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ELCC 2019: Pembrolizumab Monotherapy in Elderly Patients With Advanced NSCLC

By: Melissa E. Fryman, MS
Posted: Friday, April 19, 2019

Pembrolizumab monotherapy seems to improve overall survival in elderly patients with advanced non–small cell lung carcinoma (NSCLC), consistent with its effect in younger patients. Although “approximately 70% of newly diagnosed NSCLC cases occur in the elderly, and more than half are locally advanced or metastatic,” data on the safety and efficacy of the checkpoint inhibitor in older patients specifically have been lacking. Kaname Nosaki, MD, of the National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan, and colleagues presented their findings at the European Lung Cancer Congress (ELCC) 2019 in Geneva (Abstract 103O_PR).

In this analysis of pooled data from the KEYNOTE-010, KEYNOTE-024, and KEYNOTE-042 trials, overall survival rates of 264 elderly patients (75 years of age or older) with advanced PD-L1–positive NSCLC, treated with pembrolizumab or chemotherapy, were compared with each other and with those of 2,292 younger patients. Tumor proportion score (TPS) was ≥ 1% (KEYNOTE-010, -042) for all or ≥ 50% (KEYNOTE-024) for about half of patients in this analysis.

Overall survival was significantly improved for elderly patients with a TPS ≥ 1% treated with pembrolizumab compared with chemotherapy (hazard ratio = .76), and even more so for patients with a TPS ≥ 50% (hazard ratio = .41). The 1-year overall survival rates were comparable between elderly and younger patients

Furthermore, treatment-related adverse effects were less frequent in the pembrolizumab group than in the chemotherapy group (68% vs. 94%). Immune-mediated adverse events were more common in the pembrolizumab group (25% vs. 7%), but no more or less frequent in elderly than younger patients.

Disclosure: The study authors’ disclosure information may be found at esmo.org.



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