Akhil Santhosh: My 2 cents on why I will always prefer nivo-ipi over pembro
Akhil Santhosh, Medical Oncology Specialist at MVR Cancer Centre and Research Institute and Post DM senior resident at AIIMS, New Delhi, shared a post on X:
“The results of checkmate 8HW have been published in The New England Journal of Medicine. My 2 cents on why I will always prefer nivo-ipi over pembro?
The checkmate 8hw had less primary progressors. The initial crossover in curves was rectified early. This was due to misdiagnosis of around 13% patients as MSI high.”
The keynote 177 trial with pembro did not show benefit in key subgroups like RAS mutated disease and patients with liver mets.
The PFS benefit did not translate into a statistically significant os benefit for pembro 20% or early PD is an issue with pembro.
8HW gave nivo and ipi for 12 weeks. Niche 2 has shown that excellent responses are achieved with just 2 doses of Nivo and 1 dose of ipi. Can we deescalate here? Can ipi be switched to 6 weekly instead of 3? Checkmate 142 had an arm with nivo and ipi6 weekly which did well.
The most important comparison is nivo-ipi vs nivo alone, the analysis of which is ongoing.
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