Table 1.
Neoadjuvant trials with checkpoint inhibition.
Trial | Design | Intervention | Pathologic complete response | Grade 3–4 adverse events |
---|---|---|---|---|
Trials comparing adjuvant and neoadjuvant checkpoint inhibition | ||||
NCT02437279 Blank et al. 25 |
Phase Ib (n = 20) |
Arm A: Adjuvant ipi + nivo for 4 cycles Arm B: Neoadjuvant ipi + nivo for 2 cycles before surgery, and 2 after surgery |
Arm A: N/A Arm B: 30% |
Arm A: 90% Arm B: 90% |
Trials with only neoadjuvant arms | ||||
NCT02519322 Amaria et al. 26 |
Phase II (n = 23) |
Arm A: Neoadjuvant nivo up to 4 cycles, adjuvant nivo up to 13 cycles Arm B: Neoadjuvant ipi + nivo up to 3 cycles, adjuvant nivo up to 13 cycles |
Arm A: 25% Arm B: 45% |
Arm A: 8% Arm B: 73% |
NCT02434354 Huang et al. 47 |
Phase I (n = 29) |
200 mg of pembrolizumab, single cycle 3 weeks prior to surgery then pembrolizumab q3w for a year following surgery | 18.5% | - |
NCT02977052 Rozeman et al.48,49 |
Phase II (n = 86) |
Arm A: Neoadjuvant ipi (3mg/kg) + nivo (1 mg/kg) for 2 cycles Arm B: Neoadjuvant ipi (1 mg/kg) + nivo (3 mg/kg) for 2 cycles Arm C: Neoadjuvant ipi (3 mg/kg) for 2 cycles followed by neoadjuvant nivo (3 mg/kg) for 2 cycles |
Arm A: 47% Arm B: 57% Arm C: 23% |
Arm A: 40% Arm B: 20% Arm C: 50% |
NCT02977052 Blank et al. 36 |
Phase II (n = 99) | Neoadjuvant ipi + nivo for 6 weeks, target node resection, if pCR, no lymphadenectomy, if pPR, lymphadenectomy only, if no response, lymphadenectomy + adjuvant nivo for 52 weeks |
61% MPR | 24% |
Ipi, ipilimumab; MPR, major pathologic response, defined as < 10% viable tumor cells; nivo, nivolumab; pCR, pathologic complete response.