The effectiveness of treatment after cessation of
nivolumab in patients with advanced
non-small cell lung cancer (NSCLC) has not been well investigated. The aim of the present study was to clarify the clinical benefit of post-
nivolumab treatment in such patients.
MATERIALS AND METHODS: Among 64 patients treated with
nivolumab, 26 patients received treatment after cessation of
nivolumab due to
disease progression (n = 21) or adverse events (n = 5). The median age of the patients was 68 years and 19 patients were male. Nineteen patients had performance status (PS) 1 or less at initiation of post-
nivolumab treatment. Four, 20, and 2 patients were treated with
platinum doublets, a single agent, and molecular targeting agents, respectively. Response rate, disease control rate, and median progression-free survival of first-line post-
nivolumab treatment were 34.6% (9 patients), 73.1% (19 patients), and 2.8 months (95% confidence interval [CI]: 1.7-5.2), respectively. Adverse events (≥ grade 3) and
treatment cessation were observed in 57.7% (15 patients) and 19.2% (5 patients), respectively. There were no statistically significant differences for the majority of patient characteristics between the groups with (n = 26) and without post-
nivolumab treatment. However, PS at cessation of
nivolumab and post-progression survival (PPS) after cessation of
nivolumab (median PPS: 12.6 vs. 1.4 months, 95% CI: 3.8-14.7 vs. 0.4-2.2) were significantly different between the groups. A multivariate Cox regression analysis showed significant correlation of PS at cessation of
nivolumab (hazard ratio [HR]: 0.34, 95% CI: 0.13-0.87) and post-
nivolumab treatment (HR: 0.19, 95% CI: 0.08-0.43) with prolonged PPS after
nivolumab.
CONCLUSION: