Multicenter phase 2 NADIM trial: five-year outcomes with perioperative chemotherapy plus nivolumab for non-small cell lung cancer

Perioperative immunotherapy improves short-term outcomes in resectable non-small cell lung cancer (NSCLC), but long-term benefit is not clear. In the phase 2 NADIM trial, at 18 centers in Spain, adult patients with resectable stage IIIA NSCLC and ECOG performance status 0 or 1 received neoadjuvant paclitaxel-carboplatin chemotherapy plus nivolumab, followed by surgery and adjuvant nivolumab. At five years, the progression-free survival rate was 65.0% (95% CI 49.4-76.9) and the overall survival rate was 69.3% (53.7-80.6). Among 14 patients who died during follow-up, 9 died from disease relapse and 5 from non-tumor-related causes. Treatment-related adverse events of grade 3 or worse occurred in 30% of patients during neoadjuvant treatment and 19% during adjuvant treatment. No treatment-related surgery delayse, deaths, or unexpected long-term toxicities were reported. The authors conclude that perioperative chemoimmunotherapy showed a promising long-term benefit with no concerning safety data among patients with resectable stage IIIA NSCLC.