Chemoradiation Plus Pembrolizumab for Locally Advanced NSCLC
Posted: Thursday, December 9, 2021
The anti–PD-1 inhibitor pembrolizumab plus concurrent chemoradiation therapy demonstrated antitumor activity and a manageable toxicity profile in patients with previously untreated stage III non–small cell lung cancer (NSCLC). The results of the KEYNOTE-799 trial were presented by Salma K. Jabbour, MD, of Rutgers University in New Brunswick, New Jersey, at the 2021 American Society for Radiation Oncology (ASTRO) Annual Meeting (Abstract 16).
This nonrandomized, open-label trial enrolled 216 patients with unresectable, pathologically confirmed stage IIIA–C NSCLC. Patients in cohort A were given one cycle of carboplatin along with paclitaxel and pembrolizumab. After 3 weeks, patients received carboplatin and paclitaxel once a week for 6 weeks and two cycles of pembrolizumab every 3 weeks, plus standard thoracic radiotherapy. Patients in cohort B received three cycles of cisplatin, pemetrexed, and pembrolizumab every 3 weeks, with standard thoracic radiotherapy during cycles 2 and 3. All patients received up to 14 additional cycles of pembrolizumab every 3 weeks.
The median range from the first dose of treatment to data cutoff was 18.5 months in cohort A and 13.7 months in cohort B. The objective response rates were 70.5% and 70.6% in cohorts A and B, respectively. The 12-month overall survival rates were 81.3% and 87.0% in cohorts A and B, and the 12-month progression-free survival rates were 67.1% and 71.6%.
Grade 3 or higher treatment-related adverse events reported in more than 10% of patients included neutropenia (16.1% in cohort A and 9.8% in cohort B) and anemia (10.7% and 4.9%). The median times to the onset of any-grade pneumonitis were 4.3 months and 4.4 months in cohorts A and B, respectively. Grade 3 or higher pneumonitis occurred in nine patients (8.0%) in cohort A and in an additional seven patients (6.9%) in cohort B. Four patients in cohort A and one patient in cohort B had adverse events leading to death.
Disclosure: For Dr. Jabbour’s disclosures, visit plan.core-apps.com.
