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3-Year Survival Update of KEYNOTE-024: Comparison of Pembrolizumab and Chemotherapy

By: Celeste L. Dixon
Posted: Thursday, November 14, 2019

Long-term survival updates of the KEYNOTE-024 trial, comparing first-line pembrolizumab monotherapy with platinum-based chemotherapy for patients with advanced non–small cell lung cancer, found that overall survival with pembrolizumab exceeded that with chemotherapy, despite a majority of patients in the original chemotherapy arm crossing over to pembrolizumab. These results, with a median follow-up of 44.4 months, were presented by Martin Reck, MD, PhD, of Lung Clinic Grosshansdorf, Germany, and colleagues at the International Association for the Study of Lung Cancer (IASLC) 2019 World Conference on Lung Cancer (WCLC) in Barcelona (Abstract OA14.01).

Of 38 patients who completed 2 years of pembrolizumab (35 cycles), 34 had a durable clinical benefit and were alive at data cutoff. Pembrolizumab was also associated with less toxicity than chemotherapy.

“Median overall survival in the pembrolizumab arm was 26.3 months (95% confidence interval [CI] = 18.3–40.4 months) versus 14.2 months (CI = 9.8–18.3 months) in the chemotherapy arm (hazard ratio = 0.65),” reported Dr. Reck and his team. The original randomized cohort included 305 patients (pembrolizumab, n = 154; chemotherapy, n = 151). Initial stratification was by Eastern Cooperative Oncology Group status (0 or 1), tumor histology (squamous/nonsquamous), and region (East Asian/non–East Asian).

The 36-month overall survival rates were 43.7% and 24.9% for the pembrolizumab and chemotherapy arms, respectively. During or outside of the study, 98 patients (64.9%) crossed over from chemotherapy to the PD-L1 inhibitor. By the end of follow-up, 210 of the 305 patients had died (pembrolizumab, n = 97; chemotherapy, n = 113).

Disclosure: The study authors’ disclosure information may be found at wclc2019.iaslc.org.



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