Real-world comparative effectiveness and safety of pembrolizumab for PD-L1≥50% metastatic non-small-cell lung cancer
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View abstract on PubMed
Summary
This summary is machine-generated.First-line pembrolizumab improves survival in real-world lung cancer treatment compared to chemotherapy. However, this immunotherapy is associated with increased adverse events and healthcare utilization.
Area Of Science
- Oncology
- Immunotherapy
- Clinical Trials
Background
- Pembrolizumab demonstrated efficacy in KEYNOTE-024, but real-world effectiveness and safety data are limited.
- Understanding long-term outcomes in routine clinical practice is crucial for treatment decisions.
Purpose Of The Study
- To compare the effectiveness and safety of first-line pembrolizumab versus chemotherapy in a real-world setting.
- To evaluate overall survival and key safety outcomes including hospitalizations and adverse events.
Main Methods
- Retrospective cohort study of patients receiving first-line pembrolizumab or chemotherapy (April 2013-March 2021).
- Propensity score matching (1:1) was used to balance baseline characteristics between groups.
- Primary outcome: overall survival. Secondary outcomes: hospitalization rates, emergency department visits, specialist visits, and adverse events.
Main Results
- The matched cohort comprised 2284 pairs of patients.
- Pembrolizumab significantly improved median overall survival (13.0 months) compared to chemotherapy (9.2 months; HR 0.81, 95% CI: 0.71-0.92).
- Pembrolizumab was associated with more adverse events, specialist visits, and higher 1-year cumulative incidence of direct hospitalizations.
Conclusions
- The survival benefit of first-line pembrolizumab is confirmed in real-world clinical practice.
- While effective, pembrolizumab use in the real world is linked to increased toxicity and healthcare resource utilization.
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