Nivolumab plus Ipilimumab in Non-Small-Cell Lung Cancer

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To the Editor: Although more than 10% of the patients in the CheckMate 227 trial conducted by Hellmann et al. (Nov. 21 issue)(1) had never smoked, the effect of smoking status on survival was not fully discussed. Striking differences in the clinical and molecular characteristics of lung cancers between smokers and those who have never smoked have been identified, suggesting that the cancers are separate entities.(2) In one trial,(3) patients who had never smoked had poorer responses to nivolumab (as compared with docetaxel) than current or former smokers (hazard ratio for overall survival, 1.02 vs. 0.70). In a meta-analysis involving . . .

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