Nivolumab/ipilimumab-based regimens lift 5-year survival in PD-L1–negative Japanese mNSCLC

Nivolumab (PD-1 inhibitor) plus ipilimumab (CTLA-4 inhibitor), given first-line with or without 2 cycles of chemotherapy (CheckMate 227/9LA pooled), was analyzed in Japanese patients with metastatic NSCLC, PD-L1 <1%, and no sensitizing EGFR/ALK alterations. In the pooled immunotherapy arm (n=34) vs chemotherapy (≤4 cycles; n=41), median OS was 41.0 vs 15.2 months (HR 0.46; 95% CI 0.27–0.78) with 5-year OS 38% vs 16%; median PFS was 8.2 vs 5.6 months (HR 0.57; 95% CI 0.31–1.03). Safety was reported as consistent with prior experience with no new safety signals—important context because dual-checkpoint regimens generally carry higher immune-related toxicity than chemo-only comparators in this setting.