Pembrolizumab Plus Chemotherapy in Metastatic Squamous NSCLC
Posted: Thursday, January 3, 2019
According to results from the KEYNOTE-407 trial, the addition of pembrolizumab to platinum-based chemotherapy significantly prolonged overall and progression-free survival in patients with advanced squamous non–small cell lung cancer (NSCLC). In fact, the addition of the PD-1 inhibitor to chemotherapy improved outcomes regardless of patients’ PD-L1 expression levels. These findings, by Luis Paz-Ares, MD, of the Hospital Universitario 12 de Octubre, Madrid, and colleagues, were published in The New England Journal of Medicine as well as presented at the International Association for the Study of Lung Cancer 19th World Conference on Lung Cancer.
In this international, double-blind, randomized, phase III trial, 559 patients with metastatic, NSCLC received pembrolizumab (n = 278) or placebo (n = 281) in addition to carboplatin and either paclitaxel or nab-paclitaxel. Over a median follow-up of 7.8 months, the median overall survival was 15.9 months with pembrolizumab versus 11.3 months with the placebo (P < .001). The median progression-free survival was 6.4 months versus 4.8 months, respectively (P < .001). Furthermore, the risk of death and the risk of disease progression or death were 36% and 44% lower in the pembrolizumab group.
Adverse events of grade 3 or higher occurred in 69.8% of patients receiving pembrolizumab and in 68.2% of the patients receiving placebo. Immune-mediated adverse events of grade 3 or higher occurred in 10.8% and 3.2% of patients, respectively. One death due to pneumonitis was reported for each group.
“Given the… results observed with long-term follow-up in other studies of pembrolizumab-based therapy in patients with metastatic NSCLC, we expect that the benefit observed in the pembrolizumab-combination group will be maintained or even increase with longer follow-up,” concluded the authors.
Disclosure: Study authors’ disclosure information may be found at the NEJM.