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A Spanish trial of 86 patients with stage III lung cancer. Adding immunotherapy before surgery left 37 percent with no viable tumour in the specimen against 7 percent, and 85 percent were alive at two years against 64.
The NADIM II investigators, reported by Provencio, Nadal, Gonzalez-Larriba and colleagues, randomised 86 patients with resectable stage IIIA or IIIB non-small-cell lung cancer to neoadjuvant nivolumab with platinum chemotherapy or chemotherapy alone, followed by surgery, with six months of adjuvant nivolumab after an R0 resection in the experimental group. The primary endpoint was pathological complete response.
It is a small investigator-initiated phase 2 trial with an effect size the large industry trials have not matched, and it is the trial that made pathological complete response credible as a surrogate. It also showed something the larger trials mostly do not report: more patients in the immunotherapy arm actually reached the operating theatre.
The strongest signal that neoadjuvant immunotherapy makes stage III lung cancer operable as well as more often curable. Twenty-four percentage points more patients reaching surgery is a result that only a neoadjuvant design can produce.
Shares Perioperative Pembrolizumab for Early-Stage Non-Small-Cell Lung Cancer, Perioperative durvalumab for resectable non-small-cell lung cancer, CheckMate 816: three cycles of nivolumab plus chemotherapy before lung cancer surgery, Immune checkpoint and the tag lung-evidence.
Shares Lung cancer roadmap: from Doll and Hill and the naming of tobacco, through the cytotoxic plateau, computed tomography screening, EGFR and ALK, immunotherapy by PD-L1, the perioperative trials and PACIFIC, to DLL3 in small-cell disease and a 2032 registry watch, Trial design, endpoints and cost, Paclitaxel / nab-paclitaxel, New England Journal of Medicine and the tag lung-evidence.
Shares Immune checkpoint, Lung cancer roadmap: from Doll and Hill and the naming of tobacco, through the cytotoxic plateau, computed tomography screening, EGFR and ALK, immunotherapy by PD-L1, the perioperative trials and PACIFIC, to DLL3 in small-cell disease and a 2032 registry watch, No one can predict who responds to immunotherapy, PD-1 and the tag lung-evidence.
Shares Lung cancer roadmap: from Doll and Hill and the naming of tobacco, through the cytotoxic plateau, computed tomography screening, EGFR and ALK, immunotherapy by PD-L1, the perioperative trials and PACIFIC, to DLL3 in small-cell disease and a 2032 registry watch, Neoadjuvant / adjuvant / perioperative, Resectable stage I to III non-small-cell lung cancer, New England Journal of Medicine and the tag lung-evidence.
Shares Immune checkpoint, Lung cancer roadmap: from Doll and Hill and the naming of tobacco, through the cytotoxic plateau, computed tomography screening, EGFR and ALK, immunotherapy by PD-L1, the perioperative trials and PACIFIC, to DLL3 in small-cell disease and a 2032 registry watch, No one can predict who responds to immunotherapy, Surgery and radiotherapy cure most, get least and the tag lung-evidence.
Shares Lung cancer roadmap: from Doll and Hill and the naming of tobacco, through the cytotoxic plateau, computed tomography screening, EGFR and ALK, immunotherapy by PD-L1, the perioperative trials and PACIFIC, to DLL3 in small-cell disease and a 2032 registry watch, Neoadjuvant / adjuvant / perioperative, Resectable stage I to III non-small-cell lung cancer, Trial design, endpoints and cost and the tag lung-evidence.
Shares Lung cancer roadmap: from Doll and Hill and the naming of tobacco, through the cytotoxic plateau, computed tomography screening, EGFR and ALK, immunotherapy by PD-L1, the perioperative trials and PACIFIC, to DLL3 in small-cell disease and a 2032 registry watch, Neoadjuvant / adjuvant / perioperative, Trial design, endpoints and cost, Cisplatin and the tag lung-evidence.
Shares Immune checkpoint, Lung cancer roadmap: from Doll and Hill and the naming of tobacco, through the cytotoxic plateau, computed tomography screening, EGFR and ALK, immunotherapy by PD-L1, the perioperative trials and PACIFIC, to DLL3 in small-cell disease and a 2032 registry watch, No one can predict who responds to immunotherapy, PD-1 and the tag lung-evidence.