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Is Pembrolizumab of Benefit in Oligometastatic Lung Cancer After Local Ablative Therapy?

By: Hillary Ojeda
Posted: Tuesday, September 3, 2019

A study conducted by Joshua M. Bauml, MD, of the University of Pennsylvania Perelman School of Medicine, and colleagues found that progression-free survival improved with pembrolizumab after locally ablative therapy in patients with oligometastatic non–small cell lung cancer. The authors recommend that the single-center phase II trial results, published in JAMA Oncology, warrant additional testing in a randomized clinical trial.

“In addition, to our knowledge, this study is the first to show improved outcomes for immunotherapy after locally ablative therapy in patients with oligometastatic non–small cell lung cancer,” the investigators concluded.

A total of 45 patients received pembrolizumab at an academic referral cancer center from February 2015 to September 2017. About half of the patients were men, and the median age was 64 years. The treatment included 200 mg of pembrolizumab every 21 days for 8 cycles and started within 4 to 12 weeks of completion of locally ablative therapy. The Functional Assessment of Cancer Therapy—Lung instrument measured patients’ quality of life.

Beginning from the first cycle of treatment, the median progression-free survival was 19.1 months, which was significantly longer than historical data. The median progression-free survial from the start of pembrolizumab therapy was 18.7 months. Estimated overall survival rates at 12 months and 24 months were 90.9% and 77.5%, respectively. Pain, fatigue, and rash were the most common therapy-related adverse events.

“Our results fit well with emerging data that each oligometastasis may have a different genetic profile and distinct interactions with the immune system,” the authors commented.

Disclosure: The study authors’ disclosure information can be found at jamanetwork.com.



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