medwireNews: The improved outcomes associated with the addition of first-line pembrolizumab to chemotherapy are maintained over longer follow-up in patients with metastatic, nonsquamous non-small-cell lung cancer (NSCLC) lacking EGFR or ALK alterations, indicate updated data from the KEYNOTE-189 trial.
At a median follow-up of 23.1 months, overall survival (OS) remained significantly better among the 410 participants who received pembrolizumab alongside pemetrexed and platinum versus their 206 counterparts who instead received placebo plus chemotherapy, at a median of 22.0 versus 10.7 months, and a hazard ratio (HR) for death of 0.56. The 24-month OS rates were 45.5% and 29.9%, respectively.
Progression-free survival (PFS) was similarly significantly improved in the pembrolizumab group, at a median of 9.0 months, compared with 4.9 months in the placebo group and an HR for progression or death of 0.48. At the 24-month timepoint, the corresponding PFS rates were 20.5% and 1.5%.
Lead author Shirish Gadgeel (University of Michigan, Ann Arbor, USA) and team note that the OS and PFS advantage afforded by the addition of pembrolizumab was observed regardless of PD-L1 expression levels, or the presence of liver or brain metastases at baseline.
They note that “no new safety signals were identified” with the extended follow-up, adding that the pembrolizumab–chemotherapy combination continues to have “a manageable toxicity profile.”
And the team concludes in the Journal of Clinical Oncology that these data support the pembrolizumab-based combination “as a standard-of-care first-line therapy” for this patient population.
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