Abstract | INTRODUCTION: METHODS: We pooled data for patients with advanced NSCLC in KEYNOTE-021 cohort G (nonsquamous), KEYNOTE-189 (nonsquamous), and KEYNOTE-407 (squamous). Patients were assigned to platinum-doublet chemotherapy with or without the addition of 35 cycles of pembrolizumab 200 mg every 3 weeks. All studies permitted enrollment of patients with previously treated or untreated (KEYNOTE-189 and KEYNOTE-407 only) stable brain metastases. Patients with previously treated brain metastases were clinically stable for 2 or more weeks (≥4 wk in KEYNOTE-021 cohort G), had no evidence of new or enlarging brain metastases, and had no steroid use at least 3 days before dosing. Patients with known untreated asymptomatic brain metastases required regular imaging of the brain. RESULTS: A total of 1298 patients were included, 171 with and 1127 without baseline brain metastases. Median (range) durations of follow-up at data cutoff were 10.9 (0.1‒35.1) and 11.0 (0.1‒34.9) months, respectively. Hazard ratios (pembrolizumab + chemotherapy/ chemotherapy) were similar for patients with and without brain metastases for overall survival (0.48 [95% confidence interval (CI): 0.32‒0.70] and 0.63 [95% CI: 0.53‒0.75], respectively) and progression-free survival (0.44 [95% CI: 0.31‒0.62] and 0.55 [95% CI: 0.48‒0.63], respectively). In patients with brain metastases, median overall survival was 18.8 months with pembrolizumab plus chemotherapy and 7.6 months with chemotherapy, and median progression-free survival was 6.9 months and 4.1 months, respectively. Objective response rates were higher and duration of response longer with pembrolizumab plus chemotherapy versus chemotherapy regardless of brain metastasis status. Incidences of treatment-related adverse events with pembrolizumab plus chemotherapy versus chemotherapy were 88.2% versus 82.8% among patients with brain metastases and 94.5% versus 90.6% in those without. CONCLUSIONS:
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Authors | Steven F Powell, Delvys Rodríguez-Abreu, Corey J Langer, Ali Tafreshi, Luis Paz-Ares, Hans-Georg Kopp, Jeronimo Rodríguez-Cid, Dariusz M Kowalski, Ying Cheng, Takayasu Kurata, Mark M Awad, Jinaxin Lin, Bin Zhao, M Catherine Pietanza, Bilal Piperdi, Marina C Garassino |
Journal | Journal of thoracic oncology : official publication of the International Association for the Study of Lung Cancer
(J Thorac Oncol)
Vol. 16
Issue 11
Pg. 1883-1892
(11 2021)
ISSN: 1556-1380 [Electronic] United States |
PMID | 34265431
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
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Copyright | Copyright © 2021 Merck Sharp & Dohme Corp. and The Authors. Published by Elsevier Inc. All rights reserved. |
Chemical References |
- Antibodies, Monoclonal, Humanized
- Platinum
- pembrolizumab
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Topics |
- Antibodies, Monoclonal, Humanized
- Antineoplastic Combined Chemotherapy Protocols
(therapeutic use)
- Brain Neoplasms
(drug therapy)
- Humans
- Lung Neoplasms
(drug therapy)
- Platinum
(therapeutic use)
- Retrospective Studies
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