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WCLC 2020: Adding Ipilimumab to Pembrolizumab for Metastatic NSCLC

By: Julia Fiederlein
Posted: Monday, February 8, 2021

In the KEYNOTE-024 trial, pembrolizumab monotherapy seemed to significantly improve survival compared with platinum-doublet chemotherapy in patients with metastatic non–small cell lung cancer (NSCLC) who had high levels of PD-L1 expression and no targetable EGFR or ALK aberrations. Michael Boyer, MBBS, PhD, of the University of Sydney, Australia, and colleagues conducted the phase III KEYNOTE-598 study to determine whether adding ipilimumab to pembrolizumab improves efficacy in this population. The results were presented in January 2021 during the virtual edition of the International Association for the Study of Lung Cancer (IASLC) 2020 World Conference on Lung Cancer in Singapore (WCLC; Abstract PS01.09).

“Adding ipilimumab to pembrolizumab does not improve efficacy and is associated with greater toxicity than pembrolizumab alone as first-line therapy,” the investigators commented. “These data confirm pembrolizumab monotherapy as a standard-of-care for this population.”

Patients were randomly assigned in a 1:1 ratio to receive pembrolizumab with ipilimumab (n = 282) or a placebo (n = 281). A total of 272 patients died; the median durations of overall survival were 21.4 and 21.9 months with ipilimumab and the placebo, respectively (hazard ratio = 1.08; P = .74). The difference in the restricted mean survival time was –0.56 at the maximum observation time and –0.52 at 24 months.

The median duration of progression-free survival was 8.2 months with ipilimumab and 8.4 months with the placebo (hazard ratio = 1.06; P = .72). In both arms, the objective response rate was 45.4%. The median durations of response were 16.1 and 17.3 months with ipilimumab and the placebo, respectively.

Treatment-related adverse events occurred at a higher rate with ipilimumab than with the placebo (76.2% vs. 68.3%). Immune-mediated adverse events and infusion reactions were reported in 44.7% of patients treated with ipilimumab and in 32.4% of those treated with the placebo.

Disclosure: For full disclosures of the study authors, visit wclc2020.iaslc.org.



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