Dr. Lopes on the KEYNOTE-042 Results of Frontline Pembrolizumab in NSCLC

Gilberto Lopes, MD, a medical oncologist at the Sylvester Comprehensive Cancer Center, University of Miami Health System, discusses findings from the KEYNOTE-042 trial of frontline treatment with pembrolizumab (Keytruda) for patients with squamous and nonsquamous non—small cell lung cancer in an interview with OncLive during the 2018 ASCO Annual Meeting.

KEYNOTE-042 assessed the efficacy of pembrolizumab versus standard chemotherapy in patients with PD-L1 expression with a tumor proportion score of 1% or greater. This trial was designed for patients with either squamous or nonsquamous histology, as well, Lopes explains. The primary endpoint was overall survival (OS) which was tested sequentially for those with either PD-L1 expression of 1% or greater, 20% and greater, and 50% and greater. OS was improved across subgroups. In addition, progression-free survival was not positive at this interim analysis. The duration of response with pembrolizumab, he adds, was improved in all subgroups.

Combinations of chemotherapy and immunotherapy have also demonstrated improvements in survival outcomes for patients with NSCLC. Lopes advises that patients with high-volume disease and low PD-L1 expression should receive the combination regimen, while those with low-volume disease and high PD-L1 expression are appropriate candidates for pembrolizumab monotherapy.

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