KEYNOTE-024 shows first-line pembrolizumab has long-term overall survival benefit in patients with advanced non-small cell lung cancer and PD-L1–expressing disease.
Although historically, the 5-year OS rate for patients with advanced NSCLC treated with chemotherapy is less than 5%, patients treated with nivolumab had a 5-year OS of 13.4%.
Preclinical studies performed in cell line and mouse models of lung adenocarcinoma showed that mesothelin-directed CAR-T was effective and not associated with toxicity.
OS was significantly higher in the subgroup of patients with high tumor expression of PD-L1 who received atezolizumab plus chemotherapy compared with chemotherapy alone.
Disease progression was accelerated in nearly 21% of NSCLC patients who received immunotherapy during the trial, suggesting this treatment may be detrimental for some.
The incidences of grade 3/4 AEs were high but similar in both study arms, although the rate of hematologic AEs was higher in the chemotherapy alone arm.
Continued molecular stratification in lung cancer appears imminent, and many of the patients in these genetic subgroups may benefit from the use of targeted therapies.
Prophylactic cranial irradiation was determined to be tolerable; few adverse effects were observed in patients with stage III NSCLC receiving this treatment.