Biomarkers of nivolumab benefit in resectable non-small cell lung cancer.

Pre-surgical ctDNA clearance identifies patients most likely to benefit from perioperative nivolumab in resectable NSCLC: 66% of nivolumab-treated patients with evaluable ctDNA cleared it before surgery, and half of those had pathologic complete response, versus 38% clearance and 12% pCR on placebo. Nivolumab also prolonged EFS in patients with alterations in KEAP1, STK11, CDKN2A and/or SMARCA4 (HR 0.48, 95% CI 0.28-0.83). A machine-learning model ranked ctDNA clearance among top predictors of longer EFS.