Use of pembrolizumab resulted in a higher objective response rate (ORR) than, but similar progression-free survival (PFS) as, nivolumab among patients with recurrent or advanced non-small cell lung cancer (NSCLC), according to a retrospective analysis published in Scientific Reports.
“The efficacies of pembrolizumab and nivolumab have never been directly compared in a real-world study,” which led to this retrospective analysis, the authors wrote.
The study included 225 patients with recurrent or advanced NSCLC treated with pembrolizumab or nivolumab at the Cancer Center of the Chinese People’s Liberation Army between 2015 and 2019. The median age of the cohort was 61 years and 75% were male. The majority of disease was nonsquamous, and the remainder of patients had squamous histology. Pembrolizumab was more likely to be used in the frontline setting or as a combination therapy compared with nivolumab. Other baseline characteristics were similar between the groups.
The ORR was higher with pembrolizumab at 43% compared with 23% with nivolumab (P =.001). The ORR remained higher with pembrolizumab across subgroup analyses, including first-line treatment and combination therapy as first-line therapy.
PFS was similar between the groups, with a median of 23 weeks with pembrolizumab and a median of 21 weeks with nivolumab (P =.4031); similar results were observed with a multivariate analysis (hazard ratio, 0.917; 95% CI, 0.663-1.267; P =.598). There was also no difference in PFS between the groups in several subgroups, including first-line treatment and combination therapy as first-line treatment. Nivolumab significantly prolonged PFS when administered in combination as a second- or subsequent-line therapy (P =.04).
A multivariate analysis, however, found no difference in PFS between subgroups.
The authors concluded that because “pembrolizumab and nivolumab demonstrated similar survival benefits in patients with recurrent or advanced NSCLC in various clinical settings … our study may support the current clinical practice of choosing either drug based on patient and clinician preferences.”
Cui P, LI R, Huang Z, et al. Comparative effectiveness of pembrolizumab vs. nivolumab in patients with recurrent or advanced NSCLC. Sci Rep. 2020;10:13160. doi:10.1038/s41598-020-70207-7