Merck’s Keytruda tops chemotherapy for non-small cell lung cancer treatment

Merck’s Keytruda (Pembrolizumab) showed better results than chemotherapy at improving overall survival among first-line patients with non-small cell lung cancer in a trial whose results were published last Monday. The benefit extended across PD-L1-positive patients in the study, regardless of their level of PD-L1 expression. 

Keytruda is the first and only—PD-1/PD-L1 drug to win a monotherapy approval in the first-line treatment of non-small cell lung cancer. While initially aimed to patients with PD-L1 levels of 50% or higher, the new data could extend the therapy to many more patients; in fact, about 70% of all first-line patients are PD-L1 expressers.

Bernstein analyst Tim Anderson wrote that Keytruda will displace chemotherapy “as the reference for the majority of patients”. The results “change the way patients, physicians and payers” will value each of the approaches in development, ranging from monotherapies to chemo combos to CTLA4 combos.

“Already it is conceded that Keytruda is the best option for the PD-L1-high expressing patients given its combination of tolerability and efficacy, even though chemo-combo also shows high efficacy in the same segment,” Anderson also wrote.

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