KEY TAKEAWAYS
- The study aimed to compare long-term outcomes of pembrolizumab monotherapy versus combination therapy in patients with high PD-L1 NSCLC.
- Researchers noticed that combination therapy may offer benefits as a 1L treatment for selected patients with NSCLC.
Selecting pembrolizumab monotherapy (MONO) or pembrolizumab plus platinum-based chemotherapy (COMB) for patients with non-small cell lung cancer (NSCLC) and high programmed death-ligand 1 (PD-L1) expression is an important issue in clinical practice.
Yasuyuki Ikezawa and the team aimed to conduct a retrospective multicenter observational study of patients with NSCLC and high PD-L1 expression who received MONO or COMB as a first-line (1L) treatment and evaluated the long-term outcomes.
They performed an inclusive analysis of 298 patients with NSCLC and high PD-L1 expression who received MONO or COMB as a 1L treatment between December 2018 and January 2020. Medical records were reviewed to assess clinical efficacy and toxicity, utilizing a prolonged data cutoff for comprehensive evaluation.
About 164 patients (median age: 74 years) and 134 patients (median age: 68 years) received MONO and COMB, respectively; patients who received COMB were younger and had better performance statuses (0-1). At the prolonged data cutoff, the median follow-up was 20.2 (range: 0.1-41.4) months. The median progression-free survivals (PFS) were 7.5 and 13.1 months, and overall survivals (OSs) were 17.2 and 33.7 months for MONO and COMB, respectively.
Treatment discontinuation rates were 21.9% and 20.1% for MONO and COMB, respectively. With prolonged follow-up, although COMB demonstrated an OS benefit and higher objective response rate than MONO, in the propensity score matching analysis COMB didn’t demonstrate a significant benefit compared to MONO.
The study concluded that while COMB may offer a survival benefit and higher objective response rate compared to MONO, it did not show a significant advantage over MONO in the propensity score matching analysis. This suggests that COMB could be effective as a 1L treatment for NSCLC with high PD-L1 expression in a selected subset of patients.
The study did not receive any funds.
Source: https://pubmed.ncbi.nlm.nih.gov/39030894/
Ikezawa Y, Morita R, Mizugaki H, et al. (2024). “Real-world first-line treatment with pembrolizumab for non-small cell lung carcinoma with high PD-L1 expression: Updated analysis.” Cancer Med. 2024 Jul;13(14):e70036. doi: 10.1002/cam4.70036. PMID: 39030894; PMCID: PMC11258199.
