Oligometastatic NSCLC: pembrolizumab reduces progression after local therapy

  • Bauml JM & al.
  • JAMA Oncol
  • 11 Jul 2019

  • curated by Kelli Whitlock Burton
  • Univadis Clinical Summaries
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Takeaway

  • Patients with oligometastatic NSCLC who received pembrolizumab after locally ablative therapy (LAT) had progression-free survival (PFS) nearly 3 times longer than PFS reported in previous studies of LAT alone.

Why this matters

  • This study is the first to show improved outcomes with immunotherapy after LAT in oligometastatic NSCLC.
  • A randomized, multicenter trial of LAT with/without pembrolizumab is planned. 

Study design

  • Phase 2 trial.
  • 45 patients with oligometastatic NSCLC at diagnosis received pembrolizumab 4-12 weeks after undergoing LAT (surgery, chemoradiotherapy, stereotactic radiotherapy, and/or interventional ablation).
  • 25.0-month median follow-up.
  • Funding: Merck & Co., Inc., Kenilworth, NJ, USA; the Abramson Cancer Center.

Key results

  • Median PFS from the start of LAT (PFS-L) was significantly longer than that in previously reported studies (19.1 vs 6.6 months; P=.005).
  • Median PFS from the start of pembrolizumab therapy (PFS-P) was 18.7 months.
  • Mean OS was 90.9% at 1 year and 77.5% at 2 years.
  • 23 patients had disease progression.
  • Only 1 patient reported a grade 4 adverse event (pneumonitis).
  • No association between PFS-L and PD-L1 or CD8 status.
  • No decrease in QoL was reported.

Limitations

  • Single-center, single-group study.

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