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Top Line: Unless you’ve been living under a rock, you know that immunotherapy targeting the PD-1 axis is all the rage, especially for melanoma, renal cell carcinoma (RCC), and non-small cell lung cancer (NSCLC).
The Study: Unfortunately, immunotherapy isn’t a silver bullet since only some patients experience meaningful responses. Thus, researchers are searching for predictive and prognostic factors. This secondary analysis of 270 patients from CA209-003 attempts to add to our knowledge regarding which patients benefit the most from immunotherapy by identifying factors associated with 5-year survival among patients with advanced melanoma, RCC, or NSCLC receiving nivolumab. Patients received nivolumab (0.1-10.0 mg/kg) every 2 weeks in 8-week cycles for up to 96 weeks, unless they developed progressive disease, achieved a complete response, experienced unacceptable toxic effects, or withdrew consent. Factors associated with improved 5-year overall survival on multivariate analysis included ECOG 0 vs. ≥1, experiencing a treatment-related adverse event, objective response, and degree of tumor burden reduction. Overall survival at 5 years was negatively impacted by the presence of bone or liver metastases.
TBL: Knowing which clinical factors are associated with long term survivors with advanced melanoma, RCC, and NSCLC treated with immunotherapy may better inform patient selection and future clinical trial design. | Topalian, JAMA Oncol 2019