Immunotherapy before and after lung cancer surgery reduces risk of death and relapse

Lung cancer expert from Johns Hopkins Kimmel Cancer Center presents at World Conference on Lung Cancer

People with operable non-small cell lung cancer may fare better in the coming years if they receive immunotherapy before and after surgery, rather than just before surgery, according to a new analysis by Johns Hopkins Kimmel Cancer Center Investigators.

For the study, researchers compared the health outcomes of 147 participants in the CheckMate 816 trial – in which patients received three cycles of the immunotherapy nivolumab plus chemotherapy (neoadjuvant) before surgery – with the outcomes of 139 participants in the CheckMate 77T trial, in which patients received up to four cycles of nivolumab plus chemotherapy before surgery and up to 13 cycles of nivolumab after surgery. They followed the participants for up to four years after surgery.

They observed a 40 percent reduction in the risk of disease recurrence or death after surgery in patients who received at least one dose of nivolumab after immunotherapy/chemotherapy and surgery. A similar benefit was seen regardless of patients' cancer stage at baseline. Reductions in disease recurrence and death were also seen more often in people whose tumor expression of the protein PD-L1 (which allows cells to evade immune system attack) was less than 1%, compared with expression of 1% or more. Immunotherapy before and after surgery was found to be beneficial in patients in whom preoperative treatment and surgery did not produce a complete pathological response (absence of cancer cells).

These results were presented on Sunday, September 8, at the IASLC (International Association for the Study of Lung Cancer) 2024 World Lung Cancer Conference in San Diego.

“In recent years, there has been a major evolution in the treatment of lung cancer and melanoma from pre-surgery followed by immunotherapy to pre-surgery immunotherapy,” explains Patrick Forde, MBBCh.Associate Professor of Oncology at the Johns Hopkins University School of Medicine“But our analysis of individual patients in these two studies suggests that additional immunotherapy after surgery is likely to provide further benefit.”

The title of the abstract is “Perioperative vs. Neoadjuvant Nivolumab for Resectable NSCLC: Patient-Based Data Analysis of CheckMate 77T vs. CheckMate 816” (Presentation #3589). The studies mentioned in the abstract were sponsored by Bristol-Myers Squibb, the manufacturer of nivolumab, and were conducted at Johns Hopkins and other clinical sites.

To arrange an interview with Forde, contact Valerie Mehl at [email protected] or Amy Mone at [email protected].