Nivolumab versus pembrolizumab in previously-treated advanced non-small cell lung cancer patients: A propensity-matched real-world analysis
Menée au Japon dans un contexte de vie réelle auprès de 202 patients atteints d'un cancer du poumon non à petites cellules de stade avancé surexprimant PD-L1, cette étude rétrospective compare l'efficacité, du point de vue du taux de réponse objective, de la survie sans progression et de la survie globale, et la toxicité du nivolumab par rapport au pembrolizumab en traitement de deuxième ligne ou au-delà
Objective : Nivolumab and pembrolizumab have been the standard of care in patients with previouslytreated advanced non-small cell lung cancer (NSCLC). This study aimed to compare theefficacy and safety of nivolumab and pembrolizumab. Materials and Methods : We retrospectively reviewed data of advanced NSCLC patients with PD-L1 (Programmeddeath-ligand 1) [clone:22C3] positive tumors (Tumor proportion score [TPS] ≥ 1%) whohad been treated with nivolumab or pembrolizumab as second- or subsequent line from 2015 to 2021. Propensity score matching was performed to reduce potential selection bias. We analyzedthe clinical outcomes including objective response rate (ORR), progression-free survival(PFS), overall survival (OS), and immune-related adverse events (irAEs). Results : Among a total of 202 eligible patients, 72 pairs of patients from each group wereidentified after propensity score matching. There were no significant differencesin ORR, PFS, and OS between the two agents (nivolumab vs. pembrolizumab: ORR, 23.6%vs. 20.8%, median PFS, 3.7 months vs. 4.6 months, hazard ratio [HR] 1.02; 95% confidenceinterval [CI], 0.71 to 1.46; p = 0.92, and median OS, 27.4 months vs. 19.6 months, HR 0.78; 95% CI, 0.51 to 1.20; p = 0.24). Additionally, PFS was similar between the treatments in the PD-L1 TPS ≥50% subgroup (median PFS, 3.7 months vs. 4.6 months, HR 0.94; 95% CI, 0.56 to 1.59; p = 0.82) and PD-L1 TPS 1-49% subgroup (median PFS, 3.7 months vs.4.6 months, HR 1.13;95% CI, 0.69 to 1.85; p = 0.61). There was also no significant difference in the frequency of grade ≥ 3 irAEs(9.7% vs. 11.1%; p = 1.0). Conclusion : There is no significant difference in the efficacy and safety between nivolumab andpembrolizumab in advanced NSCLC patients with PD-L1-positive tumors in the subsequentline setting.