Tony S. Mok, MD, spoke about utilizing adjuvant or neoadjuvant treatment for patients with non–small cell lung cancer.
CancerNetwork® spoke with Tony S. Mok, MD, Li Shu Fan Medical Foundation Named Professor of Clinical Oncology and chair of Clinical Oncology at the Chinese University of Hong Kong, at the 2022 American Society of Clinical Oncology Annual Meeting about 2 trials examining neoadjuvant nivolumab (Opdivo) regimens in patients with resectable non–small cell lung cancer. The phase 3 CheckMate 816 trial (NCT02998528) examined neoadjuvant nivolumab plus chemotherapy in patients with stage IB to IIIA disease and the phase 2 NADIMII trial (NCT03838159) looked at a similar regimen in those with stage IIIA to IIIB disease. Looking at results from both trials together provides rationale for using neoadjuvant treatment in this setting.
In the past few years, the most exciting area in non–small cell lung cancer is how to manage patients with resectable disease. There are a number of trials in the adjuvant and neoadjuvant setting, and one of the most exciting is CheckMate 816 that has demonstrated improvement in both complete response and also event-free survival [EFS]. This year, we have the NADIMII [trial (NCT03838159)] that is based in Spain. It is examining neoadjuvant chemotherapy together with nivolumab for 3 cycles. It’s a randomized phase 2 study, and the design is similar to CheckMate 816. We were able to observe a significant improvement in the complete pathological response. Now, there’s not just 1 study, but there are 2 randomized studies demonstrating the same effect of improvement in the number of patients with complete pathological response. Based on the CheckMate 816 data, [the EFS rate] is marvelous if you were able to attain a complete pathological response, and that will likely be translated into an overall survival benefit. We really have to figure out now the next time a patient comes in with stage II or stage III disease if we should think about neoadjuvant [therapy] before surgery.
Forde PM, Spicer J, Lu S, et al. Neoadjuvant nivolumab plus chemotherapy in resectable lung cancer. N Engl J Med. 2022;386(21):1973-1985. doi:10.1056/NEJMoa2202170