Most Read Articles
Natalia Reoutova, 20 May 2020

Cancer patients infected with coronavirus disease 2019 (COVID-19) appear to be at higher risk of severe outcomes, including death, but cancer type and treatment serve as better predictors, according to recent research presented at the American Association for Cancer Research (AACR) 2020 Virtual Annual Meeting I.

At the time of writing, COVID-19 has spread to more than 200 countries and territories, affecting an estimated 4.5 million people and killing over 300,000. Cancer, on the other hand, is newly diagnosed in 18 million people and takes the lives of 10 million every year.

“We have invited physician scientists who are at the epicentre of the COVID-19 pandemic, taking care of patients with cancer. They gathered prospective information to understand the effects of COVID-19 on patients with cancer, are testing new treatments, and are making this knowledge available to the global research community, so we can all benefit from their experience,” said Professor Antoni Ribas from UCLA Medical Center, Los Angeles, California, US, chairperson of the COVID-19 and cancer plenary session of the meeting.

Christina Lau, 12 May 2020

Patients with advanced non-small-cell lung cancer (NSCLC) who have a past medical history of pneumonitis are at increased risk of treatment-related pneumonitis (TAP) from immune checkpoint inhibitor (ICI) regimens or chemotherapy alone, an analysis of clinical trial and real-world data has shown.

KEYNOTE-042: Pembrolizumab monotherapy works in PD-L1–positive advanced NSCLC regardless of STK11 or KEAP1 status

Dr Margaret Shi
14 May 2020

Pembrolizumab monotherapy improves overall survival (OS) and cancer control compared with platinum-based chemotherapy in patients with untreated locally advanced or metastatic programmed death-ligand 1 (PD-L1)–positive non-small-cell lung cancer (NSCLC) regardless of STK11 or KEAP1 mutation status, according to results of the phase III KEYNOTE-042 study.

“Pembrolizumab should be considered as a standard first-line treatment option for advanced PD-L1– positive NSCLC regardless of STK11 or KEAP-1 mutation status,” said investigator Dr Byoung Chul Cho from the Yonsei University, Seoul, South Korea. [Cho BC, et al, AACR 2020, abstract CT084]

In the trial, 1,274 patients (median age, 63 years; male, 70.8 percent) with untreated locally advanced or metastatic NSCLC without sensitizing EGFR mutation or ALK translocation, who had PD-L1 tumour proportion score (TPS) 1 percent, were randomized (1:1) to receive pembrolizumab (200 mg Q3W for up to 35 cycles) or chemotherapy (carboplatin plus paclitaxel or carboplatin plus pemetrexed) for up to 6 cycles.

Matched germline DNA and evaluable data for STK11 and KEAP1 mutation were available for 33.7 percent of all randomized participants, in which 53.6 percent of patients in the mutation-evaluable group received pembrolizumab monotherapy.

At baseline, the proportion of patients with PD-L1 TPS of 1–49 percent was similar between the mutation-evaluable population and the total population (54.3 percent vs 53.0 percent).

Comparable outcomes of OS, progression-free survival (PFS) and objective response rate (ORR) with pembrolizumab vs chemotherapy were achieved between the mutation-evaluable population (OS hazard ratio [HR], 0.77; 95 percent confidence interval [CI], 0.62 to 0.97) (PFS HR, 0.90; 95 percent CI, 0.73 to 1.10) (ORR, 29.6 percent vs 22.1 percent) and the total population (OS HR, 0.82; 95 percent CI, 0.71 to 0.93) (PFS HR, 1.05; 95 percent CI, 0.93 to 1.19) (ORR, 27.2 percent vs 26.5 percent).

STK11, KEAP1 and STK11/KEAP1 mutations were present in 7.7 percent, 14.9 percent and 2.8 percent of patients in the mutation-evaluable population, respectively.

Patients with vs without STK11 mutation had lower PD-L1 expression but higher tissue tumour mutational burden (tTMB) (median TPS, 15 percent vs 40 percent) (median tTMB score, 191 vs 146). Patients with vs without KEAP1 mutation had similar levels of PD-L1 expression but higher tTMB (median TPS, 40 percent vs 40 percent) (median tTMB score, 183 vs 142).

In this exploratory analysis, significant improvement in OS was demonstrated with pembrolizumab vs chemotherapy among patients with or without STK11 or KEAP1 mutation (STK11 mut: HR, 0.37; 95 percent CI, 0.16 to 0.86) (STK11 wt: HR, 0.83; 95 percent CI, 0.65 to 1.05) (KEAP1 mut: HR, 0.75; 95 percent CI, 0.42 to 1.35) (KEAP1 wt: HR, 0.78; 95 percent CI, 0.61 to 0.99).

A comparable numerical improvement in PFS with pembrolizumab vs chemotherapy was seen among patients with or without STK11 and KEAP1 mutations (STK11 mut: HR, 0.75; 95 percent CI, 0.36 to 1.57) (STK11 wt: HR, 0.91; 95 percent CI, 0.74 to 1.13) (KEAP1 mut: HR, 0.67; 95 percent CI, 0.38 to 1.17) (KEAP1 wt: HR, 0.96; 95 percent CI, 0.77 to 1.20).

The ORR was 31.3 percent vs 5.9 percent and 29.4 percent vs 23.6 percent with pembrolizumab vs chemotherapy among patients with and without STK11 mutation. Similar ORRs were reported among patients with and without KEAP1 mutation (35.5 percent vs 18.2 percent and 28.6 percent vs 22.9 percent, respectively). 
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Most Read Articles
Natalia Reoutova, 20 May 2020

Cancer patients infected with coronavirus disease 2019 (COVID-19) appear to be at higher risk of severe outcomes, including death, but cancer type and treatment serve as better predictors, according to recent research presented at the American Association for Cancer Research (AACR) 2020 Virtual Annual Meeting I.

At the time of writing, COVID-19 has spread to more than 200 countries and territories, affecting an estimated 4.5 million people and killing over 300,000. Cancer, on the other hand, is newly diagnosed in 18 million people and takes the lives of 10 million every year.

“We have invited physician scientists who are at the epicentre of the COVID-19 pandemic, taking care of patients with cancer. They gathered prospective information to understand the effects of COVID-19 on patients with cancer, are testing new treatments, and are making this knowledge available to the global research community, so we can all benefit from their experience,” said Professor Antoni Ribas from UCLA Medical Center, Los Angeles, California, US, chairperson of the COVID-19 and cancer plenary session of the meeting.

Christina Lau, 12 May 2020

Patients with advanced non-small-cell lung cancer (NSCLC) who have a past medical history of pneumonitis are at increased risk of treatment-related pneumonitis (TAP) from immune checkpoint inhibitor (ICI) regimens or chemotherapy alone, an analysis of clinical trial and real-world data has shown.