Oncology Department, CHRU Brest, Brest, France.
Pulmonology Department, CHU Hôpital Ponchaillou, Rennes, France.
Cancer Med. 2020 Apr;9(7):2309-2316. doi: 10.1002/cam4.2806. Epub 2020 Feb 5.
The KEYNOTE-024 trial demonstrated that pembrolizumab, a PD-1 inhibitor, significantly improves progression-free survival (PFS) and overall survival (OS) in selected patients with previously untreated advanced non-small cell lung cancer (NSCLC) with a PD-L1 tumor proportion score (TPS) ≥50% and without EGFR/ALK aberrations. The main aim of this study was to report the efficacy and safety profile of pembrolizumab in real-life conditions.
This was a French retrospective multicenter longitudinal study of 108 consecutive patients with advanced NSCLC, a PD-L1 TPS ≥50% and without EGFR/ALK aberrations who were treated by pembrolizumab, in first line. Patient data were obtained from medical files.
The main characteristics of the cohort were: median age [range] 66.7 [37-87] years, 64.8% male, 23.1% with a performance status (PS) of 2, and 88.9% current or former smokers. Eighty-seven percent had stage IV NSCLC at diagnosis, 9.2% untreated brain metastases at inclusion,. With a median follow-up of 8.2 months, the median PFS was 10.1 months (95% CI, 8.8-11.4). The objective response rate was 57.3% (complete response 2.7%, partial response 54.6%). Disease control rate was 71.1%. At 6 months, the OS rate estimated was 86.2%. Treatment-related adverse events (AE) of grade 3 occurred in 8% of patients. There were no grade 4 or 5 AEs.
In a real-life cohort of advanced NSCLC patients (including PS 2 and untreated brain metastases), with PD-L1 TPS ≥50%, pembrolizumab demonstrates similar PFS to the pivotal clinical trial.
KEYNOTE-024 试验表明,PD-1 抑制剂帕博利珠单抗显著改善了未经治疗的晚期非小细胞肺癌(NSCLC)患者的无进展生存期(PFS)和总生存期(OS),这些患者的肿瘤比例评分(TPS)≥50%且无 EGFR/ALK 异常。本研究的主要目的是报告帕博利珠单抗在真实环境中的疗效和安全性概况。
这是一项法国回顾性多中心纵向研究,纳入了 108 例晚期 NSCLC 患者,这些患者的 PD-L1 TPS≥50%且无 EGFR/ALK 异常,一线接受帕博利珠单抗治疗。患者数据来自病历。
队列的主要特征为:中位年龄[范围]66.7[37-87]岁,64.8%为男性,23.1%的体能状态(PS)为 2 分,88.9%为当前或既往吸烟者。87%的患者在诊断时为 IV 期 NSCLC,9.2%的患者在纳入时无治疗的脑转移。中位随访 8.2 个月时,中位 PFS 为 10.1 个月(95%CI,8.8-11.4)。客观缓解率为 57.3%(完全缓解 2.7%,部分缓解 54.6%)。疾病控制率为 71.1%。6 个月时,估计 OS 率为 86.2%。3 级治疗相关不良事件(AE)发生在 8%的患者中。无 4 级或 5 级 AE。
在 PD-L1 TPS≥50%、包括 PS 2 和未治疗脑转移的晚期 NSCLC 患者的真实队列中,帕博利珠单抗的 PFS 与关键临床试验相似。