced NSCLC,” wrote David D Stenehjem, PharmD, Department of Pharmacy Practice and Pharmaceutical Sciences, University of Minnesota, Duluth, and colleagues.

This study aimed to evaluate the effectiveness of nivolumab in patients with advanced NSCLC receiving treatment at community hospitals in the United States.

The Flatiron Health oncology database was used to extract patient data from electronic health records. OS was evaluated in patients receiving nivolumab for advanced NSCLC after prior chemotherapy.

Subgroup analyses were performed by baseline characteristics included Eastern Cooperative Oncology Group performance status (ECOG PS) and age. Cox analysis was used to determine predictors of OS.

A total of 3019 patients were included in the study: 1968 (65%) with nonsquamous NSCLC and 1051 (35%) with squamous NSCLC. Roughly 20% of patients in each cohort had a verified ECOG PS ≥2, and >25% were aged ≥75 years.

The median OS was 8.6 months (95% confidence interval [CI], 8.0-9.3) in the nonsquamous cohort and 7.4 months (95% CI, 6.8-8.5) in the squamous cohort. For patients with an ECOG PS 0-1, median OS was 10.8 months (95% CI, 9.8-11.8) and 8.7 months (95% CI, 7.6-9.7), respectively.

Programmed death ligand 1 expression ≥ 1% and ECOG PS 0-1 were associated with longer OS (P <.05) in both cohort. Conversely, the number of prior lines of therapy and age ≥75 years were found to have no significant association with OS.

“This study confirmed the effectiveness of nivolumab monotherapy for previously treated advanced NSCLC in real-world clinical practice,” concluded Dr Stenehjem and colleagues.

“Poor ECOG PS, but not advanced age, was associated with shorter OS,” they added.—Janelle Bradley

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