Journal of Immunotherapy and Precision Oncology (Aug 2023)

Treatment of Stage IV Non–Small Cell Lung Cancer with Pembrolizumab in Combination with Platinum-Based Doublet Chemotherapy in Vietnam

  • Khanh Toan Nguyen,
  • To Ta Van

DOI
https://doi.org/10.36401/JIPO-23-12
Journal volume & issue
Vol. 6, no. 3
pp. 133 – 140

Abstract

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Introduction: Lung cancer has been one of the most prevalent cancers worldwide in recent decades. According to the findings of the KEYNOTE-407 (2018) study on patients with stage IV squamous cell lung cancer, the combination of pembrolizumab and chemotherapy in the first-line treatment prolongs overall survival compared with chemotherapy alone. This study aimed to evaluate the efficacy and side effects of treating patients with stage IV non–small cell lung cancer with pembrolizumab in combination with platinum-based doublet chemotherapy. Methods: A retrospective multicenter study on 46 patients at four hospitals in Vietnam between June 2018 and August 2022. Patients received first-line treatment with a protocol of pembrolizumab in combination with platinum-based doublet chemotherapy (pemetrexed plus carboplatin or paclitaxel plus carboplatin). The study's primary endpoints were progression-free survival and safety. The secondary endpoint was overall survival. Results: The median progression-free survival was 11.0 months (95% CI, 7.4–14.7 months). The median overall survival was 23.1 months (95% CI, 18.4–27.8 months). The survival rate of patients after 1 and 2 years was 82.3% and 43.3%, respectively. The most common side effects were anemia and elevated liver enzymes, but they were primarily mild or moderate severity. Progression-free survival did not depend on cancer type based on histology (p = 0.13). The progression-free survival was independent of programmed death ligand-1 expression levels < 50% or ≥ 50% (p = 0.68). Conclusion: Treatment of stage IV non–small cell lung cancer without EGFR and ALK gene mutations with the immunotherapy protocol of pembrolizumab in combination with platinum-based doublet chemotherapy resulted in favorable outcomes without any new safety concerns. A larger sample size and longer follow-up in the future are necessary to yield more complete results.

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