Matthew D. Hellmann, MD
Treatment with pembrolizumab (Keytruda) could elicit long-term survival (LTS) rates of 21% to 25% for previously-treated patients with PD-L1–positive non–small cell lung cancer (NSCLC) compared with 3% to 4% for docetaxel, according to a statistical analysis of findings from the KEYNOTE-010 and -001 trials presented at the 2017 ASCO-SITC Symposium.1
The same validated LTS model was used on the docetaxel arm of the KEYNOTE-010 study (n = 343) for comparison, Hellmann said. At the 18-month median follow-up, the LTS rate for docetaxel was 4.3% (95% CI, 0.0-14.4), which aligned with SEER survival expectations. "The long-term survival rates for docetaxel mirror the historical 5-year survival rates we would expect to see in lung cancer before the breakthrough of immunotherapy," he noted.
A limited number of long-term results currently exist for PD-1 inhibitors. Long-term survival findings from patients with metastatic melanoma treated with the PD-1 inhibitor nivolumab (Opdivo) were presented at the 2016 AACR Annual Meeting.2
In these findings, which were from a phase I study, the 5-year overall survival rate was 34% for 107 heavily pretreated patients with metastatic melanoma who had not received prior ipilimumab (Yervoy). This rate was nearly double the SEER survival figure for melanoma of 17.9%.
"Melanoma, a disease that was previously characterized by progression, has now been profoundly changed by immunotherapies," noted Hellmann. "For ipilimumab, there's a plateau in the survival curve at about 20% that extends out more than 10 years."
Future studies will continue to assess characteristics that could help predict long-term outcomes, Hellmann noted. Additionally, biomarker analyses are also needed to identify the 25% of individuals with NSCLC who are most likely to experience a long-term response.
- Hellmann MD, Ma J, Garon EB, et al. Estimating long-term survival of PD-L1-expressing, previously treated, non-small cell lung cancer patients who received pembrolizumab in KEYNOTE-001 and -010. J Clin Oncol. 2017;35 (suppl 7S; abstract 77).
- Hodi SF, Kluger HM, Sznol M, et al. Durable, Long-term Survival in Previously Treated Patients With Advanced Melanoma Who Received Nivolumab Monotherapy in a Phase I Trial. Presented at the 2016 AACR Annual Meeting; April 16-20, New Orleans, Louisiana. Abstract CT001.
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