Does Pembrolizumab Plus Chemotherapy–Induced Pneumonitis Impact Survival Outcomes in NSCLC?
Posted: Friday, July 2, 2021
Cytotoxic chemotherapy is frequently administered in combination with PD-1/PD-L1 checkpoint inhibitors for the treatment of advanced non–small cell lung cancer (NSCLC); however, information regarding the incidence and characteristics of pneumonitis caused by this combination therapy is limited. Nobuyuki Yamamoto, MD, PhD, of Wakayama Medical University, Japan, and colleagues conducted a multicenter retrospective cohort study including 36 centers to examine the effect of this adverse event on survival outcomes in patients treated with a platinum agent plus pemetrexed and pembrolizumab. Their findings were published in the European Journal of Cancer.
“Treatment-related pneumonitis occurred at a higher rate in the real-world population than that reported previously; it led to worse survival outcomes,” the investigators commented. “Additional studies are required to improve the safety of this combination therapy.”
Between December 2018 and June 2019, a total of 299 chemotherapy-naive patients with nonsquamous NSCLC were administered a platinum agent plus pemetrexed and pembrolizumab. Pneumonitis was the most frequently reported nonhematologic adverse event of grade 3 or higher. A total of 37 patients had all-grade pneumonitis; of them, 21 developed this adverse event within 90 days of treatment initiation. Of the 10 patients with pneumonitis of grade 3 or higher, 9 experienced this adverse event within 90 days of treatment initiation.
The median durations of progression-free survival and time to treatment failure were 7.5 and 5.9 months, respectively. After adjustments were made for immortal time bias, pneumonitis seemed to be independently associated with a shorter duration of progression-free survival (hazard ratio = 1.99; P = .03) and overall survival (hazard ratio = 3.03; P = .03).
Disclosure: For full disclosures of the study authors, visit ejcancer.com.
