Abstract 24P
Background
In clinical trials, 1L pembrolizumab + chemotherapy in patients (pts) with non-squamous (NSQ) and squamous (SQ) metastatic NSCLC has demonstrated durable, clinically meaningful survival benefits over 5 years compared with chemotherapy. This retrospective study aimed to evaluate 5-year real-world outcomes with pembrolizumab + chemotherapy at US oncology practices.
Methods
Using the nationwide Flatiron Health electronic health record-derived deidentified database, we selected adult pts with ECOG performance status of 0–1 initiating 1L therapy for advanced/metastatic NSCLC (unresectable stages IIIB/IIIC, or IV); pts enrolled in clinical trials were excluded. Pts with NSQ histology and no EGFR/ALK/ROS1 alteration initiated 1L pembrolizumab plus platinum/pemetrexed from 1-Jun-2017 to 30-Sept-2021. Pts with SQ histology initiated 1L pembrolizumab plus carboplatin/(nab)paclitaxel from 1-Nov-2018 to 30-Sep-2020. Overall survival (OS) and real-world time on treatment, by histology and known PD-L1 status, were estimated from 1L initiation using the Kaplan-Meier method. Data cutoff was 30-Sep-2024.
Results
Among 1960 and 433 pts with NSQ and SQ advanced/metastatic NSCLC, respectively, 46% and 32% were women; median age was 68 and 70 years; PD-L1 expression was not documented for 314 (16%) and 116 pts (27%). Median (range) follow-up from 1L initiation to data cutoff was 60 mo (36–88) and 60 mo (48–71) for NSQ and SQ, respectively. Median OS was 15.0 and 12.9 mo; 5-year OS rates were 21.6% and 18.2%, respectively (Table). 2-year on-treatment rates were 15.1% and 12.6%, respectively.
Table 24POS with pembrolizumab + chemotherapy in advanced/metastatic NSCLC, by histology & known PD-L1
| N | All NSQ 19B0 | PD-L1 ConclusionsWith 5-year follow-up in a real-world population, 1L pembrolizumab + chemotherapy demonstrated long-term effectiveness, with 5-yr OS rates consistent with those observed in KEYNOTE-189 (19.4%) and KEYNOTE-407 (18.4%). Our findings suggest real-world benefits of 1L pembrolizumab + chemotherapy across PD-L1 expression strata for pts with advanced/metastatic NSCLC. Editorial acknowledgementMedical writing and editorial assistance were provided by Elizabeth V. Hillyer, DVM (freelance). This assistance was funded by Merck Sharp & Dohme LLC, a subsidiary of Merck & Co., Inc., Rahway, NJ, USA. Legal entity responsible for the studyMerck Sharp & Dohme LLC, a subsidiary of Merck & Co., Inc., Rahway, NJ, USA. FundingMerck Sharp & Dohme LLC, a subsidiary of Merck & Co., Inc., Rahway, NJ, USA. DisclosureV. Velcheti: Financial Interests, Personal, Advisory Role: BMS, Merck, GSK Oncology, Amgen, Taiho Oncology, Takeda, Roche Diagnostics. R. Babel: Financial Interests, Personal, Full or part-time Employment: Merck & Co., Inc.; Financial Interests, Personal, Stocks/Shares: Merck & Co., Inc. Y. Kao: Financial Interests, Personal, Full or part-time Employment: Merck & Co., Inc.; Financial Interests, Personal, Stocks/Shares: Merck. D.R. Chirovsky: Financial Interests, Personal, Full or part-time Employment: Merck & Co., Inc.; Financial Interests, Personal, Stocks/Shares: Merck & Co., Inc. A. Namakydoust: Financial Interests, Personal, Full or part-time Employment: Merck & Co., Inc.; Financial Interests, Personal, Stocks/Shares: Merck & Co., Inc. S.V. Liu: Financial Interests, Personal, Advisory Board, Consultant: AstraZeneca, Daiichi Sankyo, Genentech/Roche, Janssen, Jazz Pharmaceuticals, Merck, Novartis, Regeneron, Sanofi; Financial Interests, Personal, Advisory Board: Bristol Myers Squibb, RAPT Therapeutics, Gilead, Guardant Health, Merus, Takeda, Revolution Medicines, Amgen, AbbVie, Boehringer Ingelheim, Mirati, Pfizer; Financial Interests, Personal, Invited Speaker: OSE Immunotherapeutics, Yuhan; Financial Interests, Institutional, Invited Speaker: Alkermes, Elevation Oncology, Genentech, Gilead, Merck, Merus, Nuvalent, RAPT, Turning Point Therapeutics, AbbVie, AstraZeneca, OSE Immunotherapeutics, Puma, Ellipses; Non-Financial Interests, Personal, Member: ASCO, IASLC. This site uses cookies. Some of these cookies are essential, while others help us improve your experience by providing insights into how the site is being used. For more detailed information on the cookies we use, please check our Privacy Policy.
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