- Checkmate 9la brain metastases driver#
- Checkmate 9la brain metastases plus#
- Checkmate 9la brain metastases free#
We conducted a retrospective study to investigate whether ICIs combined with pemetrexed as maintenance therapy have clinical benefits in patients with advanced NS-NSCLC. Importantly, no clinical studies have investigated the difference in the efficacy and safety of ICIs with or without pemetrexed as first-line maintenance therapy in NS-NSCLC. The results imply that chemotherapy may not be required for maintenance therapy in these patients. In patients with PD-L1 TPS ≥1% or ≥ 50%, the “chemo-free” mode of pembrolizumab monotherapy still improved overall survival and avoided chemotherapy-induced adverse events.
Checkmate 9la brain metastases plus#
In addition, a minority of patients with ICIs plus pemetrexed maintenance discontinue pemetrexed after maintenance for fewer cycles. However, there are still a few patients in the real world do not receive pemetrexed for some reason and choose ICIs monotherapy as maintenance therapy.
Studies such as KEYNOTE189, CameL, and RATIONALE304 usually design ICIs plus pemetrexed as maintenance therapy after ICIs plus 4–6 cycles of pemetrexed/platinum. The success of immune checkpoint inhibitors heralds the dawn of a new age in maintenance therapy. Based on the AVAPERL and COMPASS studies, bevacizumab plus pemetrexed as maintenance therapy is recommended after first-line bevacizumab plus pemetrexed/platinum. In patients with NS-NSCLC, the PARAMOUNT study showed that pemetrexed as continuous maintenance therapy could reduce the risk of disease progression and prolong progression-free survival. Maintenance therapy in the National Comprehensive Cancer Network (NCCN) guidelines refers to using at least one of the agents given in the first line, beyond 4–6 cycles, in the absence of disease progression. Therefore, the efforts to improve the treatment effect are mainly reflected in the combination of new ICIs or the improvement of maintenance treatment programs.
Checkmate 9la brain metastases driver#
Based on multiple studies, first-line ICIs combined with chemotherapy significantly prolonged the progression-free survival (PFS) and overall survival (OS) of patients with advanced non-squamous NSCLC (NS-NSCLC) and has become the first-line standard treatment for NSCLC patients without driver gene mutations. The revolutionary development of immune checkpoint inhibitors (ICIs) has significantly changed the treatment model for lung cancer in recent years. Non-small cell lung cancer (NSCLC) accounts for 85%, with non-squamous tissue type as the primary subtype. The incidence and mortality of lung cancer are still among the top malignant tumors globally. ICIs with or without pemetrexed can be used as maintenance therapy after first-line ICIs plus 4–6 cycles of pemetrexed/platinum in patients with advanced NS-NSCLC based on PD-L1 expression. The incidence of fatigue was significantly higher in the ICIs plus pemetrexed group ( P = 0.023). The 2-year survival rates of the two groups were similar (66.7% vs. Results for median PFS2 were similar to median PFS1, with statistically significantly different only in patients with PD-L1 TPS < 1% ( P = 0.008). Among patients with PD-L1 TPS ≥50% or 1–49%, the median PFS1 in both groups was not statistically significant ( P = 0.866, P = 0.589, respectively). Among patients with PD-L1 TPS < 1%, the median PFS1 was worse with ICIs monotherapy (9.50 months vs. There were no statistically significant difference in median PFS1 between the ICIs monotherapy group and ICIs plus pemetrexed group (12.00 months vs.
Eighty-two patients received ICIs plus pemetrexed as maintenance therapy, and 38 patients received ICIs monotherapy. ResultsĪ total of 120 patients received ICIs with or without pemetrexed as maintenance therapy.
Checkmate 9la brain metastases free#
Progression Free Survival 1 (PFS1) and PFS2, defined as the interval from the date of initial treatment and maintenance therapy to the date of systemic progression/death or the last follow-up, respectively. Patients were divided into ICIs plus pemetrexed group and ICIs monotherapy group. We performed a retrospective study analyzing clinical data of patients with NS-NSCLC who were diagnosed in Zhejiang Cancer Hospital from September 2018 to May 2021 and received maintenance therapy after 4–6 cycles of ICIs plus pemetrexed/platinum. No clinical study has compared the efficacy and safety of ICIs with or without pemetrexed as maintenance therapy. Some patients in the real world receive ICIs monotherapy as maintenance therapy. Advanced non-squamous non-small cell lung cancer (NS-NSCLC) patients without driver gene mutations are usually treated with immune checkpoint inhibitors (ICIs) plus pemetrexed as maintenance therapy after first-line ICIs plus 4–6 cycles of pemetrexed/platinum.
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