Nivolumab, a PD-1 immune-checkpoint inhibitor, has shown overall survival benefit when compared to docetaxel in previously treated advanced squamous-cell and non-squamous cell NSCLC1,2.
A retrospective, descriptive analysis was carried out on 21 patients who received Nivolumab on compassionate access program at CMN from July 2015 to April 2016 .
The median age of patients was 62 years (range 28-80), 12 patients were female (57%) and 9 (42%) were male. 17 (81%) had been diagnosed with adenocarcinoma and 4 (19%) with squamous cell carcinoma. 4 patients had brain metastases.19 patients (90%) had previously been treated with carboplatin and gemcitabine. 11 patients (52%) had previously received pemetrexed. 2 patients had prior treatment with tyrosine kinase inhibitors. 9 received nivolumab as 2nd line therapy, 7 patients received as third line and 5 patients as fourth line. 2 (10%) patients had a partial response and 10 (48%) stable disease with DCR of 57%. 9 (42%) had disease progression on first assessment. Pseudo-progression was seen in 4 patients (19%). Treatment is ongoing in 9 patients (42%) (duration of therapy ranging from 5 to13 months). Treatment was discontinued in 11 patients (52%) due to disease progression.
Toxicities, of any grade, were reported in 12 patients (57%). Development of rash was the most frequent toxicity experienced (5 patients; 24%). Grade 3 pruritus, pneumonitis, rash and fatigue were experienced. One patient required a psychiatric admission in the absence of previous history of psychiatric illness. No patients discontinued treatment due to toxicity.