A phase III trial in resectable non-small cell lung cancer compared chemotherapy alone with chemotherapy plus nivolumab given before surgery. All participants underwent surgery after treatment. After five years, 65% of participants receiving nivolumab plus chemotherapy were still alive versus 55% receiving chemotherapy alone. Biomarker analyses showed that nearly all participants with complete tumour eradication before surgery survived at five years, while survival was much lower among those with detectable cancer cells. Circulating tumour DNA in blood also correlated with outcomes, with about three-quarters of participants without detectable ctDNA surviving versus about half with detectable ctDNA. These markers may help predict treatment response and prognosis.
"A phase III trial led by Patrick Forde at Trinity College Dublin begins to fill that gap. The team recruited 358 people with non-small cell lung cancer - the most common form of the disease - whose tumours were surgically removable. Each person was randomly assigned to receive chemotherapy alone or in combination with the immunotherapy nivolumab. After treatment, all patients underwent surgery. At the end of five years, 65% of participants who received nivolumab plus chemotherapy were still alive, compared with only 55% who received chemotherapy alone."
"The researchers also searched trial data for biomarkers that might predict outcomes. They found that almost every person whose tumour was completely wiped out before surgery was still alive at the five-year mark, compared with only 56% of those who still had detectable cancer cells. Forde's team also examined circulating tumour DNA (ctDNA) in the blood. Three-quarters of participants whose blood tests revealed no ctDNA before surgery survived the study period, compared with about half of those whose tests confirmed the presence of ctDNA."
Read at Nature
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