There is a new first-line therapy which helps people with advanced non-small-cell lung cancer (NSCLC). Its name is platinum-based chemotherapy and it lacks any targetable mutations. The pembrolizumab substance has recently replaced the cytotoxic chemotherapy as the first-line treatment. This addition brought a dramatic increase in the positive response. Moreover, there was a longer progression-free survival rate than when the doctors used only chemotherapy.
The study was, in fact, a double-blind, phase 3 trial. The scientists initially randomly assigned 616 patients that had metastatic nonsquamous NSCLC to get a platinum-based drug, pemetrexed, plus a placebo or 200 mg of pembrolizumab every 3 weeks.
Another thing to note is that the patients had never received another treatment for the metastatic disease. The scheme was followed in 4 cycles, followed by placebo or pembrolizumab, which totals to 35 cycles. Meanwhile, the patients also received a pemetrexed maintenance therapy. The main goals were the overall survival, as well as a progression-free one. The results were assessed by an independent central radiologic review.
The results didn’t delay in appearing. The estimated rate of survival after one year rose to 69.2% in the group that took pembrolizumab. At the same time, for the group that was administered placebo, the overall survival rate was 49.4%. However, there was a visible improvement in the overall survival across all the categories the scientists evaluated.
In the first group, the median progression-free survival reached 8.8 months, while in the second group it reached 4.9 months. There were also some adverse events of grade 3 or more serious, which appeared in 67.2% of the patients who took pembrolizumab and in 65.8% of those who took placebo.
All in all, it seems that the addition of pembrolizumab to the regular treatment with pemetrexed plus a platinum-based drug changed all the results for the better.