Immunotherapy for lung cancer! Mosadon keytruda single drug first-line treatment significantly prolonged the overall survival, and KRAS mutation was not related!

December 16, 2019 / BIOON / -- cancer immunotherapy giant Merck & Co recently released exploratory analysis data of key phase III keynote-042 study of lung cancer The results showed that PD-L1 (tumor In NSCLC patients with proportion score [TPS] ≥ 1%, anti-PD-1 therapy (Coretta, common name: pembrolizumab, pabolizumab) as the first-line treatment of single drug therapy improved the overall survival (OS), progression free survival (PFS), and overall remission rate (ORR), regardless of KRAS mutation Dr Jonathan Cheng, vice president of oncology clinical research, MSD research laboratory, said: "KRAS mutations occur in about 20% of NSCLC patients, and some previous studies have shown that these mutations are related to poor response to treatment Therefore, in this exploratory analysis, it is encouraging to note that keytruda monotherapy is associated with survival benefits in patients with metastatic non squamous NSCLC, regardless of KRAS mutation status " The purpose of the exploratory analysis was to assess the incidence of KRAS mutations in the keynote-042 trial and their relationship to efficacy Among the 1274 patients in the study who had not received treatment (primary treatment), tumor expression PD-L1 (TPS ≥ 1%), metastatic non squamous NSCLC, 301 patients had KRAS evaluable data (n = 232, no KRAS mutation; n = 69, KRAS mutation, including n = 29, KRAS G12C mutation) Tissue tumor mutation load (ttmb) and KRAS mutation state were measured by tumor tissue total exon sequencing (WES) and matched normal DNA (blood) In the study, patients were randomly assigned 1:1 and received: intravenous keytruda 200mg (q3w) (n = 637) every three weeks or chemotherapy (pemetrexed or paclitaxel) (n = 637) selected by the investigator Treatment continued until disease progression or unacceptable toxicity The primary end point was OS in patients with TPS ≥ 50%, ≥ 20% and ≥ 1%, evaluated sequentially The secondary endpoints were PFS and orr The results of this exploratory analysis showed that keytruda monotherapy was associated with improved clinical outcomes compared with chemotherapy in patients with metastatic non squamous NSCLC, regardless of KRAS mutation status In this analysis, keytruda reduced mortality by 58% (HR = 0.42 [95% CI: 0.22-0.81]) in patients with any KRAS mutation and 72% (HR = 0.28 [95% CI: 0.09-0.86]) in patients with KRAS G12C mutation compared to chemotherapy The safety of keytruda is consistent with the previously reported results in patients with metastatic NSCLC Other therapeutic results of this exploratory analysis show that lung cancer is the main cause of cancer death worldwide It is formed in lung tissue, usually in cells in the airway The two main types of lung cancer are non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC) NSCLC is the most common type of lung cancer, accounting for about 85% of all cases NSCLC has many subtypes, including adenocarcinoma (40% of lung cancer), squamous cell carcinoma (25% - 30%) and large cell carcinoma (10% - 15%) Lung cancer can also be characterized by different biomarkers, including PD-L1, KRAS, ALK, EGFR and ros1 KRAS mutations occur in about 20% of NSCLC cases Keytruda belongs to PD - (L) 1 tumor immunotherapy, which helps detect and fight against tumor cells by improving the ability of human immune system Keytruda is a humanized monoclonal antibody that blocks the interaction between PD-1 and its ligands PD-L1 and PD-L2, thus activating T lymphocytes that may affect tumor cells and healthy cells So far, a number of PD - (L) 1 tumor immunotherapies have been approved worldwide, among which keytruda is the leader in this field and has approved more than 20 treatment indications MSD has the largest clinical development project in immunooncology in the industry At present, more than 1000 clinical trials are investigating the role of keytruda in various types of tumors and treatment backgrounds The keytruda clinical project aims to understand the role of the drug in cancer and factors that may predict patients' benefits from keytruda treatment, including exploring several different biomarkers At the end of November this year, keytruda was approved by China National Drug Administration (nmpa) to combine carboplatin and paclitaxel for the first-line treatment of metastatic squamous cell non-small cell lung cancer (NSCLC) It is worth mentioning that this approval is also keytruda's third first-line approval in NSCLC treatment in less than a year Now, the drug is the first anti PD-1 therapy approved by China for the first-line treatment of squamous and non squamous NSCLC combined with chemotherapy, and single drug treatment of NSCLC (tumor proportion score [TPS] ≥ 1%) Original source: data from exploration analysis show Merck's keytruda ® (pembrolizumab) improved overall survival as monthly for the first line treatment of metastatic non small cell lung cancer rehabilitation of KRAS national status