Addition of pembrolizumab to chemotherapy extends survival in advanced lung cancer

Introducing first-line immunotherapy could benefit long-term outcomes in advanced non–small-cell lung cancer (NSCLC), a study has revealed^[1]
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In a phase III trial published in the New England Journal of Medicine (16 April 2018), researchers randomly assigned 616 patients with previously untreated metastatic non-squamous NSCLC without sensitising mutations to pemetrexed and a platinum-based drug, plus either 200mg of pembrolizumab or placebo, every 3 weeks for 4 cycles. This was followed by pembrolizumab or placebo for up to a total of 35 cycles plus pemetrexed maintenance therapy.

After a median follow-up of 10.5 months, the estimated overall survival in the pembrolizumab group was 69.2% compared with 49.4% in the placebo group. Median progression-free survival was 8.8 months in the pembrolizumab group and 4.9 months in the placebo group.

The addition of pembrolizumab did not appear to increase the frequency of adverse events.

The researchers concluded: “The addition of pembrolizumab to induction therapy with pemetrexed and a platinum-based drug, and to pemetrexed maintenance therapy, resulted in significantly longer overall survival and progression-free survival, and a higher response rate than the addition of placebo.”