Shirish Gadgeel, MBBS of U-M Rogel Cancer Center @UMRogelCancer answers common questions on KEYNOTE-189. If the PD-L1 expression is less than 1%, should therapy for pembrolizumab be considered in NSCLC?
In KEYNOTE-189, first- pembrolizumab plus pemetrexed- significantly improved overall survival (OS) and progression- survival (PFS) compared to placebo plus pemetrexed- in patients with non-- non- metastatic lung cancer (NSCLC), regardless of the expression of tumor programmed death- 1 (PD-).
Patients were allocated randomly (2:1) to receive pemetrexed and platinum plus pembrolizumab (n=410) or placebo (n=206) for 4 cycles every 3 weeks, then pemetrexed maintenance plus pembrolizumab or placebo for up to 35 cycles in total. In the placebo-combination category, eligible patients with progression of the disease may cross over to pembrolizumab monotherapy. Answer was evaluated by central analysis using RECIST (version 1.1). The revised analysis was not assigned an alpha.