Keytruda May Help Fight Tough-to-Treat Lung Cancer

In study, the immune-based therapy beat an older drug with fewer side effects, but it's expensive

By Robert Preidt

Saturday, December 19, 2015

SATURDAY, Dec. 19, 2015 (HealthDay News) -- The immune therapy drug Keytruda (pembrolizumab) may extend the lives of people with advanced lung cancer, a new study finds.

Keytruda is commonly used to treat other tumor types, and made headlines recently after it helped former President Jimmy Carter fight off brain cancer.

In this study, researchers compared Keytruda to the chemotherapy drug docetaxel in more than 1,000 patients with non-small cell lung cancer. All of the patients were battling tumors that had progressed even after chemotherapy.

Non-small cell lung cancer is the leading form of the disease.

All of the patients' tumors produced a protein called PD-L1, which can shield the tumor from immune system attack, according to a team led by Dr. Roy Herbst, professor of medicine at Yale University School of Medicine.

Among patients with the highest amounts of PD-L1, those who received Keytruda lived twice as long as those who received docetaxel alone -- 14.9 months vs. 8.2 months, Herbst's team found. Patients with low levels of PD-L1 also benefited from Keytruda.

Treatment-linked side effects were less in patients given Keytruda versus those who took docetaxel, the study found.

There might be one drawback to Keytruda, however: cost. A year's supply of the drug carries a price tag of about $150,000.

The new study was published Dec. 19 in The Lancet and also presented at the annual meeting of the European Society for Medical Oncology on Saturday. The research was funded by Keytruda's maker, Merck & Co.

The findings suggest that the drug might be offered earlier to patients with a particular lung tumor profile, said Herbst, who is also chief of medical oncology at Yale Cancer Center and Smilow Cancer Hospital in New Haven, Conn.

"I believe we should treat patients with the best available drugs as soon as possible. Now that we have learned which patients are most likely to benefit from the anti-PD-L1 strategy, we could begin moving this drug to the earlier setting stages," he said in a Yale news release.

"In this direction, I am eager to see the results of ongoing studies testing [Keytruda] in the first-line setting and as an adjuvant after surgery to hopefully reduce high rates of lung cancer recurrence," he added.

One expert agreed that the findings may mark an advance against lung cancer.

"This is a fascinating development in cancer treatment that uses targeted immunotherapy instead of standard chemotherapy," noted Dr. Len Horovitz, a pulmonary specialist at Lenox Hill Hospital in New York City.

"This is being examined in other cancers as well," he added, "and may represent the dawn of new immune-based approaches to cancer."

In October, the U.S. Food and Drug Administration approved Keytruda for the treatment of patients with advanced non-small cell lung cancer whose tumors express PD-L1 and whose cancer progressed while or after receiving platinum-containing chemotherapy.

SOURCES: Len Horovitz, M.D., pulmonary specialist, Lenox Hill Hospital, New York City; Yale University, news release, Dec. 19, 2015

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