Table 2.
Phase 3 trials of checkpoint inhibitors plus chemotherapy for first line treatment of metastatic non-squamous NSCLC.
| Trial | PD-L1 staining* | Therapy | ORR (95% CI) | Median PFS (95% CI) | Median OS (95% CI) | 1 year OS (95% CI) |
|---|---|---|---|---|---|---|
| KEYNOTE-189 (16, 17) | TC ≥ 50% | Pembrolizumab + Platinum + Pemetrexed (n = 132) | 61.4% (52.5–69.7) | 9.4 mo (9.0–13.8) | NR | 73%a |
| Platinum + Pemetrexed (n = 70) | 22.9% (13.7–34.4) | 4.7 mo (3.1–6.0) | 10.0 mo (7.5-NE) | 48.1%a | ||
| Any | Pembrolizumab + Platinum + Pemetrexed (n = 410) | 47.6% (42.6–52.5) | 8.8 mo (7.6–9.2) | NR | 69.2% (64.1–73.8) | |
| Platinum + Pemetrexed (n = 206) | 18.9% (13.8–25.0) | 4.9 mo (4.7–5.5) | 11.3 mo (8.7–15.1) | 49.4% (42.1–56.2) | ||
| IMpower150 (18–20) | TC ≥ 50% or IC ≥ 10%b | Atezolizumab + Bevacizumab + Carboplatin + Paclitaxel (n = 71) | 69%a | 12.6 mo (10.9–23.4) | 25.2a | N/A |
| Bevacizumab + Carboplatin + Paclitaxel (n = 64) | 49%a | 6.8 mo (5.6–8.4) | 15.0a | N/A | ||
| Any | Atezolizumab + Bevacizumab + Carboplatin + Paclitaxel (n = 356) | 63.5% (58.2–68.5) | 8.3 mo (7.7–9.8) | 19.2 mo (18.0–23.8) | 67.3% (62.4–72.2) | |
| Bevacizumab + Carboplatin + Paclitaxel (n = 336) | 48% (42.5–53.6) | 6.8 mo (6.0–7.1) | 14.7 mo (13.3–16.9) | 60.6% (55.3–65.9) | ||
| IMpower130 (21) | TC ≥ 50% or IC ≥ 10%b | Atezolizumab + Carboplatin + Nab-paclitaxel (n = 88) | N/A | 6.4 mo (5.49–9.76) | 17.3 mo (14.78-NR) | N/A |
| Carboplatin + Nab-paclitaxel (n = 42) | N/A | 4.6 mo (3.22–7) | 16.0 mo (10.94-NR) | N/A | ||
| Any | Atezolizumab + Carboplatin + Nab-paclitaxel (n = 451) | 49.2%a | 7.0 mo (6.2–7.3) | 18.6 mo (16–21.2) | 63.1%a | |
| Carboplatin + Nab-paclitaxel (n = 228) | 31.9%a | 5.5 mo (4.4–5.9) | 13.9 mo (12.0–18.7) | 55.5%a | ||
| IMpower132 (22) | TC ≥ 50% or IC ≥ 10%b | Atezolizumab + Platinum + Pemetrexed (n = 25) | 72%a | 10.8 moa | N/A | N/A |
| Platinum + Pemetrexed (n = 20) | 55%a | 6.5 moa | N/A | N/A | ||
| Any | Atezolizumab + Platinum + Pemetrexed (n = 292) | 47%a | 7.6 mo (6.6–8.5) | 18.1 mo (13.0-NE) | N/A | |
| Platinum + Pemetrexed (n = 286) | 32%a | 5.2 mo (4.3–5.6) | 13.6 mo (11.4–15.5) | N/A |
PD-L1 staining on tumor cells was defined by the 22C3 assay for pembrolizumab and the Dako 28-8 assay for nivolumab. With atezolizumab PD-L1 staining on tumor cells or immune cells was done using the SP142 assay. Platinum includes either carboplatin or cisplatin.
Confidence interval not available.
For the IMpower studies patients with PD-L1 ≥ 50% on tumor cells or PD-L1 ≥ 10% immune cells are grouped together as PD-L1 high staining.
PD-L1, programmed death ligand 1; ORR, objective response rate; PFS, progression free survival; OS, overall survival; CI, confidence interval; mo, months; NR, not reached; NE, not evaluable; TC, tumor cells; IC, immune cells; N/A, not available.