Cited by 795Cancer Immunotherapy and BiomarkersLung Cancer Treatments and MutationsLung Cancer Research Studies

Cemiplimab monotherapy for first-line treatment of advanced non-small-cell lung cancer with PD-L1 of at least 50%: A multicentre, open-label, global, phase 3, randomised, controlled trial

Sezer, Ahmet, Kilickap, Saadettin, Gümüş, Mahmut, Bondarenko, Igor, Özgüroğlu, Mustafa, Gogishvili, Miranda, Turk, Haci M, Cicin, Irfan +19 more·2021·The Lancet

Abstract

Background We aimed to examine cemiplimab, a programmed cell death 1 inhibitor, in the first-line treatment of advanced non-small-cell lung cancer with programmed cell death ligand 1 (PD-L1) of at least 50%.Methods In EMPOWER-Lung 1, a multicentre, open-label, global, phase 3 study, eligible patients recruited in 138 clinics from 24 countries (aged ≥18 years with histologically or cytologically confirmed advanced non-small-cell lung cancer, an Eastern Cooperative Oncology Group performance status of 0-1; never-smokers were ineligible) were randomly assigned (1:1) to cemiplimab 350 mg every 3 weeks or platinum-doublet chemotherapy. Crossover from chemotherapy to cemiplimab was allowed following disease progression. Primary endpoints were overall survival and progression-free survival per masked independent review committee. Primary endpoints were assessed in the intention-to-treat population and in a prespecified PD-L1 of at least 50% population (per US Food and Drug Administration request to the sponsor), which consisted of patients with PD-L1 of at least 50% per 22C3 assay done according to instructions for use. Adverse events were assessed in all patients who received at least one dose of the assigned treatment. This study is registered with ClinicalTrials.gov, NCT03088540 and is ongoing.Findings Between June 27, 2017 and Feb 27, 2020, 710 patients were randomly assigned (intention-to-treat population). In the PD-L1 of at least 50% population, which consisted of 563 patients, median overall survival was not reached (95% CI 17·9-not evaluable) with cemiplimab (n=283) versus 14·2 months (11·2-17·5) with chemotherapy (n=280; hazard ratio [HR] 0·57 [0·42-0·77]; p=0·0002). Median progression-free survival was 8·2 months (6·1-8·8) with cemiplimab versus 5·7 months (4·5-6·2) with chemotherapy (HR 0·54 [0·43-0·68]; p<0·0001). Significant improvements in overall survival and progression-free survival were also observed with cemiplimab in the intention-to-treat population despite a high crossover rate (74%). Grade 3-4 treatment-emergent adverse events occurred in 98 (28%) of 355 patients treated with cemiplimab and 135 (39%) of 342 patients treated with chemotherapy.Interpretation Cemiplimab monotherapy significantly improved overall survival and progression-free survival compared with chemotherapy in patients with advanced non-small-cell lung cancer with PD-L1 of at least 50%, providing a potential new treatment option for this patient population.Funding Regeneron Pharmaceuticals and Sanofi.

Integrity signals

Registry

Crossref · 10.1016/s0140-6736(21)00228-2

Cites

31 of 31 references verified0 citation errors · 0 not checkable

Statistics

Recomputing p-values needs the paper’s full text.

Claims the paper makes

This paper’s full text isn’t openly available, so its claims and self-check weren’t run. The registry and citation checks still apply.

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • Cemiplimab may result in better overall survival and progression-free survival compared to platinum-based chemotherapy in patients with advanced NSCLC.

    “It may result in better OS and PFS compared to platinum-based chemotherapy in patients with advanced NSCLC, indicating a possible new treatment option for these patients [51].”

    From Immune Checkpoint Inhibitors in Cancer Therapy (2022) · cites this paper as [51]

Cites

Flagged first, then by citations

Cited by

Sorted by citations

Authors
Sezer, A., Kilickap, S., Gümüş, M., Bondarenko, I., Özgüroğlu, M., Gogishvili, M., Turk, H. M., Cicin, I., Bentsion, D., Gladkov, O., Clingan, P., Sriuranpong, V., Rizvi, N., Gao, B., Li, S., Lee, S., McGuire, K., Chen, C.-I., Makharadze, T., Paydas, S., Nechaeva, M., Seebach, F., Weinreich, D. M., Yancopoulos, G. D., Gullo, G., Lowy, I., & Rietschel, P.
Affiliations
  • Başkent University (TR)
  • Istanbul Medeniyet University (TR)
  • Dnipro State Medical University (UA)
  • Istanbul University-Cerrahpaşa (TR)
  • University of Wollongong (AU)
  • Chulalongkorn University (TH)
  • Columbia University Irving Medical Center (US)
  • Regeneron (United States) (US)
  • Arkhangel'skiy Klinicheskiy Onkologicheskiy Dispanser (RU)
Corresponding author
Sezer, Ahmet
Venue
The Lancet
Publisher
Elsevier BV
Published
2021-02
Volume
397
Issue
10274
Pages
592-604
ISSN
  • 0099-5355 (ISSN-L)
  • 0140-6736
OpenAlex
W3129022890
Cited by
789
References
31
Citations by year
2026: 52 · 2025: 133 · 2024: 164 · 2023: 197 · 2022: 167 · 2021: 74 · 2013: 1
FWCI
54.84
Type
journal article
Language
en
Open access
closed
Locations
  • The Lancet (publishedVersion)
  • PubMed (publishedVersion)
  • Research Online (University of Wollongong) (submittedVersion)
  • Trakya University's Institutional Open Access System (Trakya University) (submittedVersion)
Funders
  • Sanofi
  • Regeneron Pharmaceuticals
Topics
  • Health Sciences › Medicine › Oncology › Cancer Immunotherapy and Biomarkers
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Lung Cancer Treatments and Mutations
  • Health Sciences › Medicine › Oncology › Lung Cancer Research Studies
Keywords
cemiplimab, non-small cell lung cancer, PD-L1 expression, PD-1 inhibitors, first-line therapy, platinum-based chemotherapy, overall survival, progression-free survival, immune checkpoint inhibitors, treatment crossover, adverse events, immune-related adverse events, immunotherapy versus chemotherapy, never smokers
MeSH terms
Pemetrexed, Antineoplastic Agents, Immunological, Progression-Free Survival, Immune Checkpoint Inhibitors, Gemcitabine, Aged, Antineoplastic Combined Chemotherapy Protocols, Carcinoma, Non-Small-Cell Lung, Cisplatin, Deoxycytidine, Female, Humans, Lung Neoplasms, Male, Middle Aged, Survival Rate, Carboplatin, Paclitaxel, B7-H1 Antigen, Antibodies, Monoclonal, Humanized

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review