免疫療法と化学療法の併用で肺がん生存率が向上(Immunotherapy plus chemotherapy boosts lung cancer survival rate)

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2025-06-03 ジョンズ・ホプキンス大学(JHU)

ジョンズ・ホプキンズ大学の研究で、手術可能な非小細胞肺がん患者に対し、手術前に免疫療法薬ニボルマブと化学療法を併用することで、5年生存率が大幅に向上することが示されました。第3相試験では、24%が完全寛解を達成し、その95%が5年後も生存。術後の追加治療なしで高い効果を示し、治療の新たな選択肢として期待されます。この成果は『NEJM』誌に掲載され、ASCO年次総会でも発表されました。

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肺癌におけるネオアジュバント・ニボルマブ+化学療法による全生存期間 Overall Survival with Neoadjuvant Nivolumab plus Chemotherapy in Lung Cancer

Patrick M. Forde, M.B., B.Ch., Ph.D., Jonathan D. Spicer, M.D., Ph.D., Mariano Provencio, M.D., Ph.D., Tetsuya Mitsudomi, M.D., Ph.D., Mark M. Awad, M.D., Ph.D., Changli Wang, M.D., Shun Lu, M.D., Ph.D., +20 , for the CheckMate 816 Investigators
The New England Journal of Medicine  Published: June 2, 2025

Abstract

Background

Neoadjuvant nivolumab plus chemotherapy significantly improved pathological complete response and event-free survival in patients with resectable non–small-cell lung cancer (NSCLC) in a phase 3 trial. Data are needed on overall survival.

Methods

In this open-label, phase 3 trial, patients with stage IB to IIIA resectable NSCLC were randomly assigned to receive nivolumab plus chemotherapy or chemotherapy alone for three cycles, followed by surgery. The primary end points were event-free survival and pathological complete response. Here, we report the results of the planned analysis of overall survival.

Results

A total of 358 patients were concurrently assigned to receive nivolumab plus chemotherapy (179 patients) or chemotherapy alone (179 patients). The final analysis of overall survival significantly favored neoadjuvant nivolumab plus chemotherapy over chemotherapy (hazard ratio for death, 0.72; 95% confidence interval [CI], 0.523 to 0.998; P=0.048). At a median follow-up of 68.4 months, the 5-year overall survival was 65.4% with nivolumab plus chemotherapy and 55.0% with chemotherapy alone, with consistency across most subgroups. In exploratory analyses, the 5-year overall survival in the nivolumab-plus-chemotherapy group was 95.3% (95% CI, 82.7 to 98.8) among the patients with a pathological complete response and 55.7% (95% CI, 46.9 to 63.7) among those without such a response; survival was 75.0% among the patients with presurgery clearance of circulating tumor DNA (ctDNA) and 52.6% among those without such clearance. No new safety signals were observed.

Conclusions

Three cycles of neoadjuvant nivolumab plus chemotherapy significantly improved overall survival among patients with resectable NSCLC as compared with chemotherapy alone. (Funded by Bristol Myers Squibb; CheckMate 816 ClinicalTrials.gov number, NCT02998528.)

医療・健康
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