# First-line nivolumab plus ipilimumab in metastatic non-small cell lung cancer: 5-year outcomes in Japanese patients from CheckMate 227 Part 1

Source: https://onco.cc/key-papers/paper-checkmate-227-int-j-clin-oncol-2023-update/  
OnCo record `paper-checkmate-227-int-j-clin-oncol-2023-update` (Key paper). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Later report from the CheckMate 227 trial registered as NCT02477826, in International journal of clinical oncology (2023); its title describes an updated or longer-term analysis.

## Summary

Background: In CheckMate 227 Part 1 (NCT02477826), first-line nivolumab plus ipilimumab demonstrated long-term durable overall survival (OS) benefit versus chemotherapy in patients with metastatic non-small cell lung cancer (NSCLC), regardless of tumor programmed death ligand 1 (PD-L1) expression. We report results in Japanese patients with ≥ 5-year follow-up.

Methods: Adults with stage IV/recurrent NSCLC without EGFR/ALK aberrations were randomized 1:1:1 to nivolumab plus ipilimumab, nivolumab alone, or chemotherapy (patients with tumor PD-L1 ≥ 1%), or nivolumab plus ipilimumab, nivolumab plus chemotherapy, or chemotherapy (patients with tumor PD-L1 < 1%). Five-year efficacy and safety were assessed in Japanese patients.

Results: At 62.1 months' minimum follow-up, 143 Japanese patients with PD-L1 ≥ 1% or < 1% were randomized to nivolumab plus ipilimumab (n = 66) or chemotherapy (n = 77). Five-year OS rates were 46% with nivolumab plus ipilimumab versus 34% with chemotherapy (PD-L1 ≥ 1%) and 36% versus 19% (PD-L1 < 1%). Median duration of response was 59.1 versus 7.1 months (PD-L1 ≥ 1%) and 17.3 versus 3.0 months (PD-L1 < 1%). Among 5-year survivors treated with nivolumab plus ipilimumab (PD-L1 ≥ 1% and < 1%; n = 27), 59% (95% CI, 39%-75%) were off treatment for ≥ 3 years without receiving subsequent therapy. No new safety signals were observed.

Conclusions: At 5-year follow-up, nivolumab plus ipilimumab continued to show long-term durable clinical benefit versus chemotherapy, regardless of tumor PD-L1 expression. Consistent with findings for the global population, these data support the use of nivolumab plus ipilimumab as first-line treatment in Japanese patients with metastatic NSCLC.

Indexed on Europe PMC as PubMed record 37548831 (DOI 10.1007/s10147-023-02390-2). Its abstract cites the registry id NCT02477826, which is how it was matched to this trial; no figure has been checked by an editor.

## Fields

- Kind: Key paper
- Last checked: 2026-09-22
- Tags: europepmc-ingest
- Journal: International journal of clinical oncology
- Year: 2023
- DOI: 10.1007/s10147-023-02390-2
- Authors: Nishio M, Ohe Y, Ikeda S, et al.
- What it means: A second publication from the CheckMate 227 trial, later than the first and described in its title as an update or longer-term analysis. Read it with the primary publication linked from the trial page; the record was linked automatically and its figures have not been checked by hand.
- Caveats: Matched to the trial by the registry id cited in the Europe PMC record; the summary reproduces the record's abstract and no figure has been verified against the full paper.; Chosen as a later report by words in its title (updated, long-term, final, overall survival or a year count), not by reading the paper.

## Sources

- Int J Clin Oncol 2023: https://doi.org/10.1007/s10147-023-02390-2
- PubMed: https://pubmed.ncbi.nlm.nih.gov/37548831/
- Europe PMC: https://europepmc.org/article/MED/37548831
- ClinicalTrials.gov NCT02477826: https://clinicaltrials.gov/study/NCT02477826

## Connected records

- trials: [CheckMate 227](https://onco.cc/trials/checkmate-227/)
- journals: [International journal of clinical oncology](https://onco.cc/journals/international-journal-of-clinical-oncology/)

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