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Neoadjuvant nivolumab plus chemotherapy in resectable lung cancer

One-paragraph summary

CheckMate 816 randomized resectable stage IB–IIIA NSCLC to three cycles of nivolumab plus platinum-doublet chemotherapy or chemotherapy alone before surgery. Median EFS was 31.6 versus 20.8 months (HR 0.63, 97.38% CI 0.43–0.91), and pathologic complete response was 24.0% versus 2.2%; surgery occurred in 83.2% versus 75.4% (PMID 35403841).

Key findings

  • EFS HR: 0.63.
  • Median EFS: 31.6 versus 20.8 months.
  • pCR: 24.0% versus 2.2%.
  • Surgery completion: 83.2% versus 75.4%.
  • Grade 3–4 treatment-related adverse events: 33.5% versus 36.9%.
  • The regimen did not mandate postoperative checkpoint maintenance.

Limitations

  • Mixed NSCLC histology; adenocarcinoma-specific interaction is limited.
  • EGFR/ALK biology requires separate treatment reasoning.
  • pCR is prognostic but not a validated individual treatment-switch rule.
  • The trial does not compare neoadjuvant-only with perioperative checkpoint therapy.

Why it matters

CheckMate 816 established that preoperative chemo-immunotherapy can improve pathologic response and event-free survival without reducing surgery completion, creating the comparator for later perioperative programs.

Cited by wiki pages

  • Overview
  • Early-stage and perioperative therapy
  • Guidelines
  • Clinical trials landscape