Pembrolizumab versus Pembrolizumab plus Chemotherapy in Non-small Cell Lung Cancer with High PD-L1 Expression - Multicenter Real-world Evidence Study

Result code in IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00209805%3A_____%2F25%3A00080521" target="_blank" >RIV/00209805:_____/25:00080521 - isvavai.cz</a>

Alternative codes found

RIV/00216208:11110/25:10499886 RIV/00216208:11140/25:10499886 RIV/00216208:11150/25:10499886 RIV/61989592:15110/25:73634692 and 4 more

Result on the web

<a href="https://www.jcancer.org/v16p3015.htm" target="_blank" >https://www.jcancer.org/v16p3015.htm</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.7150/jca.113815" target="_blank" >10.7150/jca.113815</a>

Result language

angličtina

Original language name

Pembrolizumab versus Pembrolizumab plus Chemotherapy in Non-small Cell Lung Cancer with High PD-L1 Expression - Multicenter Real-world Evidence Study

Original language description

Background: Patients with non-small cell lung cancer (NSCLC) with PD-L1 expression &gt;= 50% can be treated with immunotherapy alone or with a combination of immunotherapy and chemotherapy. One of these options is treatment with pembrolizumab (P) with/without chemotherapy (CHT). Meta-analyses from randomized trials suggest a beneficial effect on response rate (RR) or progression free survival (PFS) when using the combination treatment P + CHT compared to P alone, but not on improving overall survival (OS). However, data from real-world clinical practice are insufficient especially in European patients. Regional differences, e.g. in the representation of KRAS mutations between Asian and European patients, could theoretically influence potential differences between P + CHT and P. Therefore, the aim of this study was to compare P + CHT versus P alone in real clinical practice in patients from Central Europe. Methods: Retrospective data from 8 comprehensive oncology centres in Central Europe were used. All patients with PD-L1 expression &gt;= 50% with stage IV NSCLC treated with pembrolizumab in daily practice to June 2024 were included and their data statistically analysed. Results: In the whole group 793 patients was included in the study-706 treated with P and 87 with P+ CHT. In this unadjusted sample, we observed significantly higher RR (p &lt;0.0001) and OS (p = 0.044) for the P + CHT group vs. P. For significant differences in both groups, where performance status in particular played a role in survival in the Cox model, we subsequently performed patient matching 2 (P+CHT):1 (P) from the whole group of patients. After this patient matching, we continued to observe a significant difference in RR (p = 0.005), but no longer in OS (p = 0.103). The PFS was not significantly different in both cases (p= 0.174 for unadjusted patients resp. p = 0.342 for matching groups). Conclusions: P+CHT leads to a significantly higher RR compared to P and can therefore be considered in patients with a more certain treatment response goal (e.g., bulky symptomatic tumor), however, this advantage does not translate into PFS and OS benefit.

Czech name

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Czech description

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Type

J_imp - Article in a specialist periodical, which is included in the Web of Science database

CEP classification

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OECD FORD branch

30204 - Oncology

Project

Result was created during the realization of more than one project. More information in the Projects tab.

Continuities

I - Institucionalni podpora na dlouhodoby koncepcni rozvoj vyzkumne organizace

Publication year

2025

Confidentiality

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Name of the periodical

Journal of Cancer

ISSN

1837-9664

e-ISSN

—

Volume of the periodical

16

Issue of the periodical within the volume

10

Country of publishing house

AU - AUSTRALIA

Number of pages

9

Pages from-to

3015-3023

UT code for WoS article

001577057100001

EID of the result in the Scopus database

2-s2.0-105011860594