Comparative effectiveness of nivolumab versus standard of care for third-line patients with small-cell lung cancer

To estimate the comparative effectiveness of nivolumab versus standard of care (SOC) in terms of overall survival (OS) for small-cell lung cancer patients treated with two prior lines of chemotherapy, in other words, third line in the USA. Data were from CheckMate 032, a single-arm trial of nivolumab, and real-world electronic patient records. Comparisons of OS were conducted using three different methods to adjust for differences (regression, weighting and doubly robust) between the populations. Nivolumab was associated with longer survival compared with SOC (hazard ratio for OS: 0.58–0.70) across all methods for adjustment. Nivolumab was more efficacious in terms of OS as third-line treatment for small-cell lung cancer compared with current SOC in the USA. Small-cell lung cancer is an aggressive disease and often patients require multiple treatments to help them live longer. In this study, we looked at how long patients survived when receiving nivolumab compared with other commonly used therapies as their third treatment (known as third line) in the USA. Data came from the CheckMate 032 single-arm clinical trial of nivolumab and real-world electronic patient records from a US database where patients received standard of care treatment. We used several analysis methods and found that patients treated with nivolumab survived for longer than patients treated with standard of care in the USA. There is a high unmet need in the third-line small-cell lung cancer population and results from this study will help inform decision makers of the potential therapeutic option of nivolumab treatment.