2024 World Conference on Lung Cancer (WCLC) - Posters-P4.11E.02 Efficacy of Pembrolizumab Plus Pemetrexed in Older Patients with Non-squamous NSCLC According to PD-L1 Status from the CJLSG1901 Study

P4.11E.02 Efficacy of Pembrolizumab Plus Pemetrexed in Older Patients with Non-squamous NSCLC According to PD-L1 Status from the CJLSG1901 Study

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The CJLSG1901 study assessed the efficacy and safety of pembrolizumab plus pemetrexed in older patients (aged 75 and above) with metastatic non-squamous non-small cell lung cancer (NSCLC), specifically focusing on those with different levels of PD-L1 status. Pembrolizumab combined with pemetrexed and carboplatin is commonly used for treating metastatic non-squamous NSCLC, but its effects in older populations have been uncertain.<br /><br />Key findings from the study include an objective response rate (ORR) of 36.7%, meeting the primary endpoint. Further analysis revealed that patients with PD-L1 levels of 1-49% exhibited a higher ORR of 46.4% compared to those with PD-L1 levels below 1%, who showed a 23.8% ORR. This suggests greater effectiveness in those with higher PD-L1 expression.<br /><br />Patients with higher PD-L1 levels also experienced better outcomes in terms of disease control rate (DCR) and progression-free survival (PFS), with median PFS being 7.8 months for PD-L1 1-49% compared to 4.4 months for PD-L1 below 1%. However, median overall survival (OS) was similar between the two groups: 19.1 months (PD-L1 1-49%) and 19.4 months (PD-L1 below 1%).<br /><br />The study concluded that pembrolizumab plus pemetrexed appears more effective and has a favorable safety profile in this older patient group, particularly for those with higher PD-L1 expression. This suggests the potential for tailored treatment strategies based on PD-L1 status, although OS benefits were not significant despite better response and control rates.<br /><br />Funding for this research was partially provided by the National Cancer Center Research and Development Fund and MSD K.K., with acknowledgments to all participants involved in the study.

Asset Subtitle

Yoshihito Kogure

Meta Tag

Speaker Yoshihito Kogure

Topic Metastatic NSCLC – Immunotherapy

Keywords

CJLSG1901 study

pembrolizumab

pemetrexed

older patients

metastatic NSCLC

PD-L1 status

objective response rate

disease control rate

progression-free survival

tailored treatment