Carboplatin, Pemetrexed, Pembrolizumab in advanced or metastatic non-small cell lung cancer

Regimen in use at

Regimen

Study	Evidence	ORR	Comparator	Efficacy
Langer et al. 2016 (KEYNOTE-021)	Randomized Phase II	71%	Carboplatin & Pemetrexed +/- pemetrexed maintenance	Superior ORR

Chemotherapy

• Carboplatin (Paraplatin) AUC 5 IV over 15 to 60 minutes once on day 1
• Pemetrexed (Alimta) 500 mg/m² IV over 10 minutes once on day 1
• Pembrolizumab (Keytruda) 200 mg IV over 30 minutes once on day 1, given 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. Followed by pembolizumab +/- pemetrexed maintenance therapy

References

1. 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 link to original article contains verified protocol supplementary appendix; PubMed