Two-year treatment with Pembrolizumab monotherapy in advanced non-small cell lung cancer: a reflection based on real-world data

Abstract

Introduction and objectives: Immunotherapy has introduced advances in the treatment of non -small cell lung cancer. However, data from current clinical practice on potential responder groups, optimal duration of treatment and safety issues remain unclear. It is intended to produce a reflection on the population of patients with a favourable response to Pembrolizumab and how they have evolved clinically over time.
Materials and methods: Retrospective study of patients who completed at least 2 years/35 cycles of Pembrolizumab was conducted, with descriptive analysis of clinicopathological characteristics and medical results obtained during the follow -up period.
Results: Twenty -three patients were identified, mostly men (95.7%), diagnosed with adenocarcinoma (78.3%) at an average age of 62.0 -year -old, with good functional status. During treatment, 69.6% of cases achieved an objective response. At the time of the study, with a median follow -up of 35.2 months, 17 patients were alive and in remission (73.9%), 7 of which (41.1%) with disease controlled for more than 32.6months (maximum observed of 48.7) months; among those who progressed (13.0%), only 1 achieved a partial response again within 5.1 months of reintroduction of immunotherapy. Grade >2 adverse events occurred in 9 patients (39%), leading to different clinical outcomes; of these, 44% showed recurrence even after suspension of immunotherapy.
Discussion and conclusions: The data seem to support the potential lasting benefit of Pembrolizumab described in recent studies, with a manageable, although not negligible, safety profile. In the absence of relevant toxicity and in the face of disease progression, a second course may be considered. However, more prospective, and multicenter studies, with a larger sample and a longer follow -up period, are needed to support these data.