Durvalumab With or Without Tremelimumab vs Standard Chemotherapy in First-line Treatment of Metastatic Non–Small Cell Lung Cancer: The MYSTIC Phase 3 Randomized Clinical Trial
Open accessAbstract
Importance: Checkpoint inhibitors targeting programmed cell death 1 or its ligand (PD-L1) as monotherapies or in combination with anti-cytotoxic T-lymphocyte-associated antigen 4 have shown clinical activity in patients with metastatic non-small cell lung cancer. Objective: To compare durvalumab, with or without tremelimumab, with chemotherapy as a first-line treatment for patients with metastatic non-small cell lung cancer. Design, Setting, and Participants: This open-label, phase 3 randomized clinical trial (MYSTIC) was conducted at 203 cancer treatment centers in 17 countries. Patients with treatment-naive, metastatic non-small cell lung cancer who had no sensitizing EGFR or ALK genetic alterations were randomized to receive treatment with durvalumab, durvalumab plus tremelimumab, or chemotherapy. Data were collected from July 21, 2015, to October 30, 2018. Interventions: Patients were randomized (1:1:1) to receive treatment with durvalumab (20 mg/kg every 4 weeks), durvalumab (20 mg/kg every 4 weeks) plus tremelimumab (1 mg/kg every 4 weeks, up to 4 doses), or platinum-based doublet chemotherapy. Main Outcomes and Measures: The primary end points, assessed in patients with ≥25% of tumor cells expressing PD-L1, were overall survival (OS) for durvalumab vs chemotherapy, and OS and progression-free survival (PFS) for durvalumab plus tremelimumab vs chemotherapy. Analysis of blood tumor mutational burden (bTMB) was exploratory. Results: Between July 21, 2015, and June 8, 2016, 1118 patients were randomized. Baseline demographic and disease characteristics were balanced between treatment groups. Among 488 patients with ≥25% of tumor cells expressing PD-L1, median OS was 16.3 months (95% CI, 12.2-20.8) with durvalumab vs 12.9 months (95% CI, 10.5-15.0) with chemotherapy (hazard ratio [HR], 0.76; 97.54% CI, 0.56-1.02; P = .04 [nonsignificant]). Median OS was 11.9 months (95% CI, 9.0-17.7) with durvalumab plus tremelimumab (HR vs chemotherapy, 0.85; 98.77% CI, 0.61-1.17; P = .20). Median PFS was 3.9 months (95% CI, 2.8-5.0) with durvalumab plus tremelimumab vs 5.4 months (95% CI, 4.6-5.8) with chemotherapy (HR, 1.05; 99.5% CI, 0.72-1.53; P = .71). Among 809 patients with evaluable bTMB, those with a bTMB ≥20 mutations per megabase showed improved OS for durvalumab plus tremelimumab vs chemotherapy (median OS, 21.9 months [95% CI, 11.4-32.8] vs 10.0 months [95% CI, 8.1-11.7]; HR, 0.49; 95% CI, 0.32-0.74). Treatment-related adverse events of grade 3 or higher occurred in 55 (14.9%) of 369 patients who received treatment with durvalumab, 85 (22.9%) of 371 patients who received treatment with durvalumab plus tremelimumab, and 119 (33.8%) of 352 patients who received treatment with chemotherapy. These adverse events led to death in 2 (0.5%), 6 (1.6%), and 3 (0.9%) patients, respectively. Conclusions and Relevance: The phase 3 MYSTIC study did not meet its primary end points of improved OS with durvalumab vs chemotherapy or improved OS or PFS with durvalumab plus tremelimumab vs chemotherapy in patients with ≥25% of tumor cells expressing PD-L1. Exploratory analyses identified a bTMB threshold of ≥20 mutations per megabase for optimal OS benefit with durvalumab plus tremelimumab. Trial Registration: ClinicalT rials.gov Identifier: NCT02453282.
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Subgroup analysis showed that tremelimumab plus durvalumab markedly improved the OS of NSCLC patients with a high tumor mutation burden.
“However, the subgroup analysis showed that tremelimumab plus durvalumab markedly improved the OS of NSCLC patients with a high tumor mutation burden [145], indicating the importance of appropriate patient selection for the optimal benefit of tremelimumab plus durvalumab.”
From Combination strategies with PD-1/PD-L1 blockade: current advances and future directions (2022) · cites this paper as [145]
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Cites
New response evaluation criteria in solid tumours: revised RECIST guideline (version 1.1)
Eisenhauer, E. A., Therasse, P., Bogaerts, J., Schwartz, L. H., Sargent, D., Ford, R., Dancey, J., Arbuck, S., Gwyther, S., Mooney, M., et al. (2009) · European Journal of Cancer · doi:10.1016/j.ejca.2008.10.026 · Cited by 29,534 · see citing works
Toxicity and response criteria of the Eastern Cooperative Oncology Group
Oken, M. M., Creech, R. H., Tormey, D. C., Horton, J., Davis, T. E., Mcfadden, E. T., & Carbone, P. P. (1982) · American Journal of Clinical Oncology · doi:10.1097/00000421-198212000-00014 · Cited by 11,607 · see citing works
Pembrolizumab versus Chemotherapy for PD-L1-Positive Non-Small-Cell Lung Cancer
Reck, M., Rodríguez-Abreu, D., Robinson, A. G., Hui, R., Csőszi, T., Fülöp, A., Gottfried, M., Peled, N., Tafreshi, A., Cuffe, S., et al. (2016) · New England Journal of Medicine · doi:10.1056/nejmoa1606774 · Cited by 10,089 · see citing works
Nivolumab versus docetaxel in advanced nonsquamous non-small-cell lung cancer
Borghaei, H., Paz-Ares, L., Horn, L., Spigel, D. R., Steins, M., Ready, N. E., Chow, L. Q., Vokes, E. E., Felip, E., Holgado, E., et al. (2015) · New England Journal of Medicine · doi:10.1056/nejmoa1507643 · Cited by 9,335 · see citing works
Self-citationNivolumab versus Docetaxel in Advanced Squamous-Cell Non–Small-Cell Lung Cancer
Brahmer, J., Reckamp, K. L., Baas, P., Crinò, L., Eberhardt, W. E. E., Poddubskaya, E., Antonia, S., Pluzanski, A., Vokes, E. E., Holgado, E., et al. (2015) · New England Journal of Medicine · doi:10.1056/nejmoa1504627 · Cited by 8,447 · see citing works
Self-citationMutational landscape determines sensitivity to PD-1 blockade in non–small cell lung cancer
Rizvi, N. A., Hellmann, M. D., Snyder, A., Kvistborg, P., Makarov, V., Havel, J. J., Lee, W., Yuan, J., Wong, P., Ho, T. S., et al. (2015) · Science · doi:10.1126/science.aaa1348 · Cited by 7,802 · see citing works
Self-citationPembrolizumab plus chemotherapy in metastatic non–small-cell lung cancer
Gandhi, L., Rodríguez-Abreu, D., Gadgeel, S., Esteban, E., Felip, E., De Angelis, F., Domine, M., Clingan, P., Hochmair, M. J., Powell, S. F., et al. (2018) · New England Journal of Medicine · doi:10.1056/nejmoa1801005 · Cited by 6,607 · see citing works
Self-citationDurvalumab after chemoradiotherapy in stage III non–small-cell lung cancer
Antonia, S. J., Villegas, A., Daniel, D., Vicente, D., Murakami, S., Hui, R., Yokoi, T., Chiappori, A., Lee, K. H., de Wit, M., et al. (2017) · New England Journal of Medicine · doi:10.1056/nejmoa1709937 · Cited by 4,593 · see citing works
Self-citationGenetic Basis for Clinical Response to CTLA-4 Blockade in Melanoma
Snyder, A., Makarov, V., Merghoub, T., Yuan, J., Zaretsky, J. M., Desrichard, A., Walsh, L. A., Postow, M. A., Wong, P., Ho, T. S., et al. (2014) · New England Journal of Medicine · doi:10.1056/nejmoa1406498 · Cited by 4,286 · see citing works
Tumor mutational load predicts survival after immunotherapy across multiple cancer types
Samstein, R. M., Lee, C.-H., Shoushtari, A. N., Hellmann, M. D., Shen, R., Janjigian, Y. Y., Barron, D. A., Zehir, A., Jordan, E. J., Omuro, A., et al. (2019) · Nature Genetics · doi:10.1038/s41588-018-0312-8 · Cited by 4,071 · see citing works
Self-citationAtezolizumab for First-Line Treatment of Metastatic Nonsquamous NSCLC
Socinski, M. A., Jotte, R. M., Cappuzzo, F., Orlandi, F., Stroyakovskiy, D., Nogami, N., Rodríguez-Abreu, D., Moro-Sibilot, D., Thomas, C. A., Barlesi, F., et al. (2018) · New England Journal of Medicine · doi:10.1056/nejmoa1716948 · Cited by 3,733 · see citing works
Pembrolizumab plus chemotherapy for squamous non-small-cell lung cancer
Paz-Ares, L., Luft, A., Vicente, D., Tafreshi, A., Gümüş, M., Mazières, J., Hermes, B., Çay Şenler, F., Csőszi, T., Fülöp, A., et al. (2018) · New England Journal of Medicine · doi:10.1056/nejmoa1810865 · Cited by 3,617 · see citing works
Self-citationMok, T. S. K., Wu, Y.-L. L. C., Kudaba, I., Kowalski, D. M., Cho, B. C., Turna, H. Z., de Castro, G., Srimuninnimit, V., Лактионов, К. К., Bondarenko, I., et al. (2019) · The Lancet · doi:10.1016/s0140-6736(18)32409-7 · Cited by 3,319 · see citing works
Self-citationScagliotti, G. V., Parikh, P., von Pawel, J., Biesma, B., Vansteenkiste, J., Manegold, C., Serwatowski, P., Gatzemeier, U., Digumarti, R., Zukin, M., et al. (2008) · Journal of Clinical Oncology · doi:10.1200/jco.2007.15.0375 · Cited by 3,203 · see citing works
Nivolumab plus ipilimumab in lung cancer with a high tumor mutational burden
Hellmann, M. D., Ciuleanu, T.-E., Pluzanski, A., Lee, J. S., Otterson, G. A., Audigier-Valette, C., Minenza, E., Linardou, H., Burgers, S., Salman, P., et al. (2018) · New England Journal of Medicine · doi:10.1056/nejmoa1801946 · Cited by 3,063 · see citing works
Nivolumab plus ipilimumab in advanced non-small-cell lung cancer
Hellmann, M. D., Paz-Ares, L., Bernabe Caro, R., Zurawski, B., Kim, S.-W., Carcereny Costa, E., Park, K., Alexandru, A., Lupinacci, L., de la Mora Jimenez, E., et al. (2019) · New England Journal of Medicine · doi:10.1056/nejmoa1910231 · Cited by 2,823 · see citing works
Self-citationOverall Survival with Durvalumab after Chemoradiotherapy in Stage III NSCLC
Antonia, S. J., Villegas, A., Daniel, D., Vicente, D., Murakami, S., Hui, R., Kurata, T., Chiappori, A., Lee, K. H., de Wit, M., et al. (2018) · New England Journal of Medicine · doi:10.1056/nejmoa1809697 · Cited by 2,798 · see citing works
Self-citationFehrenbacher, L., Spira, A., Ballinger, M., Kowanetz, M., Vansteenkiste, J., Mazieres, J., Park, K., Smith, D., Artal-Cortes, A., Lewanski, C., et al. (2016) · The Lancet · doi:10.1016/s0140-6736(16)00587-0 · Cited by 2,756 · see citing works
First-Line Nivolumab in Stage IV or Recurrent Non–Small-Cell Lung Cancer
Carbone, D. P., Reck, M., Paz-Ares, L., Creelan, B., Horn, L., Steins, M., Felip, E., van den Heuvel, M. M., Ciuleanu, T.-E., Badin, F., et al. (2017) · New England Journal of Medicine · doi:10.1056/nejmoa1613493 · Cited by 2,503 · see citing works
Self-citationDiscrete sequential boundaries for clinical trials
GORDON LAN, K. K., & DEMETS, D. L. (1983) · Biometrika · doi:10.1093/biomet/70.3.659 · Cited by 2,310 · see citing works
Discrete Sequential Boundaries for Clinical Trials
Lan, K. K. G., & DeMets, D. L. (1983) · Biometrika · doi:10.2307/2336502 · Cited by 2,310 · see citing works
West, H., McCleod, M., Hussein, M., Morabito, A., Rittmeyer, A., Conter, H. J., Kopp, H.-G., Daniel, D., McCune, S., Mekhail, T., et al. (2019) · The Lancet Oncology · doi:10.1016/s1470-2045(19)30167-6 · Cited by 1,662 · see citing works
Self-citationNon-invasive analysis of acquired resistance to cancer therapy by sequencing of plasma DNA
Murtaza, M., Dawson, S.-J., Tsui, D. W. Y., Gale, D., Forshew, T., Piskorz, A. M., Parkinson, C., Chin, S.-F., Kingsbury, Z., Wong, A. S. C., et al. (2013) · Nature · doi:10.1038/nature12065 · Cited by 1,624 · see citing works
Non-Invasive Analysis of Acquired Resistance to Cancer Therapy By Sequencing of Plasma Dna
(2014) · Annals of Oncology · doi:10.1093/annonc/mdu312.5 · Cited by 1,174 · see citing works
Gandara, D. R., Paul, S. M., Kowanetz, M., Schleifman, E., Zou, W., Li, Y., Rittmeyer, A., Fehrenbacher, L., Otto, G. A., Malboeuf, C. M., et al. (2018) · Nature Medicine · doi:10.1038/s41591-018-0134-3 · Cited by 1,156 · see citing works
Ciuleanu, T., Brodowicz, T., Zielinski, C., Kim, J. H., Krzakowski, M., Laack, E., Wu, Y.-L., Bover, I., Begbie, S., Tzekova, V., et al. (2009) · The Lancet · doi:10.1016/s0140-6736(09)61497-5 · Cited by 1,111 · see citing works
Paz-Ares, L. G., de Marinis, F., Dediu, M., Thomas, M., Pujol, J.-L., Bidoli, P., Molinier, O., Sahoo, T. P., Laack, E., Reck, M., et al. (2013) · Journal of Clinical Oncology · doi:10.1200/jco.2012.47.1102 · Cited by 624 · see citing works
Antonia, S., Goldberg, S. B., Balmanoukian, A., Chaft, J. E., Sanborn, R. E., Gupta, A., Narwal, R., Steele, K., Gu, Y., Karakunnel, J. J., et al. (2016) · The Lancet Oncology · doi:10.1016/s1470-2045(15)00544-6 · Cited by 602 · see citing works
Self-citationReady, N., Hellmann, M. D., Awad, M. M., Otterson, G. A., Gutierrez, M., Gainor, J. F., Borghaei, H., Jolivet, J., Horn, L., Mates, M., et al. (2019) · Journal of Clinical Oncology · doi:10.1200/jco.18.01042 · Cited by 581 · see citing works
Garassino, M. C., Cho, B.-C., Kim, J.-H., Mazières, J., Vansteenkiste, J., Lena, H., Corral Jaime, J., Gray, J. E., Powderly, J., Chouaid, C., et al. (2018) · The Lancet Oncology · doi:10.1016/s1470-2045(18)30144-x · Cited by 568 · see citing works
Self-citationMaio, M., Scherpereel, A., Calabrò, L., Aerts, J. G. J. V., Cedrés, S., Bearz, A., Nackaerts, K., Fennell, D. A., Kowalski, D. M., Tsao, A. S., et al. (2017) · The Lancet Oncology · doi:10.1016/s1470-2045(17)30446-1 · Cited by 422 · see citing works
Self-citationIdentification and Characterization of MEDI4736, an Antagonistic Anti–PD-L1 Monoclonal Antibody
Stewart, R. A., Morrow, M., Hammond, S. A., Mulgrew, K. A., Marcus, D., Poon, E., Watkins, A., Mullins, S., Chodorge, M., Andrews, J. L., et al. (2015) · Cancer Immunology Research · doi:10.1158/2326-6066.cir-14-0191 · Cited by 409 · see citing works
Mao, X., Zhang, Z., Zheng, X., Xie, F., Duan, F., Jiang, L., Chuai, S., Han‐Zhang, H., Han, B., & Sun, J. (2016) · Journal of Thoracic Oncology · doi:10.1016/j.jtho.2016.11.2235 · Cited by 160 · see citing works
Planchard, D., Reinmuth, N., Орлов, С. В., Fischer, J. R., Sugawara, S., Mańdziuk, S., Márquez-Medina, D., Novello, S., Takeda, Y., Soo, R. A., et al. (2020) · Annals of Oncology · doi:10.1016/j.annonc.2020.02.006 · Cited by 153 · see citing works
Self-citationPapadimitrakopoulou, V. A., Cobo, M., Bordoni, R. E., et al. (2018) · Journal of Thoracic Oncology · doi:10.1016/j.jtho.2018.08.262 · Cited by 121 · see citing works
Self-citationAntonia, S. J., Balmanoukian, A. S., Brahmer, J. R., Ou, S. I., Hellmann, M. D., Kim, S.-W., Ahn, M., Kim, D., Gutierrez, M. E., Liu, S. V., et al. (2019) · Journal of Thoracic Oncology · doi:10.1016/j.jtho.2019.06.010 · Cited by 98 · see citing works
Self-citationClinical activity and biomarkers of MEDI4736, an anti-PD-L1 antibody, in patients with NSCLC.
Brahmer, J. R., Rizvi, N. A., Lutzky, J., Khleif, S. N., Blake-Haskins, A., Li, X., Robbins, P. B., Vasselli, J., Ibrahim, R. A., & Antonia, S. J. (2014) · Journal of Clinical Oncology · doi:10.1200/jco.2014.32.15_suppl.8021 · Cited by 78 · see citing works
Self-citationKim, E. S., Velcheti, V., Mekhail, T. M., Leal, T. A. B., Dowell, J. E., Tsai, M. L., Dakhil, C. S. R., Stella, P. J., Shen, V., Hu, S., et al. (2018) · Annals of Oncology · doi:10.1093/annonc/mdy424.067 · Cited by 62 · see citing works
Self-citationQiu, P., Poehlein, C. H., Marton, M. J., et al. (2019) · Scientific Reports · doi:10.1038/s41598-018-37128-y · Cited by 49 · see citing works
Tarhini, A. A., & Kirkwood, J. M. (2008) · Expert Opinion on Biological Therapy · doi:10.1517/14712598.8.10.1583 · Cited by 44 · see citing works
Quinn, K., Helman, E., Nance, T., et al. (2018) · Annals of Oncology · doi:10.1093/annonc/mdy269.129 · Cited by 18 · see citing works
ARCTIC: Durvalumab + tremelimumab and durvalumab monotherapy vs SoC in ≥ 3L advanced NSCLC treatment
Kowalski, D. M., Reinmuth, N., Orlov, S., et al. (2018) · Annals of Oncology · doi:10.1093/annonc/mdy292.001 · Cited by 17 · see citing works
Self-citationWu, Y.-L. L. C., Lü, S., Clarke, S. J., Lactionov, K. P., Li, P., Kirkby, M., Xie, Y., & Stockman, P. K. (2017) · Annals of Oncology · doi:10.1093/annonc/mdx380.079 · Cited by 5 · see citing works
Self-citationHiggs, B. W., Morehouse, C., Brohawn, P. Z., et al. (2018) · Annals of Oncology · doi:10.1093/annonc/mdy269.063 · Cited by 5 · see citing works
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Research works printed but not linked: 2
- [24]Chaft J, Cho BC, Ahn M-J,. Safety and activity of second-line durvalumab + tremelimumab in non-squamous advanced NSCLC [abstract CT113]. Cancer Res. 2018; 78(13)(suppl). doi: 10.1158/1538-7445.AM2018-CT113 · DOI
- [39]AstraZeneca. Imfinzi and imfinzi plus tremelimumab delayed disease progression in phase III POSEIDON trial for 1st-line treatment of stage IV non–small cell lung cancer [press release]. https://www.astrazeneca.com/media-centre/press-releases/2019/imfinzi-and-imfinzi-plus-tremelimumab-delayed-disease-progression-in-phase-iii-poseidon-trial-for-1st-line-treatment-of-stage-iv-non-small-cell-lung-cancer.html. October 28, 2019. Accessed November 20, 2019.
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- Authors
- Rizvi, N. A., Cho, B. C., Reinmuth, N., Lee, K. H., Luft, A., Ahn, M.-J., van den Heuvel, M. M., Cobo, M., Vicente, D., Smolin, A., Moiseyenko, V., Antonia, S. J., Le Moulec, S., Robinet, G., Natale, R., Schneider, J., Shepherd, F. A., Geater, S. L., Garon, E. B., Kim, E. S., Goldberg, S. B., Nakagawa, K., Raja, R., Higgs, B. W., Boothman, A.-M., Zhao, L., Scheuring, U., Stockman, P. K., Chand, V. K., Peters, S., & for the MYSTIC Investigators
- Affiliations
- Columbia University Irving Medical Center (US)
- Yonsei University (KR)
- Asklepios Fachkliniken München-Gauting (DE)
- Chungbuk National University (KR)
- Leningrad Regional Cancer Center (RU)
- Samsung Medical Center (KR)
- Nederlands Kanker Instituut–Antoni van Leeuwenhoekziekenhuis, Amsterdam, the Netherlands
- Hospital Regional Universitario de Málaga (ES)
- Hospital Universitario Virgen Macarena (ES)
- Department of Radiology, Burdenko Main Military Clinical Hospital, Moscow, Russia
- Oncological Clinical Research Center, St Petersburg, Russia
- Moffitt Cancer Center (US)
- Department of Medical Oncology, Institut Bergonié, Bordeaux, France
- Centre Hospitalier Régional Universitaire de Brest (FR)
- Cedars-Sinai Medical Center (US)
- Winthrop-University Hospital (US)
- University of Toronto (CA)
- Prince of Songkla University (TH)
- University of California, Los Angeles (US)
- Levine Cancer Institute (US)
- Yale Cancer Center (US)
- Kindai University (JP)
- AstraZeneca (United States) (US)
- AstraZeneca (United Kingdom) (GB)
- Centre Hospitalier Universitaire Vaudois (CH)
- Corresponding author
- Rizvi, Naiyer A.
- ORCID
- Rizvi, Naiyer A.
- Cho, Byoung Chul
- Reinmuth, Niels
- Lee, Ki Hyeong
- Ahn, Myung-Ju
- Cobo, Manuel
- Vicente, David
- Smolin, Alexey
- Moiseyenko, Vladimir
- Antonia, Scott J.
- Shepherd, Frances A.
- Geater, Sarayut Lucien
- Garon, Edward B.
- Kim, Edward S.
- Goldberg, Sarah B.
- Nakagawa, Kazuhiko
- Raja, Rajiv
- Higgs, Brandon W.
- Zhao, Luping
- Scheuring, Urban
- Stockman, Paul K.
- Peters, Solange
- Venue
- JAMA Oncology
- Publisher
- American Medical Association (AMA)
- Published
- 2020-05-01
- Volume
- 6
- Issue
- 5
- Pages
- 661
- ISSN
- 2374-2437 (ISSN-L)
- PMC
- PMC7146551
- OpenAlex
- W3016210953
- Cited by
- 623
- References
- 44
- Citations by year
- 2026: 30 · 2025: 68 · 2024: 91 · 2023: 128 · 2022: 130 · 2021: 128 · 2020: 47 · 2013: 1
- FWCI
- 39.09
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- cc-by-nc-nd
- Locations
- JAMA Oncology (publishedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- SERVAL (Université de Lausanne) (publishedVersion, cc-by-nc-nd)
- IRIS (submittedVersion, cc-by-nc-nd)
- Radboud Repository (Radboud University) (submittedVersion)
- RISalud Institutional Health Repository of Andalucía (submittedVersion, cc-by-nc-nd)
- Radboud Repository (Radboud University) (submittedVersion, other-oa)
- Funders
- AstraZeneca
- National Institutes of Health (UL1TR001863)
- National Center for Advancing Translational Sciences
- Topics
- Health Sciences › Medicine › Oncology › Cancer Immunotherapy and Biomarkers
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Lung Cancer Treatments and Mutations
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Lung Cancer Diagnosis and Treatment
- Keywords
- durvalumab, tremelimumab, metastatic non-small cell lung cancer, first-line therapy, PD-L1 inhibitors, CTLA-4 blockade, combination immunotherapy, platinum-based chemotherapy, overall survival, progression-free survival, PD-L1 expression, tumor mutational burden, treatment-naive patients
- MeSH terms
- Antineoplastic Agents, Immunological, Adult, Aged, Aged, 80 and over, Antibodies, Monoclonal, Antineoplastic Combined Chemotherapy Protocols, Carcinoma, Non-Small-Cell Lung, Female, Humans, Lung Neoplasms, Male, Middle Aged, Neoplasm Metastasis, Antibodies, Monoclonal, Humanized
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