Trial reportJournal for immunotherapy of cancer2024
Four-year clinical update and treatment switching-adjusted outcomes with first-line nivolumab plus ipilimumab with chemotherapy for metastatic non-small cell lung cancer in the CheckMate 9LA randomized trial.
Trial report in Journal for immunotherapy of cancer, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 38 papers, 5 of them syntheses that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
38 citing papers in PubMed, 5 syntheses or guidelines pooled it, 57 citations in OpenAlex.
- Chemotherapy backbone and outcomes of immune checkpoint inhibitor combinations across solid tumors: a pan-tumor network meta-analysis.The oncologist · 2026Pooled it
- Advancements in Immunotherapy for Lung Cancer: A Meta-Analysis of Clinical Trial Outcomes.The clinical respiratory journal · 2026Pooled it
- Efficacy and safety of immunotherapy in driver mutation-negative advanced non-small cell lung cancer: A systematic review and meta-analysis.The Indian journal of medical research · 2026Pooled it
- Pooled it
- Incidence of pneumonitis with CTLA-4 inhibitors in non-small cell lung cancer: a systematic review and meta-analysis.Frontiers in medicine · 2025Pooled it
- Neoadjuvant Nivolumab Plus Ipilimumab Versus Chemotherapy in Resectable Lung Cancer.Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2025Trial
- PD-L1 score among non-small cell lung cancer patients: are we holding out for a hero?Journal of thoracic disease · 2026Article
- Review
- Circulating low-density neutrophils as biomarkers of resistance to first-line anti-PD-1/PD-L1 immunotherapy in non-small cell lung cancer.Translational oncology · 2026Article
- Comprehensive characterization of non-small cell lung cancer of different PD-L1 expression classes: a study of 1,038 Chinese patients.Journal of thoracic disease · 2026Article
- Effectiveness and safety of combination immunotherapy with or without ipilimumab according to PD-L1 expression in patients with non-small cell lung cancer: a multi-center retrospective cohort study.Translational lung cancer research · 2026Article
- Enhanced antitumor efficacy of combined targeting of adenosine ACancer immunology, immunotherapy : CII · 2026Article
- Comparison of real-world efficacy and safety of nivolumab plus ipilimumab or pembrolizumab combined with platinum-based chemotherapy as first-line treatment for advanced non-small cell lung cancer in a German population.Cancer immunology, immunotherapy : CII · 2026Article
- Immune checkpoint blockade in cancer: current insights and future horizons.Discover oncology · 2026Review
- Cadonilimab (PD-1/CTLA-4 bispecific antibody) combination therapy for driver gene-negative advanced NSCLC: a single-center retrospective real-world study.Frontiers in oncology · 2026Article
- Observational
- Comparative effectiveness and safety of systemic therapies for treatment-naïve, PD-L1 expression <1% advanced NSCLC: a systematic review and network meta-analysis.Translational lung cancer research · 2025Article
- Review
- Unraveling the molecular-pathological characteristics and cellular complexity of the tumor immune microenvironment in metastatic non-small cell lung cancer.Cell communication and signaling : CCS · 2025Review
- Microbiota-centered interventions to boost immune checkpoint blockade therapies.The Journal of experimental medicine · 2025Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
26 authors at 19 institutions in 10 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIn CheckMate 9LA, nivolumab plus ipilimumab with chemotherapy prolonged overall survival (OS) versus chemotherapy regardless of tumor PD-L1 expression or histology. We report updated efficacy and safety in all randomized patients with a minimum 4-year follow-up and an exploratory treatment-switching adjustment analysis in all treated patients who received chemotherapy and subsequent immunotherapy.
methodsAdults with stage IV/recurrent non-small cell lung cancer (NSCLC), no sensitizing
resultsWith a 47.9-month minimum follow-up for OS, nivolumab plus ipilimumab with chemotherapy continued to prolong OS over chemotherapy in all randomized patients (HR 0.74, 95% CI 0.63 to 0.87; 4-year OS rate: 21% versus 16%), regardless of tumor PD-L1 expression (HR (95% CI): PD-L1<1%, 0.66 (0.50 to 0.86) and ≥1%, 0.74 (0.60 to 0.92)) or histology (squamous, 0.64 (0.48 to 0.84) and non-squamous, 0.80 (0.66 to 0.97)). In patients who discontinued all components of nivolumab plus ipilimumab with chemotherapy due to TRAEs (n=61), the 4-year OS rate was 41%. With treatment-switching adjustment for the 36% of patients receiving subsequent immunotherapy in the chemotherapy arm, the estimated HR of nivolumab plus ipilimumab with chemotherapy versus chemotherapy was 0.66 (95% CI 0.55 to 0.80). No new safety signals were observed.
conclusionsIn this 4-year update, patients treated with nivolumab plus ipilimumab with chemotherapy continued to have long-term, durable efficacy benefit over chemotherapy regardless of tumor PD-L1 expression and/or histology. A greater estimated relative OS benefit was observed after adjustment for subsequent immunotherapy use in the chemotherapy arm. These results further support nivolumab plus ipilimumab with chemotherapy as a first-line treatment for patients with metastatic/recurrent NSCLC, including those with tumor PD-L1<1% or squamous histology, populations with high unmet needs.
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