Pembrolizumab a good option for NSCLC with PS2

  • Middleton G & al.
  • Lancet Respir Med
  • 19 Mar 2020

  • curated by Kelli Whitlock Burton
  • Univadis Clinical Summaries
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Takeaway

  • Pembrolizumab is safe and effective in patients with advanced NSCLC and performance status (PS) 2 as first- or subsequent-line therapy, offering outcomes similar to those in prior studies of patients with PS 0-1.

Why this matters

  • Clinical trials of pembrolizumab included only NSCLC patients with PS 0-1, even though about 18% of all NSCLC patients have PS2.
  • Currently, standard therapy for these patients in the United Kingdom is carboplatin-based chemotherapy as a first-line treatment and docetaxel as second-or-later line therapy.

Study design

  • Multicenter phase 2 trial.
  • 60 patients with advanced NSCLC and PS2 received pembrolizumab.
  • Funding: MSD.

Key results

  • Median follow-up, 10 months.
  • 40% received pembrolizumab as first-line therapy.
  • Median PFS, 4.4 months; median OS, 9.8 months.
  • 37% reported a durable clinical benefit (DCB; 38% as first-line; 36% as second or greater).
  • DCB higher in patients with greater tumor progression score (22% in TPS
  • Objective response rate was 27% overall (31% in previously treated patients and 21% in treatment-naïve patients).
  • 28% reported toxicity associated with dose delay or drug discontinuation.
  • No grade 5 adverse events.

Limitations

  • Single-arm, open-label study.