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Cemiplimab-rwlc Monotherapy and PD-L1 Expression in Advanced NSCLC

By: Hope Craig, MSPH
Posted: Friday, March 12, 2021

According to results from the phase III randomized EMPOWER-Lung 1 trial, published in The Lancet, cemiplimab-rwlc monotherapy, compared with chemotherapy, significantly improved overall survival and progression-free survival in patients with advanced non–small cell lung cancer (NSCLC) who had at least 50% expression of PD-L1 in tumor cells. Ahmet Sezer, MD, of Başkent University, Adana, Turkey, and colleagues suggest this agent as a potential new treatment option for this patient population.

“Cemiplimab was superior to chemotherapy in the first-line treatment of advanced NSCLC with PD-L1 of at least 50% and without EGFR, ALK, or ROS1 aberrations,” the investigators commented.

This clinical trial was designed to assess the first-line treatment of cemiplimab compared with chemotherapy in patients with advanced or metastatic NSCLC with PD-L1 in at least 50% of tumor cells. The trial recruited 710 patients from 138 clinics from 24 countries. Patients were randomly assigned to receive either cemiplimab (350 mg administered intravenously every 3 weeks for up to 108 weeks) or standard-of-care platinum-doublet chemotherapy (for 4 to 6 cycles).

The median overall survival was not reached with cemiplimab versus 14.2 months with chemotherapy (P = .0002). A total of 74% of patients crossed over to cemiplimab following disease progression on chemotherapy. In addition, the PD-1 monoclonal antibody reduced the risk of death by 32% in all patients and by 43% among those with PD-L1 expression of at least 50%. Median progression-free survival was 8.2 months with cemiplimab versus 5.7 months with chemotherapy (P < .0001). In terms of toxicity, 28% of patients given cemiplimab experienced grade 3 or 4 treatment-emergent adverse events, compared with 39% of those treated with chemotherapy.

Disclosure: Full authors’ disclosures are available at thelancet.com.



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