KEY TAKEAWAYS
- The study aimed to investigate the real-world efficacy and safety of pembrolizumab and atezolizumab in 1L treatment for patients with NSCLC.
- Researchers noticed that pembrolizumab provides effective disease control and survival in advanced NSCLC with manageable safety.
By 2021, the FDA approved pembrolizumab and atezolizumab for first-line (1L) treatment of patients with high programmed death ligand-1 (PD-L1) positivity in locally advanced and metastatic non-small-cell lung cancer (NSCLC). This decision was based on compelling evidence from global, multicentric trials showing improved progression-free survival (PFS) and overall survival (OS) for these patients.
Nensi Lalić and the team aimed to assess the real-world efficacy and safety of pembrolizumab and atezolizumab in patients with NSCLC with high PD-L1 expression.
Researchers performed an inclusive analysis of 79 patients diagnosed with NSCLC and PD-L1 expression ≥50% from January 2019 to December 2022 at the Institute for Pulmonary Diseases of Vojvodina. These patients, treated with pembrolizumab as 1L therapy, were categorized based on histological type into adenocarcinoma (ADC) or squamous cell carcinoma (SCC).
The study assessed PFS in 52 patients of 72 patients and censored OS in 32 patients, considering factors such as histological type, tumor proportion score (TPS) of PD-L1 expression, and metastatic status within the Tumor Nodes Metastasis (TNM) classification. Multivariable proportional hazard regression analysis identified independent factors influencing mortality outcomes.
About 79 patients diagnosed with NSCLC and PD-L1 expression ≥50% were included in the study, with 50 (63.3%) having ADC and 29 (36.7%) having SCC. PD-L1 expression was obtained from broncho biopsy (BB) in 55 (69.6%) patients. The majority, 49 (62%), had a TPS PD-L1 score of 51%-79%.
The median PFS for ADC was 22 months, and the censored OS was 27 months, whereas for SCC, the median PFS was 12 months, and the censored OS was 21 months. The M1b disease stage, which was the most prevalent among patients, had a PFS of 16 months and a censored OS of 18 months.
The study concluded that pembrolizumab monotherapy in patients with NSCLC at stage IV and with TPS PD-L1 positivity above 50% is a safe and effective therapy, providing a satisfactory period without disease progression and OS with acceptable treatment complications.
The study received no funding.
Source: https://pubmed.ncbi.nlm.nih.gov/39071547/
Lalić N, Bojović M, Bursać D, et al. (2024). “The efficacy outcomes in non-small cell lung cancer patients treated with PD axis inhibitor agents – a population-based study of the Vojvodina region.” Pathol Oncol Res. 2024 Jul 12;30:1611717. doi: 10.3389/pore.2024.1611717. PMID: 39071547; PMCID: PMC11272951.
