Patients with early stage metastatic non-small cell lung cancer (NSCLC) whose tumors express high levels of PD-L1 have improved quality of life with pembrolizumab treatment versus standard of care platinum-containing chemotherapy, according to new research.
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Pembrolizumab is a monoclonal antibody that blocks the interaction between PD-1 and its ligands, PD-L1 and PD-L2, which activates t-lymphocytes. In a randomized, open-label, phase III trial comparing the effects of pembrolizumab versus platinum-containing chemotherapy for first-line treatment of patients with NSCLC, researchers examined health-related quality of life (HRQoL) change from baseline to week 15 measured by global health status (physical, emotional, cognitive, and social functioning as well as fatigue and pain) and time to deterioration (symptoms such as cough, chest pain, alopecia, and dyspnea), two factors measured by European Organization for Research and Treatment of Cancer (EORTC) Core Quality of Life Questionnaires. Researchers randomly assigned 305 patients with previously untreated, advanced NSCLC to receive either pembrolizumab or platinum-containing chemotherapy every 3 weeks for 4-6 cycles. The primary endpoint for the trial was progression-free survival (PFS), which was assessed by means of a blinded, independent, central radiologic review.
Results showed improved or maintained HRQoL and symptoms with pembrolizumab compared with chemotherapy. Improvement in global health status from baseline to week 15 for pembrolizumab was 6.9 (95% CI, 3.3-10.6) compared to -0.9 (95% CI, -4.8-3.0) for chemotherapy. More patients treated with pembrolizumab reported an improvement in global health status and/or quality of life, fatigue, and pain compared with patients treated with chemotherapy. Patients treated with pembrolizumab also experienced less deterioration that patients treated with chemotherapy (30.5% and 39.2%, respectively). Data were presented at the International Association for the Study of Lung Cancer (IASLC) 17TH Annual World Conference (December 4-7; Vienna, Austria).
“For people living with lung cancer, who often face serious health challenges brought on by the disease, quality of life is a major concern when determining treatment and the data presented today help us further understand the potential clinical benefit for [pembrolizumab] in these patients,” said Martin Reck, MD, PhD, Head of the Thoracic Oncology Department, Hospital Grosshansdorf (Germany).
