Pembrolizumab, Pemetrexed, and Carboplatin Improve Lung Cancer Survival

Article

Adding pembrolizumab to pemetrexed and carboplatin for advanced nonsquamous NSCLC is associated with improved overall survival at 24 months.

First-line pemetrexed/carboplatin (PC) plus pembrolizumab for advanced nonsquamous non–small-cell lung cancer (NSCLC) is associated with improved overall survival two years after treatment, according to an updated analysis from the phase I/II KEYNOTE-021 clinical trial (abstract 9026), presented at the 2018 American Society of Clinical Oncology (ASCO) Annual Meeting, held June 1–5 in Chicago.

“In this updated analysis from cohort G of KEYNOTE-021 after approximately 2 years median follow-up, the risk of death was nearly halved (hazard ratio, 0.56; P = .015) with the combination of pembrolizumab and PC compared with PC alone in patients with previously untreated, advanced, nonsquamous NSCLC, irrespective of PD-L1 expression,” reported Ryan D. Gentzler, MD, of the University of Virginia Health System in Charlottesville, and coauthors of a poster presentation.

Long-term objective response rate (ORR) was also nearly doubled (57% vs 30%; P = .0016).

“Pembrolizumab plus PC continues to demonstrate a manageable safety profile that is, overall, similar to that of standard chemotherapy” at 24 months, the team concluded.

At the time the updated analysis was performed, the median duration of treatment was 10.1 months for patients in the pembrolizumab plus PC study group and 4.9 months for those receiving PC alone.

No new or late-emerging safety signals for the pembrolizumab plus PC regimen were identified in the updated analysis. However, 55 patients (93%) in the pembrolizumab plus PC study group experienced treatment-related adverse events of any grade, and 24 patients (41%) experienced grade 3 or worse treatment-related toxicities, including one patient who died. In contrast, 92% of patients in the PC-only study group experienced treatment-related toxicities (any grade), and 27% had grade ≥ 3 toxicities, including two cases leading to patient deaths.

Grade ≥ 3 treatment-related adverse events for patients receiving pembrolizumab plus PC included anemia (11.9% vs 12.9% in the PC-only group), fatigue (3.4% vs 0%), and decreased neutrophil counts (6.8% vs 3.2%).

Recent Videos
Advocacy groups such as Cancer Support Community and the Leukemia & Lymphoma Society may help support patients with CML undergoing treatment.
Paolo Tarantino, MD, discusses the potential utility of agents such as datopotamab deruxtecan and enfortumab vedotin in patients with breast cancer.
Paolo Tarantino, MD, highlights strategies related to screening and multidisciplinary collaboration for managing ILD in patients who receive T-DXd.
Those with CML should discuss adverse effects such as nausea or fatigue with their providers to help optimize their quality of life during treatment.
Patients with CML can become an active part of their treatment plan by discussing any questions that come to mind with their providers.
Jorge E. Cortes, MD, emphasizes proper communication between patients with chronic myeloid leukemia and their providers during the treatment course.
Dietary interventions or other medications may help mitigate diarrhea in patients who undergo therapy for chronic myeloid leukemia.
Considering notable adverse effects associated with treatment may be critical when selecting therapy options for those with CML.
Byoung Chul Cho, MD, PhD, highlights ongoing trials assessing intravenous and subcutaneous amivantamab in EGFR-mutant non–small cell lung cancer.
An AI-based system may reduce the time needed to match patients with cancer to suitable clinical trials.
Related Content