Dr. Pecot on the Frontline Standard of Care in Squamous NSCLC

Chad Pecot, MD, assistant professor, Department of Medicine, University of North Carolina (UNC) Lineberger Comprehensive Cancer Center, discusses the frontline standard of care in advanced squamous non—small cell lung cancer (NSCLC).

In the phase III KEYNOTE-407 trial, there was a significant improvement in overall survival (OS) with pembrolizumab (Keytruda) plus carboplatin and paclitaxel or nab-paclitaxel (Abraxane) versus chemotherapy alone. Notably, the trial allowed crossover, so when patients who didn't initially receive the immunotherapy started experiencing tumor growth, they were able to start receiving immunotherapy, explains Pecot. Even with the crossover, there was an improvement in OS was observed if the immunotherapy was received earlier on in treatment. Therefore, the earlier the immunotherapy was started, the better the survival benefit.

Additional analysis showed a benefit with the combination irrespective PD-L1 expression. Even patients who had no PD-L1 expression in their tumor had a notable OS benefit by adding immunotherapy. Furthermore, the regimen was observed to be well tolerated.