Anti-CTLA-4 in non-small-cell lung cancer: insights from the NIPPON study
Mené au Japon sur 295 patients atteints d'un cancer du poumon non à petites cellules de stade avancé, cet essai multicentrique de phase III compare l'efficacité, du point de vue de la survie globale, et la toxicité de l'ajout de pembrolizumab et de l'ajout de nivolumab-ipilimumab à une chimiothérapie de première ligne à base de sels de platine
The incorporation of immune checkpoint inhibitors has revolutionised the treatment landscape of advanced, non-oncogene-driven non-small-cell lung cancer (NSCLC). Multiple randomised trials have provided evidence that the addition of anti-PD-L1 to chemotherapy improves tumour response, progression-free survival, and overall survival in patients with treatment-naive, advanced-stage NSCLC. Two randomised phase 3 trials, namely CheckMate 9LA and POSEIDON, also observed an overall survival benefit with the addition of dual PD-L1 and CTLA-4 blockade to chemotherapy, adding yet two potential first-line treatment options. However, as CheckMate 9LA and POSEIDON did not include PD-L1 blockade in the control group, the additive value of CTLA-4 blockade has been the subject of a long-standing debate.