Trial reportClinical cancer research : an official journal of the American Association for Cancer Research2025
LRP1b Loss Predicts Sensitivity to Immunotherapy in Patients with NSCLC: An Analysis of the Phase III CheckMate-026 Randomized Trial.
Trial report in Clinical cancer research : an official journal of the American Association for Cancer Research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02041533 (An Open-Label, Randomized, Phase 3 Trial of Nivolumab Versus Investigator's Choice Chemotherapy as First-Line Therapy for Stage IV or Recurrent PD-L1+ Non-Small Cell Lung Cancer), which is not on this map. Cited by 3 papers.
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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.
An Open-Label, Randomized, Phase 3 Trial of Nivolumab Versus Investigator's Choice Chemotherapy as First-Line Therapy for Stage IV or Recurrent PD-L1+ Non-Small Cell Lung Cancer
Who cites it
3 citing papers in PubMed.
- Precision oncology in advanced melanoma: molecular landscapes and personalized therapy recommendations from the Molecular Tumor Board Freiburg.NPJ precision oncology · 2026Article
- Efficacy and safety of immune checkpoint inhibitors in patients with high microsatellite instability/mismatch repair-deficient advanced cholangiocarcinoma: A propensity score-matched study.JHEP reports : innovation in hepatology · 2026Article
- Distinct mutation landscape with similar immune microenvironment in primary simultaneous operable squamous cell carcinoma and peripheral-type small-cell lung cancer.Translational lung cancer research · 2026Article
Corrections and comments
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Authors and funding
10 authors.
Funding
Abstract
purposeLow-density lipoprotein receptor-related protein 1b (LRP1b) is a cell surface receptor, commonly altered in many cancers and associated with improved responses, progression-free survival (PFS), and overall survival with immune checkpoint inhibition. EXPERIMENTAL
designLRP1b alterations were determined by whole-exome sequencing and associated with PFS and objective response rates in patients with non-small cell lung cancer (NSCLC) in a post hoc analysis of the randomized controlled phase III CheckMate-026 (CM026) trial (NCT02041533) examining chemotherapy compared with nivolumab, adjusting for tumor mutational burden (TMB) and clinical features. We separately evaluated a deidentified nationwide (US-based) NSCLC clinico-genomic database for associations of LRP1b alterations and PFS with anti-PD-1 immunotherapy.
resultsIn the clinico-genomic database cohort of patients with NSCLC (N = 18,369), LRP1b mutations were positively associated with TP53/KRAS alterations and inversely with EGFR/RET/MET/ERBB2 alterations and significantly improved PFS with PD-1 inhibition (n = 1,569; adjusted HR, 0.86; P = 0.014). In CheckMate-026, patients with LRP1b alterations had a statistically significant improvement in objective response rate to nivolumab versus LRP1b wild-type patients (OR 3.5; 95% confidence interval, 1.71-7.13; P = 0.0006) but not with chemotherapy (OR 0.63; 95% confidence interval, 0.32-1.26; P = 0.19), adjusting for TMB, age, gender, histology, smoking, and performance status. LRP1b mutations were associated with improved PFS with nivolumab (HR, 0.66; P = 0.04) but not chemotherapy (HR, 1.26; P = 0.25), also maintained in multivariate and TMB-adjusted analyses.
conclusionsLRP1b mutations are a candidate predictive biomarker for immune checkpoint inhibition versus chemotherapy in NSCLC. Further mechanistic characterization of LRP1b and prospective validation are warranted and might enable future clinical use.
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