Pembrolizumab versus chemotherapy in Chinese patients with NSCLC and PD-L1 CPS ≥ 1%: five-year follow-up of KEYNOTE-042 China

In the phase 3 KEYNOTE-042 China study of participants enrolled in China in the global KEYNOTE-042 and Chinese extension studies, pembrolizumab improved overall survival verus chemotherapy in locally advanced or metastatic non-small cell lung cancer with PD-L1 tumor proportion score (TPS) ≥ 50%,20% and 1%. Five-year follow-up outcomes of the study have now been published. Participants with previously untreated LA/M NSCLC with TPS ≥1% without EGFR or ALK alterations were randomized to pembrolizumab for up to 35 three-week cycles (n=128) or carboplatin plus paclitaxel or pemetrexed with optional pemetrexed maintenance (n=134). Pembrolizumab prolonged overall survival versus chemotherapy. Grade 3 to 5 treatment-related adverse events occurred in 19.5% of patients in the pembrolizumab group and 68.8% of patients in the chemotherapy group. The authors conclude that with 5 years of follow-up, pembrolizumab continues to improve overall survival versus chemotherapy with manageable safety in Chinese participants with previously untreated LA/M NSCLC expressing PD-L1.