Evaluating pembrolizumab versus platinum-based chemotherapy for advanced NSCLC

This study evaluated the effectiveness of pembrolizumab (Keytruda) versus platinum-based chemotherapy for patients with non-small cell lung cancer (NSCLC). This study found that pembrolizumab treatment resulted in longer overall survival than treatment with platinum-based chemotherapy.

NSCLC is the most common type of lung cancer. For patients with advanced disease, targeted therapy is most often used. This type of treatment specifically targets cancer cells. This can reduce side effects. Pembrolizumab is a type of targeted therapy. It is a monoclonal antibody. It helps the body's immune system attack cancer cells. This leads to cancer cell death.

Previous studies have shown that short-term treatment with pembrolizumab improves survival compared to platinum-based chemotherapy. The long-term outcomes of pembrolizumab treatment for patients with advanced NSCLC remain unclear.

This study had 305 patients. All patients had advanced NSCLC that was previously untreated. 154 patients were treated with pembrolizumab. 151 patients were treated with platinum-based chemotherapy. Patients were followed-up for an average of 25.2 months.

At follow-up, patients in the pembrolizumab group survived for significantly longer on average than the chemotherapy group (30.0 months vs. 14.2 months). Pembrolizumab treatment was associated with a 51% lower risk of mortality.

Overall, side effects were more common in the chemotherapy group than the pembrolizumab group (90.0% vs. 76.3%). Patients treated with pembrolizumab most commonly reported diarrhea (16.2%) and fatigue (14.3%). Patients treated with chemotherapy most commonly reported low red blood cell count (44.0%) and nausea (43.3%).

More patients in the chemotherapy group reported severe side effects compared to the pembrolizumab group (53.3% vs. 31.2%). The most common included diarrhea (3.9%, pembrolizumab) and low red blood cell count (19.3%, chemotherapy). 13.3% of patients treated with chemotherapy also had severe low white blood cell count.

The study concluded that treating non-small cell lung cancer with pembrolizumab led to better outcomes than treatment with chemotherapy.

This was a small study. Also, patients in the chemotherapy group could switch over to the pembrolizumab group. This may bias the results. Larger studies are needed to confirm these results.

Talk to your doctor about whether pembrolizumab may be right for you.