Advanced non-small cell lung cancer – Treatment with Pembrolizumab

Abstract

The Guidelines Project, an initiative of the Brazilian Medical Association, aims to combine information from the medical field in order to standardize producers to assist the reasoning and decision-making of doctors. The information provided through this project must be assessed and criticized by the physician responsible for the conduct that will be adopted, depending on the conditions and the clinical status of each patient. Paz-Ares L, et al. 2018 Keynote-407 278/194 280/191 Gandhi L, et al. 2018 Keynote-189 405/272 202/133 Langer CJ, et al. 2016 Keynote-021 59/23 62/16reduction of death, in a 12-month follow-up, of 8% (95% CI -13% to -4%); favorable to the treatment with pembrolizumab plus chemotherapy; [I 2 =0%; NNT=12 (95% CI 7 to 25)] - (Figure 4). FIGURE 4. COMPARISON FOREST PLOT: PEMBROLIZUMAB + CHEMOTHERAPY VERSUS CHEMOTHERAPY, OUTCOME: MORTALITY AT 12 MONTHS. CHEMOTHERAPY CHEMOTHERAPY CHEMOTHERAPY CHEMO CHEMO CHEMOThese three RCTs analyzed adverse events of any cause, degree ≥3 in the population treated, for comparison between pembrolizumab plus chemotherapy versus chemotherapy (Table 6).

Pembrolizumab plus pemetrexed‐platinum for metastatic nonsquamous non–small‐cell lung cancer: KEYNOTE‐189 Japan Study

“…Pembrolizumab is a humanized monoclonal antibody that selectively binds to the inhibitory immune checkpoint receptor, PD‐1, and blocks its interactions with its ligands, PD‐L1 and PD‐L2, thus reactivating T‐cell–mediated tumor destruction 7‐9 . As first‐line therapy, pembrolizumab in combination with platinum‐based chemotherapy is approved (including in Japan 10,11 ) for the treatment of patients with metastatic squamous 12 and nonsquamous NSCLC 13,14 without EGFR or ALK alterations and regardless of PD‐L1 TPS after demonstrating significant survival benefit compared with chemotherapy alone in these patients.…”

“…Pembrolizumab is a humanized monoclonal antibody that selectively binds to the inhibitory immune checkpoint receptor, PD‐1, and blocks its interactions with its ligands, PD‐L1 and PD‐L2, thus reactivating T‐cell–mediated tumor destruction. 7 , 8 , 9 As first‐line therapy, pembrolizumab in combination with platinum‐based chemotherapy is approved (including in Japan 10 , 11 ) for the treatment of patients with metastatic squamous 12 and nonsquamous NSCLC 13 , 14 without EGFR or ALK alterations and regardless of PD‐L1 TPS after demonstrating significant survival benefit compared with chemotherapy alone in these patients. The benefits associated with first‐line pembrolizumab plus platinum‐based chemotherapy in patients with metastatic nonsquamous NSCLC without EGFR or ALK alterations were first demonstrated in the randomized, open‐label, phase 2 cohort G of the multicohort KEYNOTE‐021 study, where the combination was associated with a significantly higher objective response rate (ORR; 55% vs 29%; P = .0016) and significantly longer progression‐free survival (PFS; hazard ratio [HR], .53; 95% confidence interval [CI], .31‐.91; P = .010) compared with chemotherapy alone.…”

Bullous pemphigoid in elderly woman affected by non-small cell lung cancer treated with pembrolizumab: A case report and review of literature

“…In particular, pembrolizumab is a highly selective, humanized IgG4 monoclonal antibody that binds to the PD-1 receptor and blocks its interaction with the PD-L1 and PD-L2 ligands, which are expressed in antigen-presenting cells and may be expressed by tumors or other cells in the cancer microenvironment, assisting them in preventing of their detection and elimination by the immune system of the host. 2 , 3…”