Updated study results presented at the World Congress on Lung Cancer this week continue to demonstrate that treatment of advanced non small cell lung cancer (NSCLC) whose tumors expressed high levels of PD-1 with Keytruda® (pembrolizumab) is superior to standard chemotherapy and significantly improves survival.
Lung cancer remains the leading cause of cancer-related deaths worldwide. In the United States, NSCLC accounts for 75–80% of all lung cancers. Although progress has been made in recent years, the majority of patients with advanced stage lung cancer still die from their disease. New treatments are needed. Precision medicine continues to impact the lives of lung cancer patients with research into genomics and genetics leading to unprecedented progress in improving outcomes. Tailored treatments have emerged to match a person’s genetic makeup or a tumor’s genetic profile. As a result, patients with lung cancer now typically receive molecular testing that guides their physicians in determining which therapies are more likely to boost the chances of survival while limiting the potential for adverse effects. Results from studies evaluating immunomodulatory approaches using anti-PD-1 and anti-PD-L1 antibodies have demonstrated promising results and are advancing the standard of care for lung cancer.
PD-1 is a protein that inhibits certain types of immune responses. Drugs that block PD-1, such as Keytruda may enhance the ability of the immune system to fight cancer. In earlier studies Keytruda has demonstrated anticancer activity in lung cancer and has been previously approved for the treatment of advanced melanoma.
KEYNOTE-024 is a clinical trial that directly compares Keytruda to standard platinum-based chemotherapies in the treatment of patients with advanced NSCLC whose tumors expressed high levels of PD-L1. The study enrolled 305 patients to receive Keytruda or platinum-based chemotherapies: paclitaxel+carboplatin, pemetrexed+carboplatin, pemetrexed+cisplatin, gemcitabine+carboplatin, or gemcitabine+cisplatin. Patients treated with platinum based chemotherapy had the option of crossing over to Keytruda upon disease progression.
It was initially reported that Keytruda was superior compared to chemotherapy for delaying the time to cancer progression-and improving overall survival. Based on these results, an independent Data Monitoring Committee (DMC) has recommended that the trial be stopped, and that patients receiving chemotherapy in KEYNOTE-024 be offered the opportunity to receive Keytruda. Additional follow up now demonstrates that the average overall survival for Keytruda patients is 30 months compared to only 14 months for chemotherapy treated patients. The 24-month overall survival rate was 51.5 percent in the KEYTRUDA group compared to 34.5 percent in the chemotherapy group.
- (2016.) Merck’s KEYTRUDA (pembrolizumab) demonstrates superior progression-free and overall survival compared to chemotherapy as first line treatment in patients with advanced non-small cell lung cancer. [Press release.] http://www.mercknewsroom.com/news-release/oncology-newsroom/mercks-keytruda%C2%A0pembrolizumab-demonstrates-superior-progression-free- Accessed June 21, 2016.
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