EMPOWER-Lung 1
EMPOWER-Lung 1 showed that cemiplimab, a third PD-1 antibody, lengthens life compared with chemotherapy in lung cancers with high PD-L1, reproducing the pembrolizumab result with a different drug.
Overview
EMPOWER-Lung 1 randomised 710 patients with untreated advanced non-small-cell lung cancer to cemiplimab or platinum doublet chemotherapy; the primary population was the 563 patients whose tumours had confirmed PD-L1 expression of 50 percent or more. Patients on chemotherapy could cross over to cemiplimab at progression, and patients on cemiplimab could add chemotherapy.
In the PD-L1-high population median overall survival was not reached with cemiplimab against 14.2 months with chemotherapy (hazard ratio 0.57), and median progression-free survival was 8.2 against 5.7 months (hazard ratio 0.54). In the three-year update median overall survival was 26.1 months against 13.3 months, with the hazard ratio unchanged despite crossover.
The FDA approved cemiplimab for this indication in February 2021, and a companion trial, EMPOWER-Lung 3, later added cemiplimab to chemotherapy regardless of PD-L1.
- Median 26.1 vs 13.3 months with Cemiplimab compared with Platinum chemotherapy; about 12.8 months longer for half the group.
- A median is a midpoint: half the people did better than this and half did worse, so it is not a prediction for any one person.
- Put another way, the treated group had about 43 percent lower chance of the event at any given time (hazard ratio 0.57).
- Overall survival counts deaths from any cause, so it is the most direct measure of whether a treatment helps people live longer.
- Median 8.2 vs 5.7 months with Cemiplimab compared with Platinum chemotherapy; about 2.5 months longer for half the group.
- A median is a midpoint: half the people did better than this and half did worse, so it is not a prediction for any one person.
- Put another way, the treated group had about 46 percent lower chance of the event at any given time (hazard ratio 0.54).
- This is a surrogate endpoint: it measures the cancer being controlled or absent on scans and tests, which often, but not always, translates into living longer.
- These results apply to the people the trial enrolled: Untreated advanced non-small-cell lung cancer with PD-L1 of 50 percent or more and no EGFR, ALK or ROS1 alteration: cemiplimab versus platinum doublet chemotherapy, with crossover at progression. People in a different situation may not see the same effect.
- The trial selected people by a biomarker (PD-L1); the result should not be assumed for people whose cancer does not have it.
Numbers are from the trial as recorded here; see the source links in the table below. This is orientation, not medical advice: ask your team how closely the trial population matches you.
710 participants enrolled.
| Endpoint | Arm | n | Value | HR (95% CI) | p | Source |
|---|---|---|---|---|---|---|
| Overall survival, PD-L1 50% or more (three-year update)primary | Cemiplimab | 283 | 26.1 months | 0.57 | - | link |
| Platinum chemotherapy | 280 | 13.3 months | ||||
| Progression-free survival, PD-L1 50% or moreprimary | Cemiplimab | 283 | 8.2 months | 0.54 | - | link |
| Platinum chemotherapy | 280 | 5.7 months |
Similar pages
not linked directly; found by shared links- TrialKEYNOTE-042
Shares Tumour proportion score (TPS), PD-L1 expression testing (22C3, SP142, SP263), PD-L1-high non-small-cell lung cancer without a driver mutation, PD-1 / PD-L1 immune checkpoint & T-cell activation.
- TrialA Trial to Learn How the Combination of Fianlimab With Cemiplimab and Chemotherapy Works Compared With Cemiplimab and Chemotherapy for Treating Adult
Shares Regeneron, Cemiplimab, Pemetrexed, Paclitaxel / nab-paclitaxel.
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- Key paperKEYNOTE-001 (Garon 2015): pembrolizumab in non-small-cell lung cancer and the 50% PD-L1 cut-off
Shares Tumour proportion score (TPS), PD-L1 expression testing (22C3, SP142, SP263), PD-L1-high non-small-cell lung cancer without a driver mutation, PD-L1.
- TrialEMPOWER-CSCC-1
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- TrialEMPOWER-Cervical 1 / GOG-3016 / ENGOT-cx9
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- TrialA Study To Assess the Safety, Tolerability, and Efficacy of Imzokitug in Combination With Pumitamig and Platinum-Doublet Chemotherapy (PDCT) Versus Pu
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