An evaluation of the largest clinical trial of the immunotherapy drug pembrolizumab was presented at the 2018 American Society of Clinical Oncology (ASCO) Annual Meeting. At the meeting, the results of the randomized phase III trial were revealed, showing that pembrolizumab (trade name Keytruda) was a more effective initial, standalone treatment than chemotherapy for the majority of patients with the most common type of lung cancer. Many of the same drugs that are used to treat lung cancer are used to treat malignant pleural mesothelioma (MPM).
The clinical trial consisted of nearly 1,300 patients, with a median follow-up time of 12.8 months. The study revealed that, “people with advanced non-small-cell lung cancer (NSCLC) with a PD-L1 expression of 1% or more who were first treated with immunotherapy pembrolizumab lived a median of 4-8 months longer than those who received chemotherapy. In addition, severe side effects occurred in fewer patients receiving pembrolizumab than chemotherapy (18% vs. 41%).”
Although patients who received pembrolizumab had a longer median overall survival, regardless of PD-L1 expression in the tumor, the benefit of pembrolizumab was greater when the level of PD-L1 expression was higher:
-PD-L1 50% or more: 20 months with pembrolizumab vs. 12.2 months with chemotherapy
-PD-L1 20% or more: 17.7 months with pembrolizumab vs. 13 months with chemotherapy
-PD-L1 1% or more: 16.7 months with pembrolizumab vs. 12.1 months with chemotherapy
Based on earlier findings in a smaller clinical trial, the ASCO reported that the “U.S. Food and Drug Administration (FDA) approved pembrolizumab for initial treatment of NSCLC with high PD-L1 expression (score of at least 50%), which account for about one-third of these cancers.” Pembrolizumab is currently the only approved immunotherapy for initial treatment of lung cancer. It is approved for use as both a standalone treatment and in combination with chemotherapy.
At the meeting, the ASCO discussed the next steps, which included more research to define patient groups who benefit from pembrolizumab and “current ongoing research exploring use of pembrolizumab after surgery (adjuvant) and combinations of immunotherapy with bevacizumab-containing combination regimens as part of initial therapy for NSCLC.”
If you have been diagnosed with mesothelioma, talk to your doctor about promising treatment options such as pembrolizumab. Newer and emerging treatment options such as this could be effective in treating your specific type of mesothelioma. Talk to your doctor today.
Bankhead, Charles. "ASCO Releases First Mesothelioma Guideline." MedPageToday.com. MedPage Today, LLC., 26 Jan. 2018. Web. 10 Nov. 2018.
Fisher, Alise. "Immunotherapy Pembrolizumab Works Better Than Chemotherapy Alone as Initial Treatment for Most Advanced Lung Cancers." ASCO.org. American Society of Clinical Oncology (ASCO), 03 Jun. 2018. Web. 10 Nov. 2018.