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

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 cel...

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Detalles Bibliográficos
Autores principales: Yoo, Shin Hye, Keam, Bhumsuk, Kim, Miso, Kim, Se Hyun, Kim, Yu Jung, Kim, Tae Min, Kim, Dong-Wan, Lee, Jong Seok, Heo, Dae Seog
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6069908/
https://www.ncbi.nlm.nih.gov/pubmed/30094065
http://dx.doi.org/10.1136/esmoopen-2018-000332
Descripción
Sumario: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.