KEYNOTE-671 Trial Evaluates Quality of Life With Perioperative Pembrolizumab for Early Stage, Resectable NSCLC

In addition to significantly improving efficacy outcomes, the addition of perioperative pembrolizumab to chemotherapy also maintained health-related quality of life (HRQoL) compared with chemotherapy and surgery alone in patients with resectable early-stage non-small cell lung cancer (NSCLC), according to patient-reported outcome (PRO) endpoints from the KEYNOTE-671 trial.

The phase 3 KEYNOTE-671 trial showed that neoadjuvant pembrolizumab plus cisplatin-based chemotherapy, resection, and adjuvant pembrolizumab significantly improved event-free survival, overall survival, and tumor response compared with neoadjuvant chemotherapy and surgery alone.

At the 2024 American Society of Clinical Oncology Annual Meeting, Marina C. Garassino, MD, of the University of Chicago School of Medicine and Biological Science, reported results of prespecified PRO endpoints from the trial.

PROs were assessed using the EORTC QLQ-C30 and QLQ-LC13 instruments and collected at baseline, the end of the neoadjuvant phase, multiple times during adjuvant phase, and also in the post-adjuvant follow-up. All patients included in this analysis had received at least 1 dose of study treatment and completed at least 1 PRO assessment.

Looking at mean change from baseline for the Global Health Score/Quality of Life assessment, Dr. Garassino noted that “there was a decrease in the quality of life in the neoadjuvant part, that I think is attributed to the chemotherapy, and then a return of quality of life to baseline during the adjuvant part and post-adjuvant follow-up.” Similar trends were seen for physical functioning scores and role functioning.

The researchers also assessed specific symptoms. For dyspnea, cough, and pain in chest, quality of life was similar for pembrolizumab and placebo, with pembrolizumab scores never becoming significantly worse than placebo.

“The absence of a long-term decrease in health-related quality of life together with the significant improvement in OS and EFS and the absence of new safety signals supports perioperative pembrolizumab as a treatment option for resectable early-stage NSCLC,” Dr. Garassino said.

Reference

Garassino MC, Wakelee HA, Spicer J, et al. Health-related quality of life (HRQoL) outcomes from the randomized, double-blind phase 3 KEYNOTE-671 study of perioperative pembrolizumab for early-stage non-small-cell lung cancer (NSCLC). Presented at the 2024 American Society of Clinical Oncology Annual Meeting; May 31-June 4, 2024, Chicago, Illinois.