18. Efficacy and safety of pembrolizumab monotherapy in advanced non-small cell lung cancer patients treated at Hanoi Medical University Hospital

Trinh Le Huy, Đình Anh Trần

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Tóm tắt

This study evaluated the efficacy of pembrolizumab monotherapy response rate and progression-free survival and its tolerabilty in advanced non-small cell lung cancer patients. Thirty patients with lung cancer in metastatic or recurrent settings were treated with pembrolizumab monotherapy at Hanoi Medical University Hospital from October 2017 to October 2021. The mean age was 65.37 ± 5.46 (40-81). Most patients were male (86.7%). Most had non-squamous cell carcinoma (70%) and a Tumor Proportion Score (TPS) 50% (63.3%). The complete response rate was 3.3%, the partial response rate was 36.7%, and the stable disease rate was 43.3%. The overall control rate was 83.3%. Patients with TPS 50% had significantly higher response rate (47.4% vs 27.3%, p > 0.05). Median PFS was 9.6 ± 0.84 months; the figure for patients with TPS 50% was higher than for patients with TPS 1-49% (10.9 months vs. 7.2 months), p < 0.05. Only 6.2% had hyperthyroidism, and 3.1% had hypothyroidism, all in grade I. Therefore, pembrolizumab treatment in advanced non-small cell lung cancer is effective with a high disease control rate and is well-tolerated.

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Tài liệu tham khảo

1. Sung, H., Ferlay, J., Siegel, R. L., et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA: a cancer journal for clinicians. 2021; 71(3), 209-249.
2. Ettinger DS, Akerley W, Borghaei H, et al. Non-small cell lung cancer, version 2.2013. J Natl Compr Canc Netw. 2013; 11(6): 645-653; quiz 653.
3. Socinski MA, Evans T, Gettinger S, et al. Treatment of stage IV non-small cell lung cancer: Diagnosis and management of lung cancer, 3rd ed: American College of Chest Physicians evidence-based clinical practice guidelines. Chest. 2013; 143(5 Suppl): e341S-e368S
4. Forde PM, Ettinger DS. Targeted therapy for non-small-cell lung cancer: past, present and future. Expert Rev Anticancer Ther. 2013; 13(6): 745-758.
5. Reck M, Rodríguez–Abreu D, Robinson AG, et al. Updated Analysis of KEYNOTE-024: Pembrolizumab Versus Platinum-Based Chemotherapy for Advanced Non–Small-Cell Lung Cancer With PD-L1 Tumor Proportion Score of 50% or Greater. JCO. 2019; 37(7): 537-546.
6. Borghaei H, Langer CJ, Gadgeel S, et al. 24-Month Overall Survival from KEYNOTE-021 Cohort G: Pemetrexed and Carboplatin with or without Pembrolizumab as First-Line Therapy for Advanced Nonsquamous Non-Small Cell Lung Cancer. J Thorac Oncol. 2019; 14(1): 124-129.
7. Mok TSK, Wu Y-L, Kudaba I, et al. Pembrolizumab versus chemotherapy for previously untreated, PD-L1-expressing, locally advanced or metastatic non-small-cell lung cancer (KEYNOTE-042): a randomised, open-label, controlled, phase 3 trial. The Lancet. 2019; 393(10183): 1819-1830.
8. Takada K, Toyokawa G, Shoji F, Okamoto T, Maehara Y. The Significance of the PD-L1 Expression in Non–Small-Cell Lung Cancer: Trenchant Double Swords as Predictive and Prognostic Markers. Clinical Lung Cancer. 2018; 19(2): 120-129.
9. Leighl NB, Hellmann MD, Hui R, et al. Pembrolizumab in patients with advanced non-small-cell lung cancer (KEYNOTE-001): 3-year results from an open-label, phase 1 study. The Lancet Respiratory Medicine. 2019; 7(4): 347-357.
10. Gandhi L, Rodríguez-Abreu D, Gadgeel S, et al. Pembrolizumab plus Chemotherapy in Metastatic Non-Small-Cell Lung Cancer. N Engl J Med. 2018;378(22):2078-2092.
11. Paz-Ares L, Luft A, Vicente D, et al. Pembrolizumab plus Chemotherapy for Squamous Non–Small-Cell Lung Cancer. New England Journal of Medicine. 2018;379(21):2040-2051.
12. Non-small cell lung cancer collaborative group. Chemotherapy in non-small cell lung cancer: A meta-analysis using updated data on individual patients from 52 randomized clinical trials. BMJ. 2005;31:899–909.
13. Herbst RS, Baas P, Kim D-W, et al. Pembrolizumab versus docetaxel for previously treated, PD-L1-positive, advanced non-small-cell lung cancer (KEYNOTE-010): a randomised controlled trial. The Lancet. 2016;387(10027):1540-1550.