Five-year outcomes with first-line pembrolizumab versus chemotherapy for PD-L1-positive NSCLC in KEYNOTE-042

The multinational phase 3 trial KEYNOTE-042 randomized patients with locally advanced or metastatic PD-L1-positive NSCLC without EGFR/ALK alterations to first-line pembrolizumab or chemotherapy. Five-year follow-up of trial found that first-line pembrolizumab monotherapy continued to show durable clinical benefit versus chemotherapy, regardless of PD-L1 tumor proportion score (≥1%; ≥ 20%; or ≥ 50%). No new toxicities were identified. The authors conclude that first-line pembrolizumab should remain standard of care in this setting.