WCLC 2020: 3-Year Survival Update on Pembrolizumab for Locally Advanced or Metastatic NSCLC
Posted: Monday, March 1, 2021
At the International Association for the Study of Lung Cancer (IASLC) 2020 World Conference on Lung Cancer in Singapore (WCLC), held in virtual format in January 2021, Byoung Chul Cho, MD, PhD, of Yonsei Cancer Center, Seoul, Korea, and colleagues presented updated data from the KEYNOTE-042 study on first-line pembrolizumab monotherapy for patients with non–small cell lung cancer (NSCLC; Abstract FP13.03). The researchers reported improved overall survival, objective response rate, and progression-free survival in this group when compared with platinum-based chemotherapy.
“Patients who completed 35 cycles of pembrolizumab had durable responses, and second-course pembrolizumab was feasible and associated with antitumor activity,” the study authors concluded. “These findings continue to support first-line pembrolizumab in patients with locally advanced/metastatic PD-L1–positive NSCLC without sensitizing EGFR/ALK alterations.”
The researchers focused on 1,274 patients with locally advanced or metastatic NSCLC without sensitizing EGFR/ALK alterations with a PD-L1 tumor proportion score of 1% or greater. Participants were randomly assigned 1:1 to receive either 200 mg of pembrolizumab for 35 cycles or four to six cycles of chemotherapy (carboplatin AUC of 6/5 plus 200 mg/m2 of paclitaxel or 500 mg/m2 of pemetrexed). Patients with progressive disease after completing 35 cycles of pembrolizumab were allowed to receive second-course therapy.
Treatment-related adverse events of grades 3 to 5 affected 120 patients in the pembrolizumab group and 256 patients in the chemotherapy group. A total of 102 patients completed the full 35 cycles of pembrolizumab. Partial and complete responses were achieved in 84 and 2 patients, respectively. At the time of analysis, 78.4% of these patients remained alive, and the 1-year overall survival rate was 91.1%. Second-course pembrolizumab was administered to 26 patients, and their objective response and disease control rates were 15.4% and 76.9% after treatment initiation, respectively, with 80% of patients alive at data cutoff.
Disclosure: For full disclosures of the study authors, visit wclc.iaslc.org.