Can combination therapy increase lung cancer survival

From ASCO Daily News

Combining pembrolizumab with conventional chemotherapy in the first-line setting significantly prolongs median overall survival in patients with metastatic squamous non–small cell lung cancer (NSCLC), according to data from the global phase III KEYNOTE-407 trial.

The median overall survival reached 11.3 months with carboplatin and paclitaxel/nab-paclitaxel but increased to 15.9 months when pembrolizumab was paired with the chemotherapy. The overall survival benefit observed with the pembrolizumab/chemotherapy regimen persisted across all relevant patient subgroups, including those with tumor PD-L1 expression categorized as low, intermediate, or high.

“These data suggest pembrolizumab plus carboplatin and paclitaxel or nab-paclitaxel should become a new standard of care for the first-line treatment of metastatic squamous NSCLC across all the different levels of PD-L1 expression,” Luis G. Paz-Ares, MD, PhD, of the Hospital Universitario 12 de Octubre, Spain, said during his presentation at the ASCO annual conference.

A total of 559 patients enrolled in the KEYNOTE-407 clincal trial. PD-L1 expression in tumor tissue was not a prerequisite for entry; however, patients were classified prior to randomization based on tumor PD-L1 expressionas well as the choice of either paclitaxel or nab-paclitaxel and geography (East Asia vs. rest of world). Individuals were randomly assigned to receive four cycles of carboplatin and paclitaxel/nab-paclitaxel plus either pembrolizumab or placebo. Thereafter, patients received pembrolizumab or placebo maintenance therapy in accord with the assigned induction regimen. Patients in the placebo arm who developed disease progression could cross over to receive pembrolizumab monotherapy at any time.

“This trial is clearly a win,” discussant Charles G. Drake, MD, PhD, of the Columbia University Herbert Irving Comprehensive Cancer Center, said, adding that the pembrolizumab/chemotherapy combination will become a new frontline standard of care.

Combination Therapy is one of the latest, exciting advances in lung cancer research that is proving to increase the overall survival rate for lung cancer patients – NSCLC or SCLC.

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