Effectiveness and safety of pembrolizumab monotherapy in patients with locally advanced or metastatic non-small-cell lung cancer

• Published in: Journal of oncology pharmacy practice Vol. 29; no. 1; pp. 138 - 144
• Main Authors: Tamayo-Bermejo, Rocio, del Rio-Valencia, Juan Carlos, Mora-Rodriguez, Beatriz, Muñoz-Castillo, Isabel
• Format: Journal Article
• Language: English
• Published: London, England SAGE Publications 01-01-2023; Sage Publications Ltd
• Subjects: Adverse events; Aged; Antineoplastic Agents, Immunological - adverse effects; Antineoplastic Combined Chemotherapy Protocols; Apoptosis; Carcinoma, Non-Small-Cell Lung - pathology; Female; Humans; Immunotherapy; Lung cancer; Lung Neoplasms - pathology; Male; Metastases; Metastasis; Middle Aged; Monoclonal antibodies; Non-small cell lung carcinoma; Oncology; Patients; Pembrolizumab; Progression-Free Survival; Targeted cancer therapy; Pembrolizumab; metastatic; programmed death receptor 1; immunotherapy; non-small-cell lung cancer
• ISSN: 1078-1552; 1477-092X
• DOI: 10.1177/10781552211061117

Introduction
Immunotherapy has become a standard treatment for lung cancer; the objective of this study was to evaluate the effectiveness, safety of pembrolizumab monotherapy in patients with advanced or metastatic non-small-cell lung cancer used in real-world clinical practice.
Material and methods
Retrospective observational study of every patient treated with pembrolizumab in our centre from January 2017 to June 2019. Outcomes collected: sex, age, Eastern Cooperative Oncology Group, programmed death receptor 1 level, previous metastatic line therapies, adverse events and smoking status.
Results
A total of 62 patients were reviewed. The median age was 62.34 ± 10.62 years, 48 (77.41%) were men and 91.93% of patients had Eastern Cooperative Oncology Group 0. The median dose administered was 170.5 mg (108 – 240 mg) and the median follow-up was 3 months (range: 1 – 38). A median of four cycles of pembrolizumab (range: 1 – 56) were administered as monotherapy. The reason for treatment discontinuation was mainly due to disease progression in 38.70% of patients or death in 30.64%. As first-line pembrolizumab monotherapy, median progression-free survival was 7.7 months (95% CI: 3.66 – 11.73) (N = 33). With respect to patients who were treated in second–third-line treatment, median progression-free survival was 3.5 months (95% CI: 2.40 – 4.59) (N=29). As to overall survival, pembrolizumab-treated patients as first-line treatment reached 19 months median OG (95% CI: 13.36 – 24.63) (N = 33) and those treated in second–third-line treatment got 11 months (95% CI: 3.4 – 18.5). A total of 64.51% of patients presented some adverse events to pembrolizumab however, only, 9.38% of them were grade 3.
Conclusion
Pembrolizumab represents an effective and feasible alternative in terms of progression-free survival. It is a well-tolerated treatment option.