Since the 1940s, chemotherapy has been a primary treatment option for cancer. The late 20th century brought a new type of cancer treatment, immunotherapies. These immunotherapies enhance or suppress certain aspects of the immune system to assist in the termination of cancer.
Since then, there have been several immunotherapy drugs and immunotherapy technologies developed every year. Two such drugs are nivolumab and pembrolizumab. Both are FDA approved for the treatment of non-small cell carcinomas (among others) and block PD-1 (programmed cell death) mediated silencing of the immune response against cancer. This interaction allows the immune system to recognize cancer cells and target them for destruction.
A team from the Chinese PLA General Hospital in China noticed a gap in the data comparing the two first-line treatments for non-small cell carcinomas. Some clinical trials suggest one is better than the other, but the current standard of care is to treat patients with either nivolumab or pembrolizumab. The team decided to investigate the overall response rate and progression-free survival of non-small cell carcinoma patients at their hospital and identify if one is more effective than the other.
Analyses of patient treatment data for cancer tend to be complex, as many go through second rounds of treatment, so comparisons like this one tend to be challenging. However, pembrolizumab had a slight but clear advantage in overall response rate, while nivolumab had a slight edge in progression-free survival as second-line therapy. Neither showed a clear strength over the other in most cases, however.
These results validate that the current standard treatment of choosing either nivolumab or pembrolizumab, as neither was significantly better in most areas. Many new nivolumab trials focus on its effectiveness as a combination therapy, which may point to it having a strong supportive role. Both drugs target the same molecule, so it stands to reason that they would both elicit similar effects as a stand-alone therapy.
The study concludes, “According to our comparisons, pembrolizumab and nivolumab demonstrated similar survival benefits in patients with recurrent or advanced NSCLC in various clinical settings. Therefore, our study may support the current clinical practice of choosing either drug based on patient and clinician preferences.”
Sources: Nature Scientific Reports, Memorial Sloan Kettering