Dr. Camidge on the KEYNOTE-024 Trial in NSCLC

D. Ross Camidge, MD, PhD, professor, Division of Medical Oncology, Joyce Zeff Chair in Lung Cancer Research, School of Medicine, Division of Medical Oncology, University of Colorado, discusses implications of the KEYNOTE-024 trial in non—small cell lung cancer (NSCLC).

In the KEYNOTE-024 trial, patients with a tumor proportion score (TPS) of 1% or greater were eligible to enroll. Investigators enriched up to 30% of the population to say that those patients could receive pembrolizumab (Keytruda) monotherapy. However, physicians wonder if that bar was too high, explains Camidge. Although patients with a lower TPS score can derive benefit from single-agent immunotherapy, it seemed as though the benefit was being driven by the patients with high TPS, says Camidge.

The headline reported that the overall survival (OS) hazard ratio was better, which is misleading, says Camidge. When researchers included patients with greater than or equal to 1% TPS, they still included patients with high TPS. If physicians were to take those patients out and just look at the patients with 1% to 49% TPS, the OS hazard ratio would not be statistically significant. Therefore, a patient who does not have a high TPS should not receive pembrolizumab monotherapy unless they are unfit for anything else, says Camidge.