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

INTRODUCTION: In advanced non-small cell lung cancer (NSCLC), nivolumab plus ipilimumab with platinum-based chemotherapy (NIC) and pembrolizumab with platinum-based chemotherapy (PC) are commonly used treatment options. We conducted a single-center retrospective analysis comparing the two options under real-world conditions in Germany. METHODS: We collected data from patients whose treatment was initiated between July 2018 and June 2023. Primary endpoints were overall survival and safety. Categorical data were compared using the chi-squared test or Fisher's exact test. Overall survival was compared using the Kaplan-Meier method and the log-rank test. RESULTS: 200 patients, 77 treated with NIC and 123 treated with PC, were included. Baseline characteristics were unbalanced with significantly more older, squamous, and PD-L1-negative cases in the NIC group. Median overall survival (OS) and time to treatment discontinuation (TTD) were not significantly different in the NIC and PC groups (13.6 vs. 14.1 months / 5.8 vs. 6.2 months). Clinically significant adverse events (AEsi), related treatment discontinuations, and treatment-related deaths also did not differ significantly (p = 0.885/p = 1.000/p = 0.709). There were more immune-related AEsi in the NIC group (p = 0.001) and more chemo-related AEsi in the PC group (p < 0.001). CONCLUSIONS: NIC and PC seem to be equally supportable options in the treatment of advanced NSCLC. Further analyses are needed to validate our findings.