Posted: Friday, September 16, 2022
Results of the phase III KEYNOTE-407 study indicated that pembrolizumab plus platinum-based chemotherapy significantly prolonged survival outcomes in patients with previously untreated, metastatic squamous non–small cell lung cancer (NSCLC) compared with placebo plus chemotherapy. The study authors presented updated results including 5-year survival outcomes during the European Society for Medical Oncology (ESMO) Congress 2022 (Abstract 974MO). After 5 years, pembrolizumab plus chemotherapy continued to demonstrate survival benefits without increased toxicity compared with chemotherapy alone.
“These long-term data support use of pembrolizumab plus chemotherapy as a standard first-line treatment option for metastatic squamous NSCLC,” concluded Silvia Novello, MD, PhD, of the University of Turin, Italy.
Patients were randomly assigned 1:1 to receive pembrolizumab plus a platinum-based chemotherapy (n = 278) or placebo plus chemotherapy (n = 281). Eligible patients in the placebo group were allowed to cross over on study to up to 35 cycles of pembrolizumab monotherapy after verification of the percentage of tumor cells with membranous PD-L1 by blinded independent central radiologic review.
As of February 2022, the median time from randomization to data cutoff was 56.9 months. The median overall survival was 17.2 months and 11.6 months for the pembrolizumab and placebo groups, respectively. The overall survival rates were 18.4% with pembrolizumab and 9.7% in the placebo group. Severe adverse events were reported in 74.8% of the pembrolizumab group versus 70.0% in the placebo group.
Overall, 117 patients crossed over from the placebo group to receive pembrolizumab monotherapy, and an additional 26 patients received subsequent anti–PD-L1 therapy. Among the 55 patients who completed 35 cycles of pembrolizumab monotherapy, the overall response rate was 90.9%, and the 3-year overall survival rate was 69.5%.
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