Dr. Malhotra on Pembrolizumab During Concurrent Chemoradiation in NSCLC

Jyoti Malhotra, MD, MPH, medical oncologist, Rutgers Cancer Institute of New Jersey, and assistant professor of medicine, Robert Wood Johnson Medical School, Rutgers University, discusses a phase I multicenter trial of PD-1 blockade with pembrolizumab (Keytruda) with concurrent chemoradiation in patients with locally advanced, unresectable non—small cell lung cancer (NSCLC).

The treatment landscape for stage III lung cancer has changed significantly because now when patients are treated with chemoradiotherapy, they are also treated with consolidation therapy with durvalumab (Imfinzi) for up to 1 year, Malhotra explained. This phase I study, which was presented at the 2019 ASCO Annual Meeting, is looking to improve outcomes for patients with NSCLC by optimizing the combination of radiation and immunotherapy, according to Malhotra.

In this trial, there were 6 different cohorts. The first 2 cohorts received immunotherapy after completion of chemoradiation. In the last cohort, on the other hand, patients were given immunotherapy and chemoradiation concurrently.

The combination does not have any limiting toxicities, which was defined as grade 4 pneumonitis. The combination seems to have clinical activity, with a progression-free survival is 20.3 months, which is significantly longer than historical outcomes, according to Malhotra.