Dr. Borghaei on CheckMate-227 Trial Updates in NSCLC

Hossein Borghaei, DO, MS, chief of the Division of Thoracic Medical Oncology, professor of the Department of Hematology/Oncology, and co-director of the Immune Monitoring Facility at Fox Chase Cancer Center, discusses recent announcements from the CheckMate-227 trial in non—small cell lung cancer (NSCLC).

The randomized, phase III CheckMate-227 study comprised multiple cohorts of patients with PD-L1 of ≥1% and those with PD-L1-negative tumors. Moreover, a tumor mutational burden (TMB) analysis was added as a potential biomarker to be evaluated, according to Borghaei. The treatment arms for part 1a of the study, depending on whether patients have PD-L1-positive or -negative tumors, included a combination of nivolumab (Opdivo) plus ipilimumab (Yervoy) versus nivolumab alone versus chemotherapy. Part 1b examined nivolumab/ipilimumab versus nivolumab/chemotherapy versus chemotherapy in patients whose tumors that do not express PD-L1. Part 2 of the trial examined nivolumab combined with chemotherapy versus chemotherapy, regardless of PD-L1 expression. The full results of the study will be presented at an upcoming medical meeting.

The press release from the company suggested there might be an overall survival (OS) advantage with the combination of nivolumab/ipilimumab for patients with PD-L1 ≥1%. Data show that patients with TMB ≥10 mutations/megabase seem to have increased progression-free survival with nivolumab/ipilimumab versus chemotherapy alone, according to Borghaei. However, because the OS data from this analysis have not yet been released, Borghaei suggests waiting until the full data set is been presented and published before choosing how to apply it in clinical practice. These data could have the potential for a chemotherapy-sparing regimen using nivolumab/ipilimumab.

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