![]() However, the progression-free survival rate at 12 months in the KEYNOTE 799 trial (67.1% in cohort A and 71.6% in cohort B) was higher than that in the PACIFIC trial (55.9%), suggesting at least equivalent effects of pembrolizumab combined with chemoradiotherapy compared with durvalumab following chemoradiotherapy for unresectable stage III NSCLC.Īnother coprimary endpoint of the KEYNOTE 799 trial was the incidence of grade 3–5 pneumonitis. Thus, it is difficult to directly compare the results from these two trials. Regarding differences in the exclusion criteria, the KEYNOTE 799 trial excluded patients with weight loss before treatment (more than 10% in 3 months) whereas the PACIFIC trial excluded patients with disease progression during chemoradiotherapy. Given that the response rate in the PACIFIC trial was assessed after randomization of patients who had completed chemoradiotherapy (up to 42 days after the end of chemoradiotherapy), it mainly reflects the efficacy of durvalumab, whereas the KEYNOTE 799 trial investigated the effects of pembrolizumab combined with chemoradiotherapy. In a comparable patient population in the PACIFIC trial, the response rate in the durvalumab group was 28.4%. The coprimary endpoint of the objective response rate was 70.5% in cohort A and 70.6% in cohort B. Patients in cohort B (nonsquamous only) received 3 cycles of cisplatin, pemetrexed, and pembrolizumab in addition to thoracic radiotherapy in cycles 2 and 3, followed by 14 additional cycles of pembrolizumab. Patients in cohort A (squamous and nonsquamous) received 1 cycle of carboplatin, paclitaxel, and pembrolizumab, followed by carboplatin and paclitaxel, and 2 cycles of pembrolizumab plus standard thoracic radiotherapy, and finally 14 additional cycles of pembrolizumab. In the nonrandomized KEYNOTE 799 trial, Jabbour and colleagues reported the promising antitumor activity of pembrolizumab plus concurrent chemoradiation and manageable safety in patients with previously untreated, locally advanced, stage III non-small cell lung cancer (NSCLC). Review of the comparative pharmacology and clinical activity of cisplatin and carboplatin. Pembrolizumab Plus Concurrent Chemoradiation Therapy in Patients With Unresectable, Locally Advanced, Stage III Non-Small Cell Lung Cancer: The Phase 2 KEYNOTE-799 Nonrandomized Trial. Phase 1 Trial of Pembrolizumab Administered Concurrently With Chemoradiotherapy for Locally Advanced Non-Small Cell Lung Cancer: A Nonrandomized Controlled Trial. Combing the adverse events mentioned in the text and in this letter, this study indicates, to some extent, that cisplatin with pemetrexed could possibly achieve a better safety profile in the pembrolizumab plus concurrent chemoradiation therapy.ġ. ![]() Treatment-related adverse events have long been a concerning issue of concurrent therapy. nonsquamous) is suggested in cohort A to further understand adverse event profile differences between the subgroups. Moreover, subgroup analysis according to histologic type (squamous vs. These are reminiscent of the typical adverse reactions to paclitaxel and carboplatin that were adopted by cohort A. Besides, infusion reactions of any grade occurred in 10 patients (8.9%) in cohort A and 2 (2.0%) in cohort B. 4.9%), neutrophil count decreased & neutropenia of grade 3-5 (25% vs. Patients in cohort A were more prone to hematological toxicities than those in cohort B, such as thrombocytopenia of any grade (16.1% vs. 70.6%).Īside from the adverse events leading to discontinuation of treatments and death that occurred more often in cohort A than B, some toxicities more observed in cohort A may be related to the chemotherapy regimen (Table 3). This study aimed to evaluate treatment outcomes and safety of the combination therapy with different platinum-doublet chemotherapies, which showed that both regimens were associated with comparable efficacy (ORR, 70.5% vs. 2021 Jun 4) is the largest trial to date of concurrent anti–PD-(L)1 therapy plus concurrent chemoradiation therapy (cCRT) in patients with previously untreated, locally advanced, stage III NSCLC. A recent study by the same group titled Pembrolizumab plus Concurrent Chemoradiation Therapy in Patients with Unresectable, Locally Advanced, Stage III Non–Small Cell Lung Cancer the Phase 2 KEYNOTE-799 Nonrandomized Trial (JAMA Oncol. To improve outcomes for patients with locally advanced non–small cell lung cancer who do not respond well to immunotherapy, efforts have been made at combining immunotherapy concurrently with chemoradiotherapy by Salma K. ![]() Shared Decision Making and Communication. ![]()
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