The following article features coverage from the Society of Immunotherapy of Cancer (SITC) 2020 meeting. Click here to read more of Cancer Therapy Advisor‘s conference coverage.

Neoadjuvant chemotherapy plus nivolumab resulted in a higher frequency of disease downstaging and lower frequency of upstaging compared with other therapies among patients with stage I-III non-small cell lung cancer (NSCLC), according to the results of a study presented at the virtual Society for Immunotherapy of Cancer 35th Anniversary Annual Meeting & Preconference Programs (SITC 2020).

Disease downstaging after neoadjuvant therapy is associated with improved prognosis among patients with NSCLC. “We hypothesized that chemoimmunotherapy would achieve more downstaging than other therapies,” Boris Sepesi, MD, of The University of Texas MD Anderson Cancer Center in Houston, Texas, and presenter of the study, said.

The study included 302 patients with stage I-III NSCLC who received chemotherapy alone, as well as cohorts from the phase 2 NEOSTAR study: 21 who received nivolumab monotherapy, 16 who were treated with nivolumab plus ipilimumab, and 22 who received chemotherapy plus nivolumab.

Chemotherapy plus nivolumab resulted in a higher frequency of overall and tumor-specific downstaging compared with other therapies. For overall staging, 68% patients treated with chemotherapy plus nivolumab were downstaged compared with 38% for each of the other therapies (P =.048).


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For tumor downstaging, chemotherapy plus nivolumab resulted in downstaging among 59% of patients compared with 26%, 29%, and 38% among patients who received chemotherapy, nivolumab monotherapy, and nivolumab plus ipilimumab, respectively (P=.012).

“Interestingly enough, nodal downstaging was about the same among all 4 groups,” Dr Sepesi said. He noted that the sample sizes were small in the immunotherapy groups, “however, this may also suggest a different antitumor response in the primary tumor as compared to the lymph nodes.”

There was no significant difference in upstaging between treatment groups; however, there was a numerical trend of lower frequency of upstaging with chemotherapy plus ipilimumab compared with the other therapies.

Dr Sepesi concluded that “platinum doublet chemotherapy with nivolumab achieved the most robust pathological downstaging and decreased the probability of upstaging.” He noted that a phase 3 neoadjuvant trial is ongoing and will provide important information in this setting.

Read more of Cancer Therapy Advisor‘s coverage of the SITC 2020 meeting by visiting the conference page.

Reference

Sepesi B, Corsini EM, Weissferdt A, et al. Combined neoadjuvant chemo-immunotherapy therapy achieves superior downstaging of resectable non-small cell lung cancer as compared to chemotherapy, mono or dual immunotherapy. Presented at: Society for Immunotherapy of Cancer 35th Anniversary Annual Meeting & Preconference Programs (SITC 2020); November 11-14, 2020. Abstract 277. J Immunother Cancer. 2020;8(Suppl 3):A656–A959.