Efficacy and safety of Nivolumab in non‑small cell lung cancer patients in Tel‑Aviv tertiary medical center: Facing the reality
- Sivan Shamai
- Ofer Merimsky
Published online on: August 6, 2018
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Nivolumab is a human IgG4 programmed death (PD)‑1 immune checkpoint inhibitor antibody, which is approved in Israel for the treatment of patients with advanced non‑small cell lung cancer (NSCLC). It is also administered to individuals with disease progression during or after platinum‑based chemotherapy, without a need to determine the level of PD‑L1 expression in the tumor. The present study aimed to evaluate the survival and efficacy of Nivolumab treatment. A retrospective analysis was performed at a thoracic oncology service in a tertiary referral center (Tel‑Aviv Sourasky Medical Center), on patients with NSCLC (squamous and non‑squamous). All patients were treated with Nivolumab 3 mg/kg, administered intravenously every 2 weeks as part of a compassionate use program. The survival data was analyzed after 22 months. The overall survival (OS) was 34.9%, while the progression free survival (PFS) was 19.3%. The median PFS from the first dose of Nivolumab to treatment discontinuation was 4 months. A response assessment was performed in the 62 patients who received at least four cycles of Nivolumab, out of the 77 patient cohort. There was a complete response in 1 patient, a partial response in 11 patients, stable disease in 25 patients and progressive disease in 25 patients. The observed response rate of Nivolumab as a service treatment in unselected patients with unknown PD‑L1 status NSCLC was 19%. The disease control rate was 60%. In the present study Nivolumab was given to a cohort of patients representing those seen in daily clinical practice, as opposed to a clinical trial setting. Survival and efficacy results strongly support the continued use of Nivolumab as a treatment for NSCLC.