Retrospective cohort study of nivolumab-ipilimumab-chemotherapy versus pembrolizumab-chemotherapy for aNSCLC

Nivolumab plus ipilimumab with chemotherapy (NICT) and pembrolizumab with chemotherapy (PCT) are both widely used first-line regimens for advanced non-small cell lung cancer (aNSCLC) lacking actionable driver mutations. A retrospective cohort study at 13 centers in Japan compared both regimens. The median duration of follow-up exceeded 40 months. Among 161 patients with PD-L1 tumor proportion score (TPS) < 1% (NICT n=43; PCT n=118), NICT achieved significantly longer overall survival (OS) than PCT (median 47.4 versus 16.6 months; aHR 0.50; p=0.007). In contrast, among patients with PD-L1 TPS ≥ 1% (NICT n=45; PCT n=251), no significant OS differences were observed between regimens. Grade ≥ 3 TRAEs, treatment discontinuation, and treatment-related deaths were comparable between regimens. The authors conclude NICT may be a therapeutic first-line option for the treatment of PD-L1 negative aNSCLC.