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ESMO 2017: Addition of Pembrolizumab to Chemotherapy for Advanced Nonsquamous Lung Cancer

By: Cordi Craig
Posted: Friday, September 22, 2017

The addition of pembrolizumab to pemetrexed and carboplatin improved outcomes for patients with nonsquamous non–small cell lung cancer (NSCLC) versus pemetrexed and carboplatin alone. Hossein Borghaei, DO, MS, of the Fox Chase Cancer Center, Philadelphia, and colleagues led this randomized, open-label, phase I/II study. Updated results were presented at the 2017 European Society for Medical Oncology (ESMO) Congress in Madrid (Abstract LBA49).

A total of 123 patients with stage IIIB/IV nonsquamous NSCLC, no prior systemic therapy, and no epidermal growth factor receptor (EGFR) mutation or anaplastic lymphoma kinase (ALK) translocation were enrolled in KEYNOTE-021. They were randomized to receive pembrolizumab plus pemetrexed and carboplatin, or pemetrexed and carboplatin alone.

At a median follow-up of 18.7 months, the overall response rate with the triplet therapy was 57% versus 32% for the doublet therapy. Furthermore, the addition of pembrolizumab demonstrated significant improvements in progression-free survival at 19.0 months, compared with 8.9 months for patients in the control group.

Grade 3-5 adverse events occurred in 41% of patients who received pembrolizumab versus 29% for those who did not. The investigators noted that the hazard ratio for overall survival in the pembrolizumab group continues to improve.