Difference between revisions of "Carboplatin, Pemetrexed, Pembrolizumab in advanced or metastatic non-small cell lung cancer"

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<includeonly>Source: [[Carboplatin, Pemetrexed, Pembrolizumab in advanced or metastatic non-small cell lung cancer]]
 
<includeonly>Source: [[Carboplatin, Pemetrexed, Pembrolizumab in advanced or metastatic non-small cell lung cancer]]
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===Regimen===
 
===Regimen===
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|<small>'''FDA-recommended dose'''</small>
 
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{| class="wikitable" style="width: 100%; text-align:center;"
 
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!style="width: 25%"|Study
 
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!style="width: 25%"|[[Levels_of_Evidence#Evidence|Evidence]]
 
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!style="width: 25%"|Comparator
 
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!style="width: 25%"|[[Levels_of_Evidence#Comparative_efficacy|Comparative Efficacy]]
 
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|[https://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(16)30498-3/fulltext Langer et al. 2016 (KEYNOTE-021)]
 
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|style="background-color:#1a9851"|Randomized Phase II (E)
 
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|[[Complex_multipart_regimens#KEYNOTE-021|See link]]
 
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|style="background-color:#1a9850"|[[Complex_multipart_regimens#KEYNOTE-021|See link]]
 
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|[https://www.nejm.org/doi/full/10.1056/NEJMoa1801005 Gandhi et al. 2018 (KEYNOTE-189)]
 
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|style="background-color:#1a9851"|Phase III (E)
 
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|[[Complex_multipart_regimens#KEYNOTE-189|See link]]
 
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|style="background-color:#1a9850"|[[Complex_multipart_regimens#KEYNOTE-189|See link]]
 
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''Note: selection of platinum agent in KEYNOTE-189 was per investigator choice.''
 
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====Chemotherapy====
 
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*[[Carboplatin (Paraplatin)]] AUC 5 IV over 15 to 60 minutes once on day 1, '''given third'''
 
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*[[Pemetrexed (Alimta)]] 500 mg/m<sup>2</sup> IV over 10 minutes once on day 1, '''given second'''
 
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====Immunotherapy====
 
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*[[Pembrolizumab (Keytruda)]] 200 mg IV over 30 minutes once on day 1, '''given first, at least 30 minutes prior to chemotherapy'''
 
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====Supportive medications====
 
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*"Premedication with [[Folic acid (Folate)|folic acid]], [[Cyanocobalamin (Vitamin B12)|vitamin B12]], and [[:Category:Steroids|corticosteroids]] was administered according to local guidelines."
 
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'''21-day cycle for 4 cycles'''
 
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====Subsequent treatment====
 
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*[[Non-small_cell_lung_cancer#Pemetrexed_.26_Pembrolizumab|Pemetrexed & Pembrolizumab maintenance]]
 
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===References===
 
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# '''KEYNOTE-021:''' Langer CJ, Gadgeel SM, Borghaei H, Papadimitrakopoulou VA, Patnaik A, Powell SF, Gentzler RD, Martins RG, Stevenson JP, Jalal SI, Panwalkar A, Yang JC, Gubens M, Sequist LV, Awad MM, Fiore J, Ge Y, Raftopoulos H, Gandhi L; KEYNOTE-021 investigators. Carboplatin and pemetrexed with or without pembrolizumab for advanced, non-squamous non-small-cell lung cancer: a randomised, phase 2 cohort of the open-label KEYNOTE-021 study. Lancet Oncol. 2016 Nov;17(11):1497-1508. Epub 2016 Oct 10. [https://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(16)30498-3/fulltext link to original article] '''contains verified protocol''' [http://thelancet.com/cms/attachment/2074509559/2069027402/mmc1.pdf supplementary appendix][https://www.ncbi.nlm.nih.gov/pubmed/27745820 PubMed]
 
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# '''KEYNOTE-189:''' Gandhi L, Rodríguez-Abreu D, Gadgeel S, Esteban E, Felip E, De Angelis F, Domine M, Clingan P, Hochmair MJ, Powell SF, Cheng SY, Bischoff HG, Peled N, Grossi F, Jennens RR, Reck M, Hui R, Garon EB, Boyer M, Rubio-Viqueira B, Novello S, Kurata T, Gray JE, Vida J, Wei Z, Yang J, Raftopoulos H, Pietanza MC, Garassino MC; KEYNOTE-189 Investigators. Pembrolizumab plus chemotherapy in metastatic non-small-cell lung cancer. N Engl J Med. 2018 May 31;378(22):2078-2092. Epub 2018 Apr 16. [https://www.nejm.org/doi/full/10.1056/NEJMoa1801005 link to original article] [https://www.nejm.org/doi/suppl/10.1056/NEJMoa1801005/suppl_file/nejmoa1801005_protocol.pdf link to protocol] '''contains verified protocol''' [https://www.ncbi.nlm.nih.gov/pubmed/29658856 PubMed]
 

Latest revision as of 11:19, 26 July 2022



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