Effect of Pembrolizumab on Quality of Life for Patients With Advanced Lung Cancer
Compared with chemotherapy, treatment with pembrolizumab may improve or maintain the health-related quality of life (QOL) of patients with treatment-naive, advanced, programmed cell death ligand 1 (PD-L1)–positive non–small cell lung cancer (NSCLC). These KEYNOTE-24 trial results were reported by a team led by Julie R. Brahmer, MD, of Johns Hopkins Sidney Kimmel Comprehensive Center, Baltimore, in The Lancet Oncology.
Earlier results from the phase III KEYNOTE-24 trial demonstrated longer progression-free survival in this group of about 300 patients who began treatment in 2014 and 2015. These additional findings support the authors’ conclusion that the monoclonal antibody pembrolizumab “might represent a new first-line standard of care for PD-L1–expressing, advanced NSCLC.”
Patient-reported outcomes were an exploratory endpoint of KEYNOTE-24. The patients’ QOL scores were based on responses to the European Organization for the Research and Treatment of Cancer (EORTC) Quality-of-Life Questionnaire Core 30 items (QLQ-C30).
Although patients receiving platinum-based chemotherapy had reduced QOL scores after 15 weeks, those receiving pembrolizumab reported better QOL. The mean reduction in QLQ-C30 score was –0.9 for the chemotherapy group; the mean increase for the pembrolizumab group was +6.9.
Dr. Brahmer’s team also evaluated the groups’ “time to deterioration,” a composite result of answers regarding cough, chest pain, and dyspnea in the EORTC QOL Questionnaire–Lung Cancer 13. Here, too, the pembrolizumab group had better results: median not reached for pembrolizumab versus 5.0 months for chemotherapy.