LBA1510 Background: Pembrolizumab plus Platinum doublet chemotherapy is the standard of care for advanced non-small cell lung cancer (NSCLC) without actionable genomic alterations (AGAs). Access to Pembrolizumab 61.1% had ECOG PS 0-1, 38.9% had ECOG PS 2, 54.5% were former/current smokers. The most common histological subtype was adenocarcinoma (68.4%). Brain metastases were present in 27.1%. The median follow-up was 13 mos (95% CI 12.2-14.1). The median OS was 10.47 mos (95% CI 8.38-12.56) in Arm A and 13.46 mos (95% CI 11.71-15.22) in Arm B; HR 0.72 (95% CI 0.54-0.95) (p=0.020). The 1-year OS was 44.4% (95% CI 37.2-53) in Arm A and 57.32% (95% CI 44.93-65.79) in Arm B. The median PFS was 4.70 mos (95% CI 4.06-5.34) in Arm A and 6.73 mos (95% CI 5.51-7.96) in Arm B, HR 0.70 (95% CI 0.56-0.89), p=0.003. The 1-year PFS was 18.79% (95% CI 13.59 - 25.99) in Arm A and 26.72% (95% CI 20.23 - 35.29) in Arm B. Grade 3 or higher neutropenia was significantly higher in Arm B (28%) compared to Arm A (17.6%), p=0.02. There was no difference in the incidence of grade 3 or higher anemia or thrombocytopenia. Grade 3 or higher immune-related pneumonitis was seen in 3.1% in Arm B. Conclusion: The addition of low-dose Pembrolizumab to chemotherapy significantly improved overall survival and progression-free survival in patients with advanced NSCLC. There were no new safety signals. This regimen will improve access to ICIs in resource-limited settings. Clinical trial information: CTRI/2023/08/056715.
Menon et al. (Wed,) studied this question.