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肿瘤第一线 · 学术知识传播

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JCO:来自keynote189的全新分析: Pembrolizumab联合Pemetrexed和Platinum治疗转移性非鳞状非小细胞肺癌的效果

2021-11-25 杜新生 杜新生

无论PD-L1是否表达或是否有肝/脑转移,一线pembrolizumab + pemetrexed-platinum在转移性非鳞状非小细胞肺癌中继续显示出OS和PFS的显著改善。

无论PD-L1是否表达或是否有肝/脑转移,一线pembrolizumab + pemetrexed-platinum在转移性非鳞状非小细胞肺癌中继续显示出OS和PFS的显著改善。


在KEYNOTE-189实验中,无论肿瘤程序性死亡配体1 (PD-L1)的表达如何,与安慰剂+ pemetrexed-platinum相比,一线pembrolizumab + pemetrexed-platinum都能够显著改善转移性非鳞状非小细胞肺癌(NSCLC)患者的总体生存(OS)和无进展生存(PFS)情况。最近,研究人员报告了来自KEYNOTE-189的最新分析(ClinicalTrials.gov: NCT02578680)。


在该临床试验中,患者被随机分配(2:1)接受pemetrexed和platinum加pembrolizumab (n = 410)或安慰剂 (n = 206)治疗,每3周进行一次,共4个周期,然后进行pemetrexed加pembrolizumab或安慰剂维持共35个周期。安慰剂联合组中符合条件的疾病进展患者可以转到pembrolizumab单药治疗。通过中央评审对每个RECIST(版本1.1)的响应进行评估。此次更新的分析没有分配alpha值。


结果显示,截至2018年9月21日(中位随访23.1个月),pembrolizumb -联合组更新的中位OS(95% CI) 为22.0个月(19.5至25.2个月),安慰剂-联合组为10.7个月(8.7至13.6个月),(危险比[HR] 0.56; 95% CI, 0.45 ~ 0.70])。pembrolizumb -联合组和安慰剂-联合组的中位PFS(95% CI) 分别为9.0个月(8.1至9.9个月)和4.9个月(4.7至5.5个月),(HR, 0.48; 95% CI, 0.40至0.58)。


从随机化到客观肿瘤进展的时间中位数(95% CI)为下一疗程或因任何原因的死亡,以先发生者为准(无进展生存期-2;PFS-2)分别为17.0个月(15.1至19.4个月)和9.0个月(7.6至10.4个月),(HR, 0.49; 95% CI, 0.40到0.59)。pembrolizumab对OS和PFS的益处与PD-L1表达或肝/脑转移无关。pembrolizumab-联合组(71.9%)和安慰剂-联合组(66.8%)中出现3-5级不良事件的发生率相似。


因此,无论PD-L1是否表达或是否有肝/脑转移,一线pembrolizumab + pemetrexed-platinum在转移性非鳞状非小细胞肺癌中继续显示出OS和PFS的显著改善,具有可管理的安全性和耐受性。



原始出处:
Gadgeel S et al. Updated Analysis From KEYNOTE-189: Pembrolizumab or Placebo Plus Pemetrexed and Platinum for Previously Untreated Metastatic Nonsquamous Non-Small-Cell Lung Cancer. JCO, 2020; DOI: 10.1200/JCO.19.03136

 

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    2022-07-14 lidong40
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createdName=feather89, createdTime=Mon Dec 20 05:29:55 CST 2021, time=2021-12-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1891686, encodeId=8c2618916861b, content=<a href='/topic/show?id=25b0102e2df' target=_blank style='color:#2F92EE;'>#JCO#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=90, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10272, encryptionId=25b0102e2df, topicName=JCO)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6da1120, createdName=lidong40, createdTime=Thu Jul 14 22:29:55 CST 2022, time=2022-07-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2060064, encodeId=5249206006405, content=<a href='/topic/show?id=2cc599381bd' target=_blank style='color:#2F92EE;'>#非小细胞#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=99381, 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time=2021-11-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1386886, encodeId=36b713868864d, content=<a href='/topic/show?id=f08293399f9' target=_blank style='color:#2F92EE;'>#转移性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=77, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=93399, encryptionId=f08293399f9, topicName=转移性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1ac22500003, createdName=1249842em09(暂无昵称), createdTime=Sat Nov 27 07:29:55 CST 2021, time=2021-11-27, status=1, ipAttribution=)]
  5. 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href='/topic/show?id=4323140286a' target=_blank style='color:#2F92EE;'>#Pembrolizumab#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=86, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=14028, encryptionId=4323140286a, topicName=Pembrolizumab)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ac59108, createdName=hxj0117, createdTime=Sat Nov 27 07:29:55 CST 2021, time=2021-11-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1312161, encodeId=be7e1312161b2, content=<a href='/topic/show?id=6c1099e74ad' target=_blank style='color:#2F92EE;'>#非鳞状非小细胞肺癌#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=99774, encryptionId=6c1099e74ad, topicName=非鳞状非小细胞肺癌)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=73a3403, createdName=weihongyv, createdTime=Sat Nov 27 07:29:55 CST 2021, time=2021-11-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1386886, encodeId=36b713868864d, content=<a href='/topic/show?id=f08293399f9' target=_blank style='color:#2F92EE;'>#转移性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=77, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=93399, encryptionId=f08293399f9, topicName=转移性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1ac22500003, createdName=1249842em09(暂无昵称), createdTime=Sat Nov 27 07:29:55 CST 2021, time=2021-11-27, status=1, ipAttribution=)]
    2022-10-04 一闲
  6. [GetPortalCommentsPageByObjectIdResponse(id=1912723, encodeId=99de1912e236f, content=<a href='/topic/show?id=4de7112046c' target=_blank style='color:#2F92EE;'>#mAb#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=72, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11204, encryptionId=4de7112046c, topicName=mAb)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=25e7304, createdName=snf701207, createdTime=Wed Oct 12 05:29:55 CST 2022, time=2022-10-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1729212, encodeId=aa6f1e29212c6, content=<a href='/topic/show?id=986913980dd' target=_blank style='color:#2F92EE;'>#PE#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=90, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13980, encryptionId=986913980dd, topicName=PE)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f06c33759375, 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time=2021-11-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1386886, encodeId=36b713868864d, content=<a href='/topic/show?id=f08293399f9' target=_blank style='color:#2F92EE;'>#转移性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=77, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=93399, encryptionId=f08293399f9, topicName=转移性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1ac22500003, createdName=1249842em09(暂无昵称), createdTime=Sat Nov 27 07:29:55 CST 2021, time=2021-11-27, status=1, ipAttribution=)]
  7. 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