Pembrolizumab in Combination With Platinum-Based Chemotherapy in Patients With Recurrent EGFR and ALK Gene Altered...

Area of Science:

• Oncology
• Immunotherapy
• Medical Research

Background:

• Immune checkpoint inhibitors have shown limited effectiveness in patients with EGFR-mutant (EGFR+) and ALK-rearranged (ALK+) non-small cell lung cancer (NSCLC).
• Targeted therapies are standard for these patient groups, but resistance and relapse necessitate alternative treatment strategies.

Purpose of the Study:

• To evaluate the efficacy of pembrolizumab in combination with carboplatin and pemetrexed chemotherapy.
• To assess the response rate (RR), progression-free survival (PFS), and overall survival (OS) in patients with EGFR+ and ALK+ NSCLC previously treated with targeted therapy.

Main Methods:

• A phase II clinical trial was conducted with eligible patients diagnosed with EGFR+ or ALK+ NSCLC who had prior targeted therapy.
• Patients received 4 cycles of carboplatin, pemetrexed, and pembrolizumab every 3 weeks, followed by maintenance pemetrexed and pembrolizumab.
• Circulating tumor cells (CTCs) were collected to assess their correlation with treatment outcomes.

Main Results:

• The overall response rate (RR) was 46% in the EGFR+ cohort and 29% in the ALK+ cohort.
• Median PFS and OS were 8.3 and 22.2 months, respectively, for EGFR+ patients. For ALK+ patients, median PFS and OS were both 2.9 months.
• Common adverse events included fatigue, nausea, anemia, and elevated AST/ALT.

Conclusions:

• Pembrolizumab combined with chemotherapy demonstrated encouraging efficacy in patients with recurrent EGFR+ NSCLC, with a notable RR and OS.
• The combination therapy showed limited efficacy in ALK+ NSCLC patients.
• Further research may explore optimizing immunotherapy combinations for specific NSCLC subtypes.