Outcomes With Pembrolizumab Monotherapy in Patients With Programmed Death-Ligand 1-Positive NSCLC With Brain Metastases: Pooled Analysis of KEYNOTE-001, 010, 024, and 042

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art_MANS_Outcomes_With_Pembrolizumab_Monotherapy_in_Patients_With_Programmed_2021.PDF (509.34 KB)
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44
Tipo de produção
article
Data de publicação
2021
DOI
Scopus
Web of Science
PubMed
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Título do Volume
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Autores
MANS, Aaron S.
HERBST, Roy S.
HUI, Rina
PELED, Nir
KIM, Dong-Wan
NOVELLO, Silvia
SATOUCHI, Miyako
WU, Yi-Long
GARON, Edward B.
Citação
JTO CLINICAL AND RESEARCH REPORTS, v.2, n.8, article ID 100205, 11p, 2021
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Unidades Organizacionais
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Resumo
Introduction: We retrospectively evaluated outcomes in patients with programmed death-ligand 1 (PD-L1)-positive non-small-cell lung cancer (NSCLC) to determine whether baseline (i.e., at study enrollment) brain metastases were associated with the efficacy of pembrolizumab versus chemotherapy.Methods: We pooled data for patients with previously treated or untreated PD-L1-positive (tumor proportion score [TPS], >= 1%) advanced or metastatic NSCLC in KEYNOTE-001 (NCT01295827), KEYNOTE-010 (NCT01905657), KEYNOTE 024 (NCT02142738), and KEYNOTE-042 (NCT02220894). Patients received pembrolizumab (2 mg/kg, 10 mg/kg, or 200 mg every 3 wk or 10 mg/kg every 2 wk); chemotherapy was a comparator in all studies except KEYNOTE-001. All studies included patients with previously treated, stable brain metastases.Results: A total of 3170 patients were included, 293 (9.2%) with and 2877 (90.8%) without baseline brain metastases; median (range) follow-up at data cutoff was 12.9 (0.1-43.7) months. Pembrolizumab improved overall survival versus chemotherapy in patients with or without baseline brain metastases: benefit was seen in patients with PD-L1 TPS >= 50% (0.67 [95% confidence intervals (CI): 0.44-1.02] and 0.66 [95% CI: 0.58-0.76], respectively) and PD-L1 TPS >= 1% (0.83 [95% CI: 0.62-1.10] and 0.78 [95% CI: 0.710.85], respectively). Progression-free survival was improved, objective response rates were higher, and duration of response was longer with pembrolizumab versus chemotherapy regardless of brain metastasis status. The incidence of treatment-related adverse events with pembrolizumab versus chemotherapy was 66.3% versus 84.4% in patients with brain metastases and 67.2% versus 88.3% in those without.Conclusions: Pembrolizumab monotherapy improved outcomes and was associated with fewer adverse events than chemotherapy in patients with treatment naive and previously treated PD-L1-positive advanced/metastatic NSCLC regardless of the presence of baseline treated, stable brain metastases.(c) 2021 The Authors.
Palavras-chave
Pembrolizumab, Brain metastases, Chemotherapy, Non-small-cell lung cancer, PD-L1
URI
https://observatorio.fm.usp.br/handle/OPI/57915
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Coleções
Artigos e Materiais de Revistas Científicas - FM/MDR
Artigos e Materiais de Revistas Científicas - HC/ICESP
Artigos e Materiais de Revistas Científicas - LIM/24
Artigos e Materiais de Revistas Científicas - ODS/03