Randomized trial assesses overall survival benefit of pembrolizumab plus chemotherapy in metastatic NSCLC, indicating improved outcomes after adjusting for crossover.
Key Points
Assess the impact on overall survival by adjusting for treatment crossover in first-line metastatic NSCLC trials involving pembrolizumab and chemotherapy.
Analyzed pooled data from KEYNOTE-189 and KEYNOTE-407 trials with specified cut-off dates.
Utilized a Two-Stage Estimation model and Rank-Preserving Structural Failure Time model to adjust survival times.
Employed a stratified Cox regression model to estimate treatment effects between pembrolizumab plus chemotherapy and chemotherapy alone.
In KEYNOTE-189, overall survival adjusted for 56.3% crossover resulted in a treatment effect estimate of 0.44 (95% CI 0.33, 0.58) for pembrolizumab+chemotherapy compared to chemotherapy.
In KEYNOTE-407, survival adjusted for 53.7% crossover showed a treatment effect of 0.47 (95% CI 0.35, 0.63) for pembrolizumab plus chemotherapy.
The treatment effect was consistent across PD-L1 TPS cutoff values with both trials indicating significant improvement over chemotherapy alone.