Pembrolizumab for all PD-L1-positive NSCLC
Mené dans 32 pays sur 1 274 patients atteints d'un cancer du poumon non à petites cellules surexprimant PD-L1 et de stade métastatique ou localement avancé (âge médian : 63 ans), cet essai de phase III compare l'efficacité, du point de vue de la survie globale, et la toxicité du pembrolizumab et d'une chimiothérapie à base de sels de platine choisie par le médecin, en traitement de première ligne
Before the introduction of immune checkpoint inhibition therapy targeting programmed death protein 1 (PD-1) ligand (PD-L1), either given as single agent or in combination with chemotherapy, advanced non-small-cell lung cancer was uniformly fatal. These drugs have changed the treatment landscape for advanced non-small-cell lung cancer. Long-term results from studies of single-agent nivolumab and pembrolizumab have shown disease control in approximately 15% of unselected patients. In the pivotal KEYNOTE-024 study, treatment-naive patients with metastatic non-small-cell lung cancer and a PD-L1 tumour proportion score (TPS) of 50% or greater were randomly assigned to receive either pembrolizumab as monotherapy or platinum-doublet chemotherapy. Progression-free survival and overall survival favoured the pembrolizumab group. Subsequently, after approval by the US Food and Drug Administration and the European Medicines Agency, single-agent pembrolizumab became standard of care for patients with advanced non-small-cell lung cancer and a PD-L1 TPS greater than 50%.
The Lancet , commentaire, 2018