Resumen de Nivolumab for locally advanced or metastatic non-small cell lung cancer after prior chemotherapy in adults
María Isabel Castañeda Macías, Macarena Gajardo Álvarez, Inmaculada Martínez-Brocal
Nivolumab is a new monoclonal antibody licensed by EMA for treatment of locally advanced or metastatic non-small cell lung cancer (NSCLC) after prior chemotherapy in adults, which binds to the programmed death-1 (PD-1) receptor and blocks its interaction with PD-L1 and PD-L2. Nivolumab PD-L1 inhibition allows T cell activation, restoring this way their ability to detect and attack tumor cells in an effectively way. The pivotal phase III trial (CheckMate 017) showed its effectiveness in the treatment of patients with squamous cell carcinoma, after prior treatment, versus standard chemotherapy with docetaxel. According to the results of this study, nivolumab reaches an OS of 9.2 months vs 6 months, with a difference of median OS of 3.2 months, HR 0.59 (95% CI, 0.44-0.79) and p <0.001. Also, treatment-related adverse events, both hematological and non-hematological, occur less frequently in nivolumab group than in docetaxel group. With nivolumab, as with all therapeutic proteins, there is a potential risk for immunogenicity, presenting related adverse reactions which should be strictly monitored, such as: hypothyroidism, diarrhea, hepatitis, pneumonitis, nephritis, rash and hypersensitivity reactions or infusion reactions. With all these data, nivolumab has shown its superiority versus docetaxel for the treatment of Squamous cell lung carcinoma after a prior line of chemotherapy with a different but manageable adverse effects profile
