# Pembrolizumab plus Chemotherapy for Squamous Non-Small-Cell Lung Cancer

Source: https://onco.cc/key-papers/paper-keynote-407-n-engl-j-med-2018/  
OnCo record `paper-keynote-407-n-engl-j-med-2018` (Key paper). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Published report from the KEYNOTE-407 trial registered as NCT02775435, in New England Journal of Medicine (2018), chosen as the most cited paper whose own text cites the registry id.

## Summary

Background: Standard first-line therapy for metastatic, squamous non-small-cell lung cancer (NSCLC) is platinum-based chemotherapy or pembrolizumab (for patients with programmed death ligand 1 [PD-L1] expression on ≥50% of tumor cells). More recently, pembrolizumab plus chemotherapy was shown to significantly prolong overall survival among patients with nonsquamous NSCLC.

Methods: In this double-blind, phase 3 trial, we randomly assigned, in a 1:1 ratio, 559 patients with untreated metastatic, squamous NSCLC to receive 200 mg of pembrolizumab or saline placebo for up to 35 cycles; all the patients also received carboplatin and either paclitaxel or nanoparticle albumin-bound [nab]-paclitaxel for the first 4 cycles. Primary end points were overall survival and progression-free survival.

Results: After a median follow-up of 7.8 months, the median overall survival was 15.9 months (95% confidence interval [CI], 13.2 to not reached) in the pembrolizumab-combination group and 11.3 months (95% CI, 9.5 to 14.8) in the placebo-combination group (hazard ratio for death, 0.64; 95% CI, 0.49 to 0.85; P<0.001). The overall survival benefit was consistent regardless of the level of PD-L1 expression. The median progression-free survival was 6.4 months (95% CI, 6.2 to 8.3) in the pembrolizumab-combination group and 4.8 months (95% CI, 4.3 to 5.7) in the placebo-combination group (hazard ratio for disease progression or death, 0.56; 95% CI, 0.45 to 0.70; P<0.001). Adverse events of grade 3 or higher occurred in 69.8% of the patients in the pembrolizumab-combination group and in 68.2% of the patients in the placebo-combination group. Discontinuation of treatment because of adverse events was more frequent in the pembrolizumab-combination group than in the placebo-combination group (13.3% vs. 6.4%).

Conclusions: In patients with previously untreated metastatic, squamous NSCLC, the addition of pembrolizumab to chemotherapy with carboplatin plus paclitaxel or nab-paclitaxel resulted in significantly longer overall survival and progression-free survival than chemotherapy alone. (Funded by Merck Sharp & Dohme; KEYNOTE-407 ClinicalTrials.gov number, NCT02775435.).

Indexed on Europe PMC as PubMed record 30280635 (DOI 10.1056/nejmoa1810865). Its abstract cites the registry id NCT02775435, which is how it was matched to this trial; no figure has been checked by an editor.

## Fields

- Kind: Key paper
- Last checked: 2026-09-22
- Tags: europepmc-ingest
- Journal: New England Journal of Medicine
- Year: 2018
- DOI: 10.1056/nejmoa1810865
- Authors: Paz-Ares L, Luft A, Vicente D, et al.
- What it means: This is the paper Europe PMC returns for registry id NCT02775435 with the most citations, so it is the natural first reading for anyone following the KEYNOTE-407 trial. Read the abstract above alongside the trial page and the registry entry; the record was linked automatically and its figures have not been checked by hand.
- Caveats: Matched to the trial by the registry id cited in the Europe PMC record; the summary reproduces the record's abstract and no figure has been verified against the full paper.

## Sources

- N Engl J Med 2018: https://doi.org/10.1056/nejmoa1810865
- PubMed: https://pubmed.ncbi.nlm.nih.gov/30280635/
- Europe PMC: https://europepmc.org/article/MED/30280635
- ClinicalTrials.gov NCT02775435: https://clinicaltrials.gov/study/NCT02775435

## Connected records

- trials: [KEYNOTE-407](https://onco.cc/trials/keynote-407/)
- journals: [New England Journal of Medicine](https://onco.cc/journals/nejm/)

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