CheckMate 227 trial: Nivolumab + ipilimumab shows remarkable six-year survival benefits in metastatic NSCLC

The International Association for the Study of Lung Cancer (IASLC) World Conference on Lung Cancer 2023 in Singapore is set to witness a monumental breakthrough in the field of metastatic non-small cell lung cancer (NSCLC) treatment. Research findings from the CheckMate 227 trial will be presented, shedding light on the extraordinary six-year survival and quality of life benefits associated with first-line nivolumab + ipilimumab therapy.

CheckMate 227 Part 1 showed that a combination of first-line nivolumab and ipilimumab exhibited a remarkable and sustained survival advantage over traditional chemotherapy in patients with metastatic NSCLC.

Our findings represent a pivotal moment in the management of metastatic NSCLC. The extended survival and enhanced quality of life observed with nivolumab + ipilimumab underscores the potential for a paradigm shift in treatment strategies."

Dr. Solange Peters, Lausanne University Hospital in Switzerland

The study enrolled adults with treatment- naïve stage IV or recurrent NSCLC, excluding those with known EGFR/ALK alterations and with ECOG performance status of ≤1. Patients were divided into different cohorts based on tumor PD-L1 expression levels and randomized to receive nivolumab + ipilimumab, nivolumab, nivolumab + chemotherapy or chemotherapy alone.

The latest data, with a minimum follow-up of 73.4 months, reaffirmed the compelling survival benefits of nivolumab + ipilimumab over chemotherapy, Peters reported. Notably, the six-year overall survival rates were substantially higher, reaching 22% vs. 13% and 16% vs. 5%, respectively, for patients with tumor PD-L1 ≥1% or <1%. These outcomes signify an advance in the treatment of metastatic NSCLC.

Additional endpoints, including objective response rates, duration of response, and quality of life, consistently favored the nivolumab + ipilimumab combination across all patient subgroups. Notably, responders with substantial tumor burden reduction exhibited considerably improved overall survival with nivolumab + ipilimumab compared to chemotherapy.

Furthermore, the study's comprehensive assessment of patients' health-related quality of life (HRQoL) demonstrated a clear association between better baseline HRQoL and improved overall survival, regardless of the treatment received.

"The evidence we present offers a compelling case for the transformative potential of nivolumab + ipilimumab in metastatic NSCLC treatment. Our findings underscore the significance of personalized care and better outcomes for patients," said Dr. Peters.