Data from Pharmawand - Curated by EPG Health - Date added 11 September 2019

First-line monotherapy with Keytruda (pembrolizumab) from Merck Inc provides durable long-term overall survival benefit compared to chemotherapy in non-small cell lung cancer, according to new data from the phase III study Keynote -024. Patients were randomized to pembrolizumab 200 mg for two years or platinum doublet for four to six cycles plus optional maintenance (nonsquamous), with stratification by Eastern Cooperative Oncology Group score of 0 or 1, tumor histology (squamous/nonsquamous), and region (East Asia/non-East Asia).

Patients in the chemotherapy arm could cross over to pembrolizumab upon disease progression if they met eligibility criteria. The primary endpoint was progression-free survival and overall survival (OS) was a key secondary endpoint. The median overall survival length among patients in the pembrolizumab arm was 26.3 months compared to 14.2 months in the chemotherapy arm. The 36-month overall survival rate was 43.7 percent in the pembrolizumab arm vs 24.9 percent in the chemotherapy arm. Despite longer mean treatment duration in the pembrolizumab arm (11.1 vs 4.4 months), grade 3-5 treatment-related adverse events were less frequent with pembrolizumab vs chemotherapy.

In addition, initial results showed activity for a re-exposure to pembrolizumab for those patients who had progressed after having received two years of treatment with pembrolizumab with a response in 7 out of 10 patients (70 percent). Data were presented at the International Association for the Study of Lung Cancer World Conference.

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