Real-world use of different pembrolizumab regimens (3 weekly versus 6 weekly) in non-small cell lung cancer (NSCLC) patients
Osborne, Lucy Ortega-Franco, Ana Hodgson, Clare Pearce, Mark Moss, Anna Lindsay, Colin R Hughes, S. Taylor, Paul Califano, Raffaele Rafee, Shereen
Osborne, Lucy
Ortega-Franco, Ana
Hodgson, Clare
Pearce, Mark
Moss, Anna
Lindsay, Colin R
Hughes, S.
Taylor, Paul
Califano, Raffaele
Rafee, Shereen
Citations
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Abstract
Background and objectives: Pembrolizumab monotherapy given
3-weekly (3w) (200mg) is approved for the treatment of non-small cell lung cancer (NSCLC). In June 2019, NICE endorsed the 6w
regimen (400mg) based on computer modelling data (Lala, Eur J
Cancer 2020), which has been used during the COVID-19 pandemic
to reduce hospital visits. This study compared immune-related
adverse events (irAEs), discontinuation rates, and patient experience
of 3w vs 6w patients treated at The Christie NHS Foundation Trust,
Manchester, UK.
Methodology: Pharmacy records were used to identify NSCLC
patients treated with pembrolizumab, 1st, 2nd or 3rd line. IrAEs and
discontinuation rates were analysed using Kaplan Meier curves to
compare the 3w vs 6w cohorts. A sample of the cohort who received
3w then 6w undertook a questionnaire assessing patient experience.
Results: 38 patients received pembrolizumab 6w, and 91 received
pembrolizumab 3w, of the 3w, 51 switched to 6w. Baseline
characteristics were similar. Any grade irAEs and G1-2 irAEs
were significantly higher in the 6w cohort (p=0.006 and p=0.04,
respectively). Both cohorts showed low rates of G3-5 irAEs at 6
months, 2.3% vs 14.5%, 3w vs 6w, p=0.3. Discontinuation rates at 6
months due to any irAES, G1-2 irAEs or G3-5 irAEs were insignificant
in both cohorts (3w to 6w respectively): 4.5% vs 11.2%, p=0.2; 2.8% vs
8.7%, p=0.4; 2.0% vs 2.5%, p=0.3. Quality of life questionnaires showed
stability (60%) or improvement (20%) in the 6w cohort compared to
3w. 90% said their mental health did not differ between regimens.
45% and 40% of patients preferred 6w and 3w respectively, 15% had
no preference.
Conclusion: NSCLC patients treated with 6w pembrolizumab
appear to experience more low-grade irAEs compared to 3w. High-grade irAEs and discontinuation rates due to irAEs were insignificant
in both cohorts. Patients preferred the 6w regiment and found it
tolerable.
Affiliation
Description
Date
2022
Publisher
Collections
Keywords
Type
Meetings and Proceedings
Citation
Osborne L, Ortega-Franco A, Hodgson C, Pearce M, Moss A, Lindsay C, et al. Real-world use of different pembrolizumab regimens (3 weekly versus 6 weekly) in non-small cell lung cancer (NSCLC) patients. Vol. 165, Lung Cancer. Elsevier BV; 2022. p. S46.