Pembrolizumab is now available on the Pharmaceutical Benefits Scheme (PBS) for the first-line treatment of metastatic non-small cell lung cancer (NSCLC) irrespective of programmed death ligand-1 (PD-L1) status.
In the KEYNOTE-189 trial, pembrolizumab was used in conjunction with pemetrexed and platinum chemotherapy in metastatic NSCLC irrespective of PD-L1 status, opening up a new standard of care for these patients. The median duration follow-up was 18.7 months, and pembrolizumab was associated with a significantly longer overall survival (22.0 versus 10.7 months) compared to pemetrexed and platinum-based chemotherapy alone.
The incidence of treatment-related adverse effects was similar between the treatment arms. However, immune-mediated adverse effects including hypothyroidism and hyperthyroidism, pneumonitis, skin toxicity, colitis and infusion reactions, were markedly higher with the pembrolizumab combination at 22.7% and chemotherapy at 11.9%.
- Gadgeel S, Garassino MC, Esteben E, Speranza G, Felip E, Hochmair MJ, et al. 03 keynote-189: os update and progression after the next line of therapy (PFS2) with pembrolizumab + chemotherapy for metastatic nonsquamous NSCLC. Journal of Thoracic Oncology 2019; 14(11): S1153.
- Gandhi L, Rodríguez-Abreu D, Gadgeel S, Esteban E, Felip E, De Angelis F, et al. Pembrolizumab plus chemotherapy in metastatic non-small-cell lung cancer. N Engl J Med. 2018; 378: 2078-92.
- Keytruda® (pembrolizumab) Australian approved product information. Macquarie Park: Merck Sharp & Dohme. Approved November 2019.