In a nutshell
This trial determined whether combining chemotherapy and immunotherapy would be beneficial for patients with advanced non-small-cell lung cancer (NSCLC). The authors concluded that a combination of chemotherapy agents, carboplatin (Paraplatin) and pemetrexed (Alimta), with the immunotherapy agent pembrolizumab (Keytruda) was tolerable and effective in treating patients with advanced NSCLC.
Some background
Chemotherapy using two agents (doublet chemotherapy) is the first-line of treatment for patients with advanced NSCLC. In recent times there is some evidence to suggest that combining chemotherapy with immunotherapy may be beneficial to cancer patients. One such immunotherapy agent is pembrolizumab, which works to help activate the patients’ own immune cells against the cancer. Further studies are needed to determine whether combining chemotherapy and immunotharpy is beneficial in advanced NSCLC.
Methods & findings
This study examined the safety and effectiveness of the chemotherapies carboplatin and pemetrexed combined with pembrolizumab.
121 patients with advanced NSCLC who had not received previous chemotherapy were included in this trial. 59 patients in group 1 received the chemotherapies carboplatin and pemetrexed with the immunotherapy pembrolizumab. 62 patients in group 2 received only the chemotherapies.
55% of patients in group 1 saw a response to treatment, compared to 29% of patients in group 2.
For patients in group 1, 38% had disease progression compared to 52% for patients in group 2. Average time to progression was 13 months in group 1 and 8.9 months in group 2.
93% of patients in group 1 and 90% of patients in group 2 experienced side effects. The most common side effects were fatigue, nausea, anemia (low red blood cell levels), rash and hair loss. One patient in group 1 and 2 patients in group 2 died due to treatment related side effects.
The bottom line
The authors concluded that a combination of carboplatin, pemetrexed and pembrolizumab is effective and tolerable as a treatment for patients with advanced NSCLC.
The fine print
The study was funded by Merck & Co., the manufacturers of pembrolizumab.
Published By :
The Lancet. Oncology
Date :
Oct 10, 2016
