Chemotherapy adds benefit to pembrolizumab in NSCLC with high PD-L1

  • Zhou Y & al.
  • J Immunother Cancer
  • 3 May 2019

  • curated by Kelli Whitlock Burton
  • Univadis Clinical Summaries
Access to the full content of this site is available only to registered healthcare professionals. Access to the full content of this site is available only to registered healthcare professionals.

Takeaway

  • Adding chemotherapy to first-line pembrolizumab offered better objective response rate (ORR) and PFS than pembrolizumab alone in patients with advanced NSCLC and a programmed cell death-ligand 1 (PD-L1) tumor proportion score (TPS) of ≥50%.

Why this matters

  • Pembrolizumab monotherapy is the preferred treatment for NSCLC with PD-L1 TPS ≥50%, but there are few data about the benefit of adding chemotherapy.

Study design

  • Meta-analysis of 5 RCTs with 1289 patients with advanced NSCLC PD-L1 TPS ≥50%.
  • Funding: National Key R&D Program of China; others.

Key results

  • Pembrolizumab+chemotherapy offered better ORR (relative risk [RR], 2.16; P<.001 pfs p and os than chemotherapy alone in direct comparison analysis.>
  • Pembrolizumab monotherapy offered better ORR (RR, 1.33; P=.002) and OS (HR, 0.67; P<.001 but not pfs than chemotherapy alone in direct comparison analysis.>
  • In indirect comparison, pembrolizumab+chemotherapy had better ORR (RR, 1.62; P=.003) and PFS (HR, 0.55; P=.037) than pembrolizumab monotherapy.

Limitations

  • No data on head-to-head comparisons.