OncoPharm Adjuvant Pembrolizumab (NSCLC), Elacestrant, & Pirtobrutinib
Feb 2, 2023
Recent FDA approval of adjuvant pembrolizumab for NSCLC brings hope, particularly after platinum chemotherapy. The comparison with atezolizumab reveals intriguing differences in patient outcomes. Excitingly, elacestrant emerges as a breakthrough treatment for ESR1-mutant breast cancer, heralding a new era of targeted therapies. Pirtobrutinib offers promise for those facing resistance in mantle cell lymphoma. Dive into the evolving landscape of oncology with insights on treatment sequencing and the challenges of resistance.
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Adjuvant Pembrolizumab DFS Benefit
- Pembrolizumab given for one year after surgery plus platinum chemo improved disease-free survival versus placebo in resected stage IB–3A NSCLC.
- Benefit appeared regardless of PD-L1 level but was seen only in patients who received adjuvant chemotherapy.
PD-1 vs PD-L1 Differences Matter
- Atezolizumab's adjuvant benefit correlated with PD-L1 expression, favoring PD-L1 ≥1%.
- Pembrolizumab showed no clear PD-L1 trend, possibly reflecting PD-1 vs PD-L1 targeting differences.
DFS Improved, OS Still Pending
- Keynote-091 showed a hazard ratio for DFS of 0.73 and median DFS 59 vs 35 months favoring pembrolizumab.
- Overall survival data remain immature and will determine if adjuvant use increases cure rates.