![]() ![]() With 5 years of follow-up available for KEYNOTE-024, median overall survival (OS) was 26.3 months (95% CI, 18.3–40.4), and the 5-year survival rate was 32% in the pembrolizumab arm for enrolled patients with metastatic NSCLC (PD-L1 TPS ≥50%) and no sensitizing EGFR or ALK alterations ( 2). Supported by findings from the phase 3 randomized controlled trial, KEYNOTE-024 ( 1), this approval, in October 2016, was for pembrolizumab monotherapy in metastatic NSCLC with no EGFR or ALK genomic alterations and PD-L1 tumor proportion score (TPS) ≥50%, determined using a companion diagnostic test. Pembrolizumab was the first immune checkpoint inhibitor (ICI) of programmed cell death 1/programmed cell death ligand 1 (PD-1/PD-L1) approved in the United States (US) as a first-line treatment for metastatic non-small cell lung cancer (NSCLC). For 151/228 patients (66%) who discontinued pembrolizumab, the most common reasons were disease progression (70 ) and therapy-related adverse effects (35 ).Ĭonclusions: Real-world outcomes remain consistent with outcomes observed in clinical trials, supporting long-term benefits of first-line pembrolizumab monotherapy for patients with metastatic NSCLC, PD-L1 expression ≥50%, and good performance status. In the spotlight cohort, median rwPFS was 7.3 months (95% CI, 5.7–9.2) 88 patients (38.6% 95% CI, 32.2–45.2) experienced rwTR of complete or partial response. Median OS was 19.6 months (95% CI, 16.6–24.3) and 21.1 months (95% CI, 16.2–28.9), respectively 3-year OS rates were 36.2% and 38.2% in EHR and spotlight cohorts, respectively. Median follow-up from pembrolizumab initiation to data cutoff was 35.1 months (range, 12.0–52.7) and 38.4 months (range, 33.1–44.9) in EHR and spotlight cohorts, respectively. ![]() Results: The EHR cohort included 566 patients (298 men) the spotlight cohort included 228 (105 men) median age in both cohorts was 71. Kaplan-Meier analysis was used to determine overall survival (OS both cohorts) and, for the spotlight cohort, real-world progression-free survival (rwPFS) and real-world tumor response (rwTR). Methods: This retrospective two-cohort study used technology-enabled abstraction of deidentified electronic health records (EHR cohort) plus enhanced manual chart review (spotlight cohort) to study adult patients with stage IV NSCLC, PD-L1 expression ≥50%, no documented EGFR/ ALK/ROS1 genomic aberration, and ECOG performance status 0–1 who initiated first-line pembrolizumab monotherapy from 1-November-2016 to 31-March-2020 (EHR cohort, with data cutoff 31-March-2021) or from 1-December-2016 to 30-November-2017 (spotlight cohort, with data cutoff 31-August-2020). Our aim was to describe long-term outcomes of first-line pembrolizumab monotherapy at US oncology practices for patients with metastatic NSCLC, PD-L1 expression ≥50%, and good performance status. Objectives: Immune checkpoint inhibitors (ICIs) of programmed cell death 1/programmed cell death ligand 1 (PD-1/PD-L1) have been rapidly adopted in US clinical practice for first-line therapy of metastatic non-small cell lung cancer (NSCLC) since regulatory approval in October 2016, and a better understanding is needed of long-term outcomes of ICI therapy administered in real-world settings outside of clinical trials. ![]() 3Clinical Research, Merck & Co., Inc., Kenilworth, NJ, United States.2Center for Observational and Real World Evidence, Merck & Co., Inc., Kenilworth, NJ, United States.1Perlmutter Cancer Center, New York University, New York, NY, United States.Vamsidhar Velcheti 1*, Xiaohan Hu 2, Lingfeng Yang 2, M. ![]()
0 Comments
Leave a Reply. |