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Nivolumab plus Ipilimumab in Lung Cancer with a High Tumor Mutational Burden

Summary of work

Parker Institute’s Matthew Hellmann, MD, and colleagues at Memorial Sloan Kettering Cancer Center found that the odds of progression-free survival among advanced non-small cell lung cancer (NSCLC) patients with a high tumor mutational burden (TMB) was nearly three times higher when patients were treated with nivolumab and ipilimumab compared to chemotherapy-only (43% vs. 13% after one year, respectively). This work built off previous research that indicated TMB could predict response to this particular combination of immunotherapies, and it was the first phase III clinical trial to evaluate TMB as a predictive biomarker.

Why this is impactful to patients

“This study is a win for patients with metastatic lung cancer,” says Theresa LaVallee, PhD, vice president of translational medicine and regulatory affairs for the Parker Institute. Non-small cell lung cancer is the most common form of lung cancer and the leading cause of cancer deaths globally. For patients without a targetable mutation, the standard of care is chemotherapy, which is not only toxic but does not have a long-lasting effect. This study demonstrates that combining immunotherapies nivolumab and ipilimumab can be an effective and possibly durable first-line treatment option for patients; and tumor mutation burden can be a predictive biomarker to identify patients who would benefit from combination immunotherapy. “These are significant advances that can have an immediate impact on how we treat lung cancer moving forward,” says LaVallee.