Nivolumab, an immunotherapy drug, has shown unprecedented success at treating patients with certain types of advanced cancer. The U.S. Food and Drug Administration approvals for nivolumab, and other drugs like it, are for patients with advanced cancer that has progressed or relapsed while on chemotherapy. Carbone et al. tested whether nivolumab could be used as a first-line therapy (before chemotherapy) in lung cancer patients that express the nivolumab target, PD1, and unexpectedly found that the drug was not better than chemotherapy. Compared with chemotherapy, nivolumab did not extend the time before the disease progressed, nor did it improve overall survival. These results suggest that pretreatment with chemotherapy may influence the response to nivolumab.
