Pembrolizumab Improves Quality of Life in Lung Cancer Patients

Pembrolizumab was associated with clinically meaningful improvements in quality of life over chemotherapy.

Patients treated with pembrolizumab reported better quality of life compared with those given chemotherapy during the KEYNOTE-024 trial.

Prior data from the trial showed that pembrolizumab provided superior progression-free survival (PFS) and overall survival (OS) compared with chemotherapy as a first-line treatment for patients with advanced non-small cell lung cancer (NSCLC) with PD-L1 expression on greater than 50% of tumor cells, and no sensitizing EGFR or ALK aberrations, according to the press release.

Dr Julie R. Brahmer, from the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, sought to determine whether positive results from previous studies would translate into meaningful quality-of-life gains for patients in the trials.

For the study, 305 patients were randomized to receive either pembrolizumab or chemotherapy plus optional pemetrexed maintenance therapy for non-squamous disease. The key pre-specified exploratory patient-reported endpoints were changed from baseline to week 15 in EORTC QLQ-C30 global health status/quality of life (QoL) score and time to deterioration in an EORTC QLQ-LC13 composite of cough, chest pain, and dyspnea.

Improved global health status/QoL score was defined as a 10-point or greater change from baseline. The proportion of improvement at week 15 was 40% for patients in the pembrolizumab arm and 26.5% for those in the chemotherapy arm.

Fewer patients in the pembrolizumab arm had their cough, chest pain symptoms, or dyspnea deteriorate (30% versus 39%). Furthermore, time to deterioration in these symptoms was significantly prolonged with pembrolizumab.

“Pembrolizumab was associated with a clinically meaningful improvement in health care quality of life and in the time to deterioration of cough, dyspnea, and chest pain compared with platinum-based chemotherapy,” Brahmer said. “Combined with superior progression-free survival and overall survival rate of patients on pembrolizumab and manageable safety profile, these data suggest pembrolizumab may be a new standard of care for first-line treatment of PD-L1 expressing advanced non-small cell lung cancer.”

The findings were presented at the IASLC 17th World Conference on Lung Cancer (WCLC) in Vienna, Austria.