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A Randomized, Placebo-Controlled Trial of Pembrolizumab Plus Chemotherapy in Patients With Metastatic Squamous NSCLC: Protocol-Specified Final Analysis of KEYNOTE-407

Open access
Paz-Ares, Luis, Vicente, David, Tafreshi, Ali, Robinson, Andrew, Soto Parra, Hector, Mazières, Julien, Hermes, Barbara, Cicin, Irfan, Medgyasszay, Balazs, Rodríguez-Cid, Jerónimo, Okamoto, Isamu, Lee, SungSook, Ramlau, Rodryg, Vladimirov, Vladimir, Cheng, Ying, Deng, Xuan, Zhang, Ying, Bas, Tuba, Piperdi, Bilal, Halmos, Balazs·2020·Journal of Thoracic Oncology

Abstract

INTRODUCTION In the randomized KEYNOTE-407 study (ClinicalTrials.gov, NCT02775435), pembrolizumab plus carboplatin and paclitaxel/nab-paclitaxel (chemotherapy) significantly improved overall survival (OS) and progression-free survival (PFS) versus placebo plus chemotherapy in patients with previously untreated metastatic squamous non-small-cell lung cancer (NSCLC). We report updated efficacy outcomes from the protocol-specified final analysis and, for the first time, progression on next-line of treatment. METHODS Eligible patients were randomized to chemotherapy plus either pembrolizumab (n=278) or placebo (n=281). After positive results from the second interim analysis, patients still receiving placebo could crossover to pembrolizumab monotherapy at time of confirmed progressive disease. Primary endpoints were OS and PFS. PFS-2 (time from randomization to progression on next-line treatment/death, whichever occurred first) was an exploratory endpoint. RESULTS After median (range) follow-up of 14.3 (0.1-31.3) months, pembrolizumab plus chemotherapy continued to demonstrate a clinically meaningful improvement over placebo plus chemotherapy in OS (median [95%CI], 17.1 [14.4‒19.9] versus 11.6 [10.1‒13.7] months; hazard ratio [HR (95%CI)], 0.71 [0.58‒0.88]) and PFS (median, 8.0 [6.3‒8.4] versus 5.1 [4.3‒6.0] months; HR [95%CI], 0.57 [0.47‒0.69]). PFS-2 was longer for patients randomized to first-line pembrolizumab plus chemotherapy (HR [95% CI], 0.59 [0.49‒0.72]). Grade 3‒5 adverse events occurred in 74.1% and 69.6% of patients receiving pembrolizumab plus chemotherapy and placebo plus chemotherapy, respectively. CONCLUSION Pembrolizumab plus chemotherapy continued to demonstrate substantially improved OS and PFS in patients with metastatic squamous NSCLC. The PFS-2 outcomes support pembrolizumab plus chemotherapy as a standard first-line treatment in patients with metastatic squamous NSCLC.

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Metadata

Authors
Paz-Ares, L., Vicente, D., Tafreshi, A., Robinson, A., Soto Parra, H., Mazières, J., Hermes, B., Cicin, I., Medgyasszay, B., Rodríguez-Cid, J., Okamoto, I., Lee, S., Ramlau, R., Vladimirov, V., Cheng, Y., Deng, X., Zhang, Y., Bas, T., Piperdi, B., & Halmos, B.
Venue
Journal of Thoracic Oncology
Publisher
Elsevier BV
Published
2020-10
Volume
15
Issue
10
Pages
1657-1669
ISSN
1556-0864 (ISSN-L)
OpenAlex
W3037506839
Cited by
631
References
20
FWCI
51.72
Type
journal article
Language
en
Open access
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CoChat. (2026). Citation check: A Randomized, Placebo-Controlled Trial of Pembrolizumab Plus Chemotherapy in Patients With Metastatic Squamous NSCLC: Protocol-Specified Final Analysis of KEYNOTE-407. https://app.cochat.ai/papers/10.1016/j.jtho.2020.06.015
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Paz-Ares, L., Vicente, D., Tafreshi, A., Robinson, A., Soto Parra, H., Mazières, J., Hermes, B., Cicin, I., Medgyasszay, B., Rodríguez-Cid, J., Okamoto, I., Lee, S., Ramlau, R., Vladimirov, V., Cheng, Y., Deng, X., Zhang, Y., Bas, T., Piperdi, B., & Halmos, B. (2020). A Randomized, Placebo-Controlled Trial of Pembrolizumab Plus Chemotherapy in Patients With Metastatic Squamous NSCLC: Protocol-Specified Final Analysis of KEYNOTE-407. Journal of Thoracic Oncology. https://doi.org/10.1016/j.jtho.2020.06.015

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Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).

Semantic Scholar’s data is described in: Kinney, R., et al. (2023). The Semantic Scholar Open Data Platform. arXiv:2301.10140.