Dr. Gutierrez on the Safety Profile of Pembrolizumab-Based Combos in NSCLC

Martin E. Gutierrez, MD, director, co-chief and medical oncologist, Divisions of Thoracic Oncology and Gastrointestinal Oncology, John Theurer Cancer Center, Hackensack University Medical Center, discusses the safety profile of pembrolizumab (Keytruda)-based combination strategies in non-small cell lung cancer (NSCLC).

In the phase II KEYNOTE-495/KeylmPaCT trial (NCT03516981), patients with treatment-naïve, advanced NSCLC who do not harbor EGFR and BRAF mutations or ALK and ROS1 gene rearrangements will be grouped into 4 categories depending on their T cell-inflamed gene expression profile and tumor mutational burden. Each group will be randomized to receive pembrolizumab plus either MK-4280, lenvatinib (Lenvima), or the CTLA-4 inhibitor MK-1308.

The recommended phase II dose of MK-1308 and pembrolizumab has been established, says Gutierrez. A slight increase in immune-related adverse events was reported with the combination; however, this was expected. According to phase I data, MK-4280 was well tolerated. Regarding the combination of pembrolizumab and lenvatinib, investigators have yet to see an increase in toxicity beyond what is expected with lenvatinib alone, concludes Gutierrez.