For resectable early-stage NSCLC, improved event-free survival seen with pembrolizumab, regardless of N status, clinical stage, type of surgery
By Elana Gotkine HealthDay Reporter
TUESDAY, Feb. 13, 2024 (HealthDay News) — For patients with early-stage non-small cell lung cancer (NSCLC), event-free survival (EFS) is improved with neoadjuvant pembrolizumab and chemotherapy, according to a study presented at the annual meeting of The Society of Thoracic Surgeons, held from Jan. 27 to 29 in San Antonio.
Jonathan David Spicer, M.D., Ph.D., of McGill University in Montreal, and colleagues examined the impact of surgical-related data on EFS among patients receiving neoadjuvant chemotherapy for resectable early-stage NSCLC. Patients were randomly assigned to pembrolizumab 200 mg or placebo as neoadjuvant and adjuvant therapy (396 and 399 patients, respectively).
The researchers found that the median time from randomization to surgery was 15.3 weeks in both the pembrolizumab and placebo arms; for those patients who experienced surgical delay, the median time to surgery was 20.5 and 18.9 weeks for those in the pembrolizumab and placebo arms, respectively. Median duration of the surgical hospital stay was eight and 7.5 days in the pembrolizumab and placebo arms, respectively; 86.8 and 83.3 percent, respectively, underwent lobectomy or bilobectomy; and 92.0 and 84.2 percent, respectively, had R0 resection. EFS was significantly better in the pembrolizumab arm, regardless of N status (hazard ratios, 0.58, 0.56, and 0.63 for cN0, cN1, and cN2, respectively), clinical stage (hazard ratios, 0.59, 0.57, and 0.57 for IIB, IIIA, and IIIB, respectively), and type of surgery (hazard ratios, 0.58 for lobectomy or bilobectomy and 0.40 for pneumonectomy).
“Neoadjuvant pembrolizumab plus chemotherapy with adjuvant pembrolizumab provided meaningful improvement in EFS compared with neoadjuvant chemotherapy alone for resectable early-stage NSCLC regardless of clinical nodal status, baseline disease stage, or type of surgery,” the authors write.
The study (KEYNOTE-671) was funded by Merck, the manufacturer of pembrolizumab.
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