{"entity":{"id":"paper-keynote-483-lancet-2023","kind":"paper","name":"KEYNOTE-483 (CCTG IND.227): pembrolizumab plus chemotherapy versus chemotherapy in untreated pleural mesothelioma","aka":[],"tldr":"Adding pembrolizumab to platinum-pemetrexed chemotherapy lengthened survival in untreated pleural mesothelioma by about a year in non-epithelioid tumours and by a smaller margin overall, giving a chemo-immunotherapy option alongside nivolumab-ipilimumab.","summary":"Phase 3 open-label trial of 440 patients with unresectable advanced pleural mesothelioma in Canada, Italy and France randomised to pembrolizumab plus platinum-pemetrexed or chemotherapy alone.\n\nMedian overall survival was 17.3 versus 16.1 months (hazard ratio 0.79), with three-year survival 25 versus 17 percent and a larger effect in non-epithelioid disease; grade 3 to 4 adverse events were more frequent with pembrolizumab.","asOf":"2026-09-17","links":[{"label":"Lancet 2023","url":"https://doi.org/10.1016/S0140-6736(23)01613-6"},{"label":"PubMed","url":"https://pubmed.ncbi.nlm.nih.gov/37931632/"}],"tags":[],"related":[],"cancers":["pleural-mesothelioma"],"sections":[],"technologies":[],"targets":[],"drugs":["pembrolizumab"],"companies":[],"institutions":[],"pathways":[],"terms":[],"trials":["keynote-483"],"people":[],"bottlenecks":[],"keyPapers":[],"journals":["lancet"],"dependsOn":[],"notes":[],"journal":"The Lancet","year":2023,"doi":"10.1016/S0140-6736(23)01613-6","pmid":"37931632","authors":"Chu Q, Perrone F, Greillier L, et al.","paperType":"rct","findings":["Median overall survival 17.3 vs 16.1 months; hazard ratio 0.79.","Three-year overall survival 25 percent vs 17 percent."],"whatItMeans":"Pembrolizumab with chemotherapy is approved and offered first line, particularly in epithelioid disease where dual immunotherapy showed little benefit over chemotherapy.","caveats":["Modest median gain; benefit concentrated in a minority of long-term responders.","Open-label with academic sponsorship and relatively small size."],"changedPractice":true,"participants":440},"route":"/key-papers/paper-keynote-483-lancet-2023/","neighbours":{"cancer":[{"id":"pleural-mesothelioma","kind":"cancer","name":"Pleural mesothelioma","route":"/cancers/pleural-mesothelioma/"}],"drug":[{"id":"pembrolizumab","kind":"drug","name":"Pembrolizumab","route":"/drugs/pembrolizumab/"}],"trial":[{"id":"keynote-483","kind":"trial","name":"IND.227 / KEYNOTE-483","route":"/trials/keynote-483/"}],"journal":[{"id":"lancet","kind":"journal","name":"The Lancet","route":"/journals/lancet/"}]}}