Difference between revisions of "Carboplatin, Pemetrexed, Pembrolizumab in advanced or metastatic non-small cell lung cancer"
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|[https://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(16)30498-3/fulltext Langer et al. 2016 (KEYNOTE-021)] | |[https://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(16)30498-3/fulltext Langer et al. 2016 (KEYNOTE-021)] | ||
| − | |style="background-color:#1a9851"|Randomized Phase II | + | |style="background-color:#1a9851"|Randomized Phase II |
| − | |[[# | + | |[[Complex_multipart_regimens#KEYNOTE-021|See link]] |
| − | |style="background-color:#1a9850"| | + | |style="background-color:#1a9850"|[[Complex_multipart_regimens#KEYNOTE-021|See link]] |
|- | |- | ||
|[https://www.nejm.org/doi/full/10.1056/NEJMoa1801005 Gandhi et al. 2018 (KEYNOTE-189)] | |[https://www.nejm.org/doi/full/10.1056/NEJMoa1801005 Gandhi et al. 2018 (KEYNOTE-189)] | ||
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'''21-day cycle for 4 cycles''' | '''21-day cycle for 4 cycles''' | ||
====Subsequent treatment==== | ====Subsequent treatment==== | ||
| − | * | + | *[[Pembrolizumab & Pemetrexed maintenance therapy for advanced or metastatic non-small cell lung cancer|Pemetrexed & Pembrolizumab maintenance]] |
| − | |||
===References=== | ===References=== | ||
| − | # '''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 [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] | + | # '''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] |
# '''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] | # '''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] | ||
Revision as of 17:24, 9 June 2018
Regimen in use at
Regimen
| Study | Evidence | Comparator | Efficacy |
|---|---|---|---|
| Langer et al. 2016 (KEYNOTE-021) | Randomized Phase II | See link | See link |
| Gandhi et al. 2018 (KEYNOTE-189) | Phase III | See link | See link |
Note: selection of platinum agent in KEYNOTE-189 was per investigator choice.
Chemoimmunotherapy
- Carboplatin (Paraplatin) AUC 5 IV over 15 to 60 minutes once on day 1 given last
- Pemetrexed (Alimta) 500 mg/m2 IV over 10 minutes once on day 1 given second
- Pembrolizumab (Keytruda) 200 mg IV over 30 minutes once on day 1, given first, at least 30 minutes prior to chemotherapy
Supportive medications
- "Premedication with folic acid, vitamin B12, and corticosteroids was administered according to local guidelines."
21-day cycle for 4 cycles
Subsequent treatment
References
- 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. link to original article contains verified protocol supplementary appendixPubMed
- 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. link to original article link to protocol contains verified protocol PubMed