# Comparison of real-world efficacy and safety of nivolumab plus ipilimumab or pembrolizumab combined with platinum-based chemotherapy as first-line treatment for advanced non-small cell lung cancer in a German population

## TL;DR

This study compares two treatment options for advanced lung cancer in Germany and finds similar effectiveness and safety.

## Contribution

A real-world comparison of nivolumab plus ipilimumab and pembrolizumab in treating advanced non-small cell lung cancer in Germany.

## Key findings

- Median overall survival and treatment duration were similar between the two treatment groups.
- NIC had more immune-related side effects, while PC had more chemotherapy-related side effects.
- No significant differences in serious adverse events or treatment-related deaths were observed.

## Abstract

In advanced non-small cell lung cancer (NSCLC), nivolumab plus ipilimumab with platinum-based chemotherapy (NIC) and pembrolizumab with platinum-based chemotherapy (PC) are commonly used treatment options. We conducted a single-center retrospective analysis comparing the two options under real-world conditions in Germany.

We collected data from patients whose treatment was initiated between July 2018 and June 2023. Primary endpoints were overall survival and safety. Categorical data were compared using the chi-squared test or Fisher’s exact test. Overall survival was compared using the Kaplan–Meier method and the log-rank test.

200 patients, 77 treated with NIC and 123 treated with PC, were included. Baseline characteristics were unbalanced with significantly more older, squamous, and PD-L1-negative cases in the NIC group. Median overall survival (OS) and time to treatment discontinuation (TTD) were not significantly different in the NIC and PC groups (13.6 vs. 14.1 months / 5.8 vs. 6.2 months). Clinically significant adverse events (AEsi), related treatment discontinuations, and treatment-related deaths also did not differ significantly (p = 0.885/p = 1.000/p = 0.709). There were more immune-related AEsi in the NIC group (p = 0.001) and more chemo-related AEsi in the PC group (p < 0.001).

NIC and PC seem to be equally supportable options in the treatment of advanced NSCLC. Further analyses are needed to validate our findings.

The online version contains supplementary material available at 10.1007/s00262-025-04244-4.