Early Data Support Neoadjuvant Immunotherapy for NSCLC

Mark G. Kris, MD


December 22, 2021

This transcript has been edited for clarity.

Hello. This is Mark Kris from Memorial Sloan Kettering, speaking today about a press release by Bristol-Myers Squibb on November 8, 2021, announcing that their clinical trial comparing nivolumab plus chemotherapy vs chemotherapy alone in patients with resectable non–small cell lung cancer met its primary endpoint: an improvement in event-free survival.

This is a long-awaited and hoped-for development in this trial. Patients who were candidates for surgery received neoadjuvant therapy with chemotherapy alone or chemotherapy plus nivolumab, and it was just three cycles of chemotherapy with nivolumab.

The investigators from this trial had previously reported a clear improvement in the pathologic complete response rate, which we know from prior work correlates with long-term outcomes. The second major endpoint of the trial was event-free survival. In this press release, there was an announcement that that endpoint had been met as well.

What we're seeing here is a great opportunity — just 3 cycles of chemotherapy and nivolumab to improve outcomes, both event-free and probably overall survival too, based on that pathologic complete remission endpoint.

We're supported in this work by the likely quick release of additional trial results. There are trials of pembrolizumab, durvalumab, and atezolizumab in the same format. The trials have either been completed or are very, very close to completion, and these data will be reading out as well, to give additional support.

To me, this is a critical trial — the culmination of years of research showing the benefits of neoadjuvant therapy. The hope is that this concept and this whole degree of benefit that can be achieved by using chemotherapy and immunotherapy before surgery will quickly become a standard of care. This is very, very great news. More good news to come.

Mark G. Kris, MD, is chief of the thoracic oncology service and the William and Joy Ruane Chair in Thoracic Oncology at Memorial Sloan Kettering Cancer Center in New York City. His research interests include targeted therapies for lung cancer, multimodality therapy, the development of new anticancer drugs, and symptom management with a focus on preventing emesis.

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