Low-dose nivolumab can be effective in non-small cell lung cancer: alternative option for financial toxicity.

Abstract

OBJECTIVES:

Nivolumab is used at 3 mg/kg or fixed doses of 240 mg every 2 weeks. There was no dose-response/toxicity relationship of nivolumab. This study evaluated the efficacy of low-dose nivolumab as an alternative to the financial toxicity of standard-dose nivolumab in treatment of non-small cell lung cancer (NSCLC).

METHODS:

Outcomes of patients with NSCLC treated with nivolumab as a routine practice at two tertiary hospitals in Korea were retrospectively analysed. Patients who could not afford standard nivolumab treatment received low-dose nivolumab (20 or 100 mg fixed dose every 3 weeks). Others received standard dose of 3 mg/kg every 2 weeks. Progression-free survival (PFS) and overall survival (OS) were measured and compared between low-dose and standard-dose groups in overall and stratified analyses according to programmed death-ligand 1 (PD-L1) status.

RESULTS:

Among the 47 patients with NSCLC, 18 received low-dose nivolumab. PD-L1 positivity was observed in 13 (27.7%) patients and did not differ between the groups. During 5.2 months of follow-up, the objective response rate was 13.8% in the standard-dose group and 16.7% in the low-dose group (p=0.788). Dosing of nivolumab or PD-L1 expression did not significantly affect PFS or OS.

CONCLUSION:

Low-dose nivolumab can be effective in NSCLC and is worth considering as an alternative option to reducing financial toxicity. The efficacy of low-dose nivolumab requires study.

• Authors: Shin Hye Yoo, Bhumsuk Keam, Miso Kim, Se Hyun Kim, Yu Jung Kim, Tae Min Kim, Dong-Wan Kim, Jong Seok Lee, Dae Seog Heo
• Journal: ESMO open (ESMO Open) Vol. 3 Issue 5 Pg. e000332 ( 2018) ISSN: 2059-7029 [Print] England
• PMID: 30094065 (Publication Type: Journal Article)