Nivolumab in combination with chemotherapy is in clinical development as a neoadjuvant treatment for early-stage (stage IB-IIIA) operable non-small cell lung cancer (NSCLC). NSCLC is the most common type of lung cancer. Early-stage lung cancer is typically treated with surgery consisting of removing either part of or the whole of the lung, followed by chemotherapy and/or radiotherapy (adjuvant). However, the long-term outlook for patients undergoing this treatment pathway is still poor. Treatment with medicines prior to surgery (neoadjuvant) may provide better long-term survival prospects for patients with early-stage operable NSCLC.
Nivolumab is a medicinal product called an immune checkpoint inhibitor. It is administered by intravenous infusion (injection into the vein) and works by improving the activity of white blood cells (T-cells) thereby increasing the ability of the immune system to kill cancer cells. Nivolumab as a monotherapy is already licensed for a range of advanced cancers where it has shown treatment benefits. If licensed in combination with chemotherapy, it may offer an additional neoadjuvant treatment option for patients with early-stage, operable NSCLC who currently have few well tolerated and effective therapies available.
Nivolumab in combination with ipilimumab is in clinical development for PD-L1 positive patients with previously untreated unresectable or metastatic urothelial cancer regardless of cisplatin eligibility. Urothelial cancer, a subset of bladder cancer, occurs on the lining of the renal pelvis, ureter, bladder and urethra, and other parts of the urinary system. In some cases,the tumour spreads into the surrounding muscles or other parts of the body which means that it cannot be cured by surgery. Metastatic urothelial cancer occurs when the cancer has spread to other parts of the body, such as the liver or bones. The symptom of urothelial cancer is blood in the urine, but symptoms may only appear once the cancer grows larger or into the deeper layers of the bladder wall for both men and women. Other symptoms may include increased frequency/urgency/pain of urine passing, weight loss, back/lower tummy/bone pain, fatigue and illness.