medwireNews: Previously untreated patients with stage IV squamous non-small-cell lung cancer (NSCLC) report an improved health-related quality of life (HRQoL) if carboplatin plus paclitaxel or nab-paclitaxel is supplemented with pembrolizumab, KEYNOTE-407 study results suggest.
Julien Mazieres (Hôpital Larrey, Toulouse, France) and study co-authors found that the EORTC QLQ-C30 score for patients given pembrolizumab with chemotherapy increased by a least mean squares of 1.8 points at week 9 and by 4.3 points at week 18, from the initial mean baseline score of 63.9 points.
In comparison, the placebo group had a similar baseline mean EORTC QLQ-C30 score of 62.7 points, but by weeks 9 and 18, this score had decreased by a least mean squares of 1.80 and 0.57 points, respectively.
The investigators say in the Journal of Clinical Oncology, that “[t]hese results support use of pembrolizumab plus chemotherapy as first-line therapy for metastatic squamous NSCLC,” which is in line with their previously reported efficacy findings.
In the phase 3 study, pembrolizumab 200 mg or placebo was administered to 278 and 280 patients, respectively, in addition to carboplatin plus paclitaxel or nab-paclitaxel every 3 weeks for 4 cycles, after which pembrolizumab or placebo were administered alone for 31 remaining cycles.
At all time-points during the median follow-up of 7.8 months, the general health score (GHS)/QoL score of patients who received pembrolizumab was maintained above the baseline score, with the largest improvement seen at week 18, when the platinum–taxane therapy had ended.
The score for these patients was also invariably higher than that for patients receiving placebo, with a least squares mean difference between the groups of 3.8 and 4.9 points at weeks 9 and 18, respectively.
This association between pembrolizumab and higher GHS/QoL scores was reinforced by a greater number of patients given the drug reporting an improved GHS/QoL status, compared with those given placebo (30.4 vs 24.5% at week 9 and 36.2 vs 27.7% at week 18), and fewer reporting a deterioration in GHS/QoL status (26.1 vs 29.5% at week 9 and 22.8 vs 31.3% at week 18). A change in score of 10 points or more was needed to classify status as improved or deteriorated.
The proportion of participants that experienced deterioration in the composite endpoint of cough, chest pain, and dyspnea was lower in the pembrolizumab than placebo group, at 29% and 34%, respectively, but the median time to deterioration was unreached in both groups at data cutoff. Mazieres and colleagues note, however, that there was a trend towards a delay in deterioration with the addition of pembrolizumab.
They continue: “These outcomes are clinically meaningful in the context of demographic/clinical characteristics of the KEYNOTE-407 study population, most of whom were current/former smokers, ≥65 years of age, with an Eastern Cooperative Oncology Group performance status of 1.”
By Hannah Kitt
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