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MSD’s Keytruda impresses in lung cancer chemotherapy trial

Published on 21/12/15 at 02:16pm
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MSD’s Keytruda significantly improved overall survival (OS) compared to chemotherapy in people with lung cancer and PD-L1 expression, a trial has found.

In the Phase II/III KEYNOTE-010 trial, Keytruda (pembrolizumab), improved overall survival compared to chemotherapy with docetaxel. 

The study is the first study of its kind to evaluate the potential of an immunotherapy compared to chemotherapy that is based on the prospective measurement of PD-L1 expression in patients with advanced non-small cell lung cancer (NSCLC), whose tumours expressed the PD-L1 gene.  

The gene codes for a cell surface receptor protein that is thought play a role in suppressing the immune system, and the development of cancer. Keytruda is a PD-1 inhibitor that stops the immune response from being blocked, so that the immune system can recognise and attack the cancer.

The study included 1,034 patients with advanced NSCLC with PD-L1 expression, who received either a 2 mg/kg dose of Keytruda every three weeks or an investigational 10 mg/kg dose of the drug every three weeks.

Both doses were shown to significantly improve overall survival compared with docetaxel: by 29% for the 2 mg/kg dose arm and 39% for the 10 mg/kg dose. The estimated one-year OS rates for Keytruda were 43.2% and 52.3% respectively, compared to 34.6% for docetaxel.

Median OS for Keytruda was 10.4 months and 12.7 months for the respective doses, compared to 8.5 months for docetaxel.

MSD said it plans to submit a supplemental biologics license application for Keytruda for this additional indication to the FDA, based on findings from KEYNOTE-010, by the end of 2015. The company also plans to submit a marketing authorisation application to the European Medicines Agency in early 2016.

Dr Roger Perlmutter, president of Merck Research Laboratories, says: “Because lung cancer remains one of the most common and most challenging cancers to treat, understanding the role that Keytruda can play in helping patients was essential to our development program. In this study in patients with PD-L1 expression of 1% or greater, Keytruda demonstrably improved overall survival compared to chemotherapy in previously-treated patients with non-small cell lung cancer, including both squamous and non-squamous histologies.”

Dr Roy Herbst, chief of medical oncology at the Yale Cancer Centre and Smilow Cancer Hospital at Yale-New Haven, adds: “This is an exciting time, and studies such as KEYNOTE-010 with Keytruda are paving the way to a better understanding of how to identify the right medicine for each patient These study findings show Keytruda provided superior overall survival in patients with advanced lung cancer who had positive PD-L1 expression, and support its potential in the treatment of this disease.”

Joel Levy

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