The KEYNOTE 024 and KEYNOTE 010 trials demonstrated a significant overall survival and progress free survival benefit for pembrolizumab monotherapy in first and subsequent lines of therapy compared to standard chemotherapy in patients with metastatic non-small cell lung cancer who had PD-L1 positive tumors.
A new analysis of the trials, presented this weekend at the European Society of Medical Oncology (ESMO) 2018 Congress in Munich, found that patients who receive pembrolizumab not only live longer, they have a significantly greater period of time without symptoms of disease progression or toxicity.
Photos courtesy of ESMO.
The study used the Quality-adjusted Time without Symptoms of disease progression or Toxicity of treatment (Q-TWiST) analysis to determine length of quality-adjusted survival among patients in the trials. The researchers divided total survival into three health states—without toxicity before progression, with toxicity before progression, and progression until death. They considered toxicity to be adverse events of grade 3 or above. Q-TWiST was determined by adding the utility-weighted sum of the mean health state durations.
Based on this analysis, patients who received pembrolizumab in the KEYNOTE 010 trial had 3.11 months more time without disease progression or toxicity, which amounted to about 25% of the mean overall survival for those patients, compared to those who received chemotherapy. Participants in the KEYNOTE 024 trial who received pembrolizumab experienced an increase of 3.25 months in quality survival compared to patients who received chemotherapy. That amounted to about 20% of the mean overall survival.
The researchers also noted that the benefit in terms of quality adjusted survival continued to build over the follow up period with extended survival.
Source: Abstract 1224 P