Investigation of real-life data on nivolumab treatment after first-line chemotherapy in local advanced/metastatic non-small cell lung cancer

Lung cancer, with a total of 2,4 million new cases and 1,8 million deaths, is the most common type of cancer. Immunotherapy is an important treatment option for patients in advanced stages. Our study aims to examine the effectiveness and side effects of nivolumab treatment after first-line therapy in patients with locally advanced/metastatic NSCLC and to access real-life data. In our study, 145 patients who applied to the Eskişehir Osmangazi University Faculty of Medicine Medical Oncology outpatient clinic between January 2019 and July 2023 and who received nivolumab treatment after first-line therapy for locally advanced/metastatic NSCLC were retrospectively screened. The average age of the patients included in the study was 64. Within the scope of the study, no significant relationship was found between age, smoking history, histological subtype, histological grade, PD-L1 percentage, LVI, NI, LN metastasis, brain metastasis status, the chemotherapy regimen received in the first-line, and the chemotherapy regimen received in the third-line with OS and PS. The OS was found to be 12.628±0.791 months and the PS was 5.430±0.564 months. Hematological side effects were observed in 32 (22.1%) patients and non-hematological side effects in 45 (37.9%) patients. In our study, in univariate analysis, male gender, ECOG performance score of 0-1, absence of EGFR, ALK and ROS-1 mutations, receiving ≥6 cycles of first-line chemotherapy, partial and stable response to nivolumab, a higher number of nivolumab cycles, and an increase in the number of third-line chemotherapy cycles were found to be associated with longer OS. In univariate analysis, ECOG performance score of 0-1 and a higher number of nivolumab cycles were associated with longer PS. In our study, in multivariate analysis, a significant relationship was found between gender, ECOG performance score, the number of nivolumab cycles, and OS. In multivariate analysis, a significant relationship was found between stage, EGFR mutation, the number of nivolumab cycles, and PS. Key Words: lung cancer, nivolumab