Table 2. PFS and OS data from clinical trials evaluating combination chemotherapy-immune checkpoint inhibitor (ICI) and combination ICI-ICI in first line treatment of non-small cell lung cancer.
| Therapy | Trial | Trial size | Treatment regimen | ORR (%) | Median PFS (months) | HR (95% CI†) | Median OS (months) | HR (95% CI) |
|---|---|---|---|---|---|---|---|---|
| Combination Chemo-ICI | Keynote 407 (15) (squamous) | 559 | Platinum doublet vs. Platinum doublet + pembrolizumab | 57.9 vs. 38.4 | 6.4 vs. 4.8 | 0.56 (0.45–0.70) | 15.9 vs. 11.3 | 0.64 (0.49–0.85) |
| IMpower131 (16) (squamous) | 1,021 | A: carboplatin/paclitaxel/atezolizumab; B: carboplatin/nab paclitaxel/atezolizumab; C: carboplatin/nab paclitaxel |
Arm B vs.
C: 59.4 vs. 51.3 |
Arm B vs.
C: 6.3 vs. 5.6 |
Arm B vs.
C: 0.72 (0.60–0.85) |
Arm B vs. C: 14.6 vs. 14.3 | 0.92 (0.76–1.12) | |
| IMpower130 (17) (non-squamous) | 679 | Carboplatin/nab-paclitaxel +/− atezolizumab | 49.2 vs. 31.9 | 7.0 vs. 5.5 | 0.64 (0.54–0.77) | 18.6 vs. 13.9 | 0.79 (0.64–0.98) | |
| IMpower132 (18) (non-squamous) | 578 | Atezolizumab + Platinum doublet vs. Platinum doublet | 46.9 vs. 32.3 | 7.6 vs. 5.2 | 0.60 (0.49–0.72) | 18.1 vs. 13.6 | 0.81 (0.64–1.03) | |
| IMpower150 (19) (non-squamous) | 1,202 | ACP: atezolizumab/carboplatin/paclitaxel; BCP: bevacizumab/carboplatin/paclitaxel; ABCP: atezolizumab/ bevacizumab/carboplatin/ paclitaxel |
ABCP vs. BCP: 63.5 vs. 48.0 | ABCP vs. BCP: 8.3 vs. 6.8 | 0.62 (0.52–0.74) | ABCP vs. BCP: 19.2 vs. 14.7 | 0.78 (0.64–0.96) | |
| Keynote 189 (20) (non-squamous) | 616 | Platinum doublet vs. Platinum doublet + pembrolizumab | 47.6 vs. 18.9 | 8.8 vs. 4.9 | 0.52 (0.43–0.64) | NR vs. 11.3 | 0.49 (0.38–0.64) | |
| KEYNOTE 021 (21) (non-squamous) | 123 | Carboplatin + pemetrexed +/− pembrolizumab | 56.7 vs. 30.2 | 24.0 vs. 9.3 | 0.53 (0.33–0.86) | NR vs. 21.1 | 0.56 (0.32–0.95) | |
| Dual ICI | Checkmate 227 (22) | 1,739 | Nivolumab + Ipilimumab vs. Platinum doublet (TMB ≥10 per MB) | 45.3 vs. 26.9 | 7.2 vs. 5.5 | 0.58 (97.5%, 0.41–0.81) | – | – |
| MYSTIC (12) | 488 | Durvalumab + Tremelimumab vs. Platinum doublet (PD-L1 ≥25%) | 34.4 vs. 37.7 | 3.9 vs. 5.4 | 1.05 (99.5%, 0.72–1.53) | 11.9 vs. 12.9 | 0.85 (98.8% 0.61–1.17) |
†, confidence interval specified when not 95%. ORR, objective response rate; HR, hazard ratio; PFS, progression free survival; OS, overall survival; CI, confidence interval; TMB, tumour mutational burden; MB, megabase; NR, not reached.