ASCO 2018: Potential New Standard of Care in Pembrolizumab Combination for Advanced Squamous NSCLC
Posted: Tuesday, June 19, 2018
Interim analysis results of the KEYNOTE-407 trial revealed a potential new standard of care for the first-line treatment of metastatic squamous non–small-cell lung cancer (NSCLC): pembrolizumab plus carboplatin and paclitaxel or nab-paclitaxel. Luis G. Paz-Ares, MD, PhD, of the Hospital Universitario 12 de Octubre, Spain, presented his team’s findings at the 2018 American Society of Clinical Oncology (ASCO) Annual Meeting in Chicago (Abstract 105). The benefits of this immunotherapy combination were observed across all different levels of PD-L1 expression, the researchers noted.
“Adding pembrolizumab almost doubled the overall response rate of chemotherapy for [these] patients,” with no new safety concerns, Dr. Paz-Ares and colleagues noted in the abstract.
With 560 participating patients, KEYNOTE-407 is a randomized, placebo-controlled, global, phase III study. All patients received carboplatin and either paclitaxel or nab-paclitaxel for 4 cycles; half additionally received the monoclonal antibody pembrolizumab for those 4 cycles plus 31 more pembrolizumab administrations, whereas half received placebo instead.
The results from the first 204 randomized patients with a median follow-up of 7.8 months showed pembrolizumab-treated patients experienced an overall response rate of 58.4% compared with 35.0% for the control group (P = .0004). Median overall survival was 15.9 months in the pembrolizumab arm versus 11.3 months in the control arm (P = .0008), whether tumor PD-L1 expression was none/low, intermediate, or high (< 1%, 1%–49%, and ≥ 50%, respectively). The rate of responses lasting 6 months or more was 65.8% with the pembrolizumab chemotherapy versus 45.6% with chemotherapy alone.
A second interim analysis, unveiled live at the meeting, revealed overall response rate data similar to those in the first analysis: 57.9% (pembrolizumab) versus 38.4% (chemotherapy alone).
