The following article features coverage from the IASLC 2019 World Conference on Lung Cancer meeting. Click here to read more of Cancer Therapy Advisor‘s conference coverage.

As a first-line single agent, pembrolizumab showed an overall survival (OS) benefit compared with platinum-based chemotherapy at 3 years of follow-up in patients with advanced non-small cell lung cancer (NSCLC), a PD-L1 tumor proportion score of equal to or greater than 50%, and no targetable EGFR/ALK alterations. The findings from the phase 3 KEYNOTE-024 study were presented at the IASLC 2019 World Conference on Lung Cancer hosted by the International Association for the Study of Lung Cancer in Barcelona, Spain.1,2

The trial randomly assigned 305 patients with advanced NSCLC patients to receive pembrolizumab alone for 2 years (154 patients) or platinum-based chemotherapy for 4 to 6 cycles followed by optional maintenance (151 patients).

At 3 years of follow-up, patients who received pembrolizumab had significantly improved survival compared with those who received chemotherapy (hazard ratio [HR], 0.65; 95% CI, 0.50-0.86); P =.001). The median OS was approximately a year longer for the pembrolizumab group compared with the chemotherapy group (26.3 months vs 14.2 months). In addition, the 3-year OS rate was 43.7% in the pembrolizumab group and 24.9% in the chemotherapy group.

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A total of 38 patients completed 2 years of treatment with pembrolizumab, of whom 31 achieved a response, 22 have an ongoing response, and 27 still have disease control.

Treatment-related adverse events of any grade occurred less frequently in the pembrolizumab group compared with the chemotherapy group (77% vs 90%, respectively). Grade 3 or higher treatment-related adverse events were also less frequent in the pembrolizumab group compared with the chemotherapy cohort (31% vs 53%, respectively). Grade 3 or higher immune-mediated adverse events and infusion-related reactions, however, were higher in the pembrolizumab group compared with the chemotherapy group (13% vs 1%, respectively).

Read more of Cancer Therapy Advisor‘s coverage of the IASLC annual meeting by visiting the conference page.

References

  1. Reck M, Rodríguez-Abreu D, Robinson AG, et al. KEYNOTE-024 3-year survival update: Pembrolizumab vs platinum-based chemotherapy for advanced non–small-cell lung cancer. Presented at: IASLC 2019 World Conference on Lung Cancer hosted by the International Association for the Study of Lung Cancer; September 7-10, 2019; Barcelona, Spain. Abstract OA14.01.
  2. International Association for the Study of Lung Cancer. KEYNOTE-024 three-year survival update: Pembrolizumab effective as first-line therapy for advanced non–small-cell lung cancer [press release]. Published September 10, 2019. Accessed September 10, 2019.