{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T05:02:44Z","timestamp":1792558964843,"version":"4.5.0"},"reference-count":29,"publisher":"American Society of Clinical Oncology (ASCO)","issue":"6","content-domain":{"domain":["ascopubs.org"],"crossmark-restriction":true},"short-container-title":["JCO"],"published-print":{"date-parts":[[2023,2,20]]},"abstract":"<jats:sec><jats:title>PURPOSE<\/jats:title><jats:p> We present 5-year results from CheckMate 227 Part 1, in which nivolumab plus ipilimumab improved overall survival (OS) versus chemotherapy in patients with metastatic non\u2013small-cell lung cancer, regardless of tumor programmed death ligand 1 (PD-L1) status. <\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p> Adults with stage IV\/recurrent non\u2013small-cell lung cancer without EGFR mutations or ALK alterations and with tumor PD-L1 \u2265 1% or &lt; 1% (n = 1739) were randomly assigned. Patients with tumor PD-L1 \u2265 1% were randomly assigned to first-line nivolumab plus ipilimumab, nivolumab alone, or chemotherapy. Patients with tumor PD-L1 &lt; 1% were randomly assigned to nivolumab plus ipilimumab, nivolumab plus chemotherapy, or chemotherapy. End points included exploratory 5-year results for efficacy, safety, and quality of life. <\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p> At a minimum follow-up of 61.3 months, 5-year OS rates were 24% versus 14% for nivolumab plus ipilimumab versus chemotherapy (PD-L1 \u2265 1%) and 19% versus 7% (PD-L1 &lt; 1%). The median duration of response was 24.5 versus 6.7 months (PD-L1 \u2265 1%) and 19.4 versus 4.8 months (PD-L1 &lt; 1%). Among patients surviving 5 years, 66% (PD-L1 \u2265 1%) and 64% (PD-L1 &lt; 1%) were off nivolumab plus ipilimumab without initiating subsequent systemic anticancer treatment by the 5-year time point. Survival benefit continued after nivolumab plus ipilimumab discontinuation because of treatment-related adverse events, with a 5-year OS rate of 39% (combined PD-L1 \u2265 1% and &lt; 1% populations). Quality of life in 5-year survivors treated with nivolumab plus ipilimumab was similar to that in the general US population through the 5-year follow-up. No new safety signals were observed. <\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSION<\/jats:title><jats:p> With all patients off immunotherapy treatment for \u2265 3 years, nivolumab plus ipilimumab increased 5-year survivorship versus chemotherapy, including long-term, durable clinical benefit regardless of tumor PD-L1 expression. These data support nivolumab plus ipilimumab as an effective first-line treatment for patients with metastatic non\u2013small-cell lung cancer. <\/jats:p><\/jats:sec><jats:sec><jats:title\/><jats:p> [Media: see text] <\/jats:p><\/jats:sec>","DOI":"10.1200\/jco.22.01503","type":"journal-article","created":{"date-parts":[[2022,10,12]],"date-time":"2022-10-12T19:59:14Z","timestamp":1665604754000},"page":"1200-1212","update-policy":"https:\/\/doi.org\/10.1200\/crossmark","source":"Crossref","is-referenced-by-count":398,"title":["Five-Year Survival Outcomes With Nivolumab Plus Ipilimumab Versus Chemotherapy as First-Line Treatment for Metastatic Non\u2013Small-Cell Lung Cancer in CheckMate 227"],"prefix":"10.1200","volume":"41","clinical-trial-number":[{"clinical-trial-number":"nct02477826","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2443-8395","authenticated-orcid":false,"given":"Julie 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