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Keytruda success continues, beating Opdivo in lung cancer survival

Published on 17/04/18 at 08:10am

Not content with revealing two strong waves of data on its flagship immunotherapy Keytruda (pembrolizumab) over the past weeks, MSD is once again flexing its product’s muscles, this time unveiling that the anti-PD-1 drug has excelled in combination with chemotherapy in the first-line treatment of metastatic nonsquamous non-small cell lung cancer (NSCLC).

The Phase 3 data demonstrated that, when combined with pemetrexed and cisplatin or carboplatin, Keytruda reduced the risk of death by half compared to chemotherapy alone, considerably improving overall survival (OS). This OS benefit was observed irrespective of PD-L1 expression in three tested groups: those whose tumours were negative, those whose tumour proportion scores were between 1-49%, and those 50% and above.

The drug also demonstrated a “significant improvement” in progression-free survival, reducing the risk of progression or death for 48% of all participants. There were three treatment-related deaths during the trial as a result of pneumonitis.

The success, particularly in the gold standard of overall survival, puts Keytruda out in front compared to rival Opdivo, which in the same week was shown to “significantly” halt disease progression in newly-diagnosed advanced NSCLC in patients with a high tumour mutational burden.

“In this trial, Keytruda in combination with pemetrexed and platinum chemotherapy, compared with chemotherapy alone, prolonged overall survival and progression-free survival in patients with advanced nonsquamous non-small cell lung cancer regardless of PD-L1 expression,” explained Dr Leena Gandhi, Director of Thoracic Medical Oncology at NYU Langone’s Perlmutter Cancer Center and lead author of The New England Journal of Medicine paper. “There is good scientific rationale for combining Keytruda with pemetrexed and platinum chemotherapy, and these clinical data now suggest this combination as a new standard of care for the first-line treatment of these nonsquamous non-small cell lung cancer patients.”

Dr Roger M Perlmutter, President of Merck Research Laboratories, also commented: “Our goal is to extend the lives of patients with lung cancer, and the unambiguous survival findings from KEYNOTE-189 showing the risk of death was reduced by half in the Keytruda arm are important not only for patients but also for the medical community. The results of this trial have the potential to change the treatment paradigm for patients with nonsquamous non-small cell lung cancer in the first-line setting, including patients whose tumours are either PD-L1 negative or are untested.”

Matt Fellows

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