As discussed in Drugline Volume 354, pembrolizumab is available on the Pharmaceutical Benefits Scheme (PBS) for the first-line treatment of metastatic non-small cell lung cancer.
In the original KEYNOTE-024 trial, the median duration follow up was 11.2 months and pembrolizumab was associated with a significantly longer progression-free survival (10.3 versus 6.0 months) and overall survival at six months (80.2% versus 72.4%) compared to platinum-based chemotherapy.
An updated analysis of KEYNOTE-024 with a median follow up duration of 25.2 months demonstrated pembrolizumab to have a significantly improved overall survival (30 months vs 14.2 months) and a median duration of response not reached.
The 24-month overall survival rate was 51.5% in the pembrolizumab group vs 34.5% in the chemotherapy group.
The incidence of treatment-related adverse effects remains consistent as the interim data, pembrolizumab at 76.6% and chemotherapy at 90%. However, immune-mediated adverse effects including hypo- and hyperthyroidism, pneumonitis, skin toxicity and infusion reactions were markedly higher, with pembrolizumab at 33.8% and chemotherapy at 5.3%.
- Keytruda®(pembrolizumab) Australian approved product information. Macquarie Park: Merck Sharp & Dohme. Approved March 2019.
- Reck, M et al Updated Analysis of KEYNOTE-024: Pembrolizumab Versus Platinum-Based Chemotherapy for Advanced Non-Small-Cell Lung Cancer With PD-L1 Tumor Proportion Score of 50% Or Greater. Clinical Oncology 2019; 37:7: 537-546