Evaluating pembrolizumab consolidation following chemotherapy and radiation for patients with stage III non-small cell lung cancer.

This trial was carried out to examine the effectiveness of pembrolizumab (Keytruda) consolidation therapy for patients with stage III unresectable non-small cell lung cancer (NSCLC) following a course of chemotherapy and radiation therapy. The authors found that pembrolizumab consolidation improved the outcomes of these patients.

NSCLC is a form of lung cancer that is responsible for 80% of new lung cancer cases. Around one-third of these new cases have stage III (locally advanced) disease at their time of diagnosis. The standard of care for patients with this condition is platinum-based chemotherapy with radiation therapy. Despite treatment options, the outcomes of these patients are poor. 

Pembrolizumab is an immunotherapy that works by helping the immune system detect and fight cancer. It has shown good response alone or combined with chemotherapy in patients with NSCLC. There is evidence that pembrolizumab consolidation treatment may be useful in treating patients with stage III NSCLC following chemoradiation. Consolidation treatment aims to kill any cancer cells left after initial treatment. Currently, no trials have evaluated the role of pembrolizumab consolidation following chemoradiation for patients with stage III NSCLC that cannot be surgically removed.

There were 92 patients with stage III NSCLC enrolled in this trial. All patients were treated with chemotherapy and radiotherapy. Following this, patients were treated with 200mg pembrolizumab every 3 weeks for up to a year. The average follow-up time in this trial was 32.3 months. 

The average time until cancer spread or death was 30.7 months. This was compared to 12 months in a group of patients who had chemoradiation treatment alone from a previous study (control group). The average time for the disease to worsen was 18.7 months. The average overall survival was 35.8 months. 

There most common side effects were tiredness (47%), cough (25.8%), and shortness of breath (21.5%). Serious side effects were experienced by 13 patients (14.1%).

The authors concluded that pembrolizumab consolidation therapy improved the outcomes of patients with stage III unresectable NSCLC treated with chemoradiation therapy.

This study was funded by Merck, the manufacturer of pembrolizumab. This study had a small number of participants and did not have an actual control group. Further studies are needed to confirm these findings.