The standard of care for patients with stage 3 locally advanced unresectable non-small cell lung cancer currently consists of chemoradiotherapy with platinum doublet chemotherapy and daily radiotherapy.  

Research from ASCO 2020 looked at a new potential treatment that could improve and extend a patient’s life.  

Salma Jabbour, MD, from the Rutgers Cancer Institute of New Jersey, discussed the results of the KEYNOTE-799 trial with MD/alert, noting that the addition of pembrolizumab to platinum doublet chemotherapy and radiotherapy showed positive early results for safety and efficacy in that effort.
 
Dr Jabbour said while stage 4 patients often receive immunotherapy as soon as they are diagnosed, those with stage three disease, who have a better survival rate, are often waiting as long as three months to receive the same therapy after their initial diagnosis.   

“The big question with this study was looking at the objective response rates and the toxicity rates with regards to pneumonitis by moving pembrolizumab earlier into the treatment regimen of these patients and allowing stage three patients to receive immune checkpoint inhibition from day one of their therapy rather than potentially after they complete chemoradiation, potentially eight weeks after they’ve really started their chemotherapy. It’s really moving it into the stage three population to try to really treat distant metastatic disease much earlier and hopefully help patients by the synergy that we would expect with chemo and radiation therapy and with immunotherapy, and also to target micro metastatic disease, which is still really a big issue for our stage 3 patients who experience a high rate of distant relapse,” Dr Jabbour said.

She said the researchers were encouraged by the response rates and not surprised by the toxicity results.  

The clinical trial was one of several looking at the use of pembrolizumab with results expected to be presented at the annual ASCO meeting in Chicago.  

While the annual conference was forced to go to a virtual format due to the COVID-19 outbreak, Dr Jabbour said she believes the drug has already “revolutionized” treatment of stage 4 non-small cell lung cancer. She added that her results and others being presented at the conference show the treatment can make a more significant impact as additional research is conducted. 
 

by Adam Hochron