Multicenter phase 2 trial of pembrolizumab plus chemotherapy without radiotherapy for locally advanced NSCLC with PD-L1 TPS 50% or higher

The phase 2 Evolution study, at nine centers in Japan, evaluated the radiotherapy free regimen of pembrolizumab plus platinum-based chemotherapy as first-line treatment for unresectable, locally advanced NSCLC with PD-L1 tumor proportion score 50% or higher in patients with ECOG performance score 0 or 1. The 2-year progression-free survival rate was 67% (90% CI 46-83). The most common grade 3 or worse adverse events were neutropenia (38% of patients), leukopenia (19%), and pneumonia (14%). Serious adverse events occurred in 33%; no treatment-related deaths were reported. The authors conclude that pembrolizumab plus chemotherapy, without radiotherapy, might provide a feasible and promising treatment strategy for this patient group.