KEYNOTE-483 (CCTG IND.227): pembrolizumab plus chemotherapy versus chemotherapy in untreated pleural mesothelioma
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.
Overview
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.
Median 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.
- Median overall survival 17.3 vs 16.1 months; hazard ratio 0.79.
- Three-year overall survival 25 percent vs 17 percent.
Pembrolizumab with chemotherapy is approved and offered first line, particularly in epithelioid disease where dual immunotherapy showed little benefit over chemotherapy.
- Modest median gain; benefit concentrated in a minority of long-term responders.
- Open-label with academic sponsorship and relatively small size.
Similar pages
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- TreatmentAnetumab ravtansine
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