Outcomes of Pembrolizumab plus chemotherapy for patients with metastatic non-squamous NSCLC: Real-world evidence
Background Pembrolizumab with chemotherapy (immunochemotherapy) has shown encouraging overall survival (OS) benefits in non-squamous mNSCLC, as demonstrated by the KEYNOTE-189 trial. However, randomised controlled trials may not fully capture the diversity of real-world patients. This study aims to...
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Taylor & Francis
2025-12-01
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| Series: | Pulmonology |
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| Online Access: | https://www.tandfonline.com/doi/10.1080/25310429.2025.2457856 |
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| author | Irina Surovtsova Felix J. F. Herth Daria B. Kokh Philipp Morakis |
| author_facet | Irina Surovtsova Felix J. F. Herth Daria B. Kokh Philipp Morakis |
| author_sort | Irina Surovtsova |
| collection | DOAJ |
| description | Background Pembrolizumab with chemotherapy (immunochemotherapy) has shown encouraging overall survival (OS) benefits in non-squamous mNSCLC, as demonstrated by the KEYNOTE-189 trial. However, randomised controlled trials may not fully capture the diversity of real-world patients. This study aims to evaluate immunochemotherapy outcomes in a real-world setting, including subgroups underrepresented in the KEYNOTE-189 trial.Methods Patients diagnosed with non-squamous mNSCLC 2011-2022 and recorded in Cancer Registry Database of the German Federal State Baden-Württemberg (BWCR), were analysed. OS was assessed using Kaplan-Meier and multivariable Cox models, adjusted for major clinical parameters. Results were compared with KEYNOTE-189.Results Among 2630 eligible cases, 1314 patients received chemotherapy alone and 1316 received immunochemotherapy. Median OS (mOS) was 14.1 months (95%CI: 13.1–15.4) for immunochemotherapy and 10.4 months (95%CI: 9.7–11.2) for chemotherapy alone, with an HR of 0.7 (95%CI: 0.64–0.77). A significant benefit was seen in M1c stage (HR 0.7, 95%CI: 0.63–0.79). No significant OS improvement was observed in patients with ECOG 2–3 or bone metastases.Conclusion This real-world evidence suggests that immunochemotherapy generally improves OS in mNSCLC. Subgroup analysis showed no survival benefit for patients with ECOG >1 or bone metastasis, but a benefit for patients with M1c stage. |
| format | Article |
| id | doaj-art-5b848d7feb474b6bb0b84bbfee82809e |
| institution | Kabale University |
| issn | 2531-0429 2531-0437 |
| language | English |
| publishDate | 2025-12-01 |
| publisher | Taylor & Francis |
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| series | Pulmonology |
| spelling | doaj-art-5b848d7feb474b6bb0b84bbfee82809e2025-02-05T10:29:42ZengTaylor & FrancisPulmonology2531-04292531-04372025-12-0131110.1080/25310429.2025.2457856Outcomes of Pembrolizumab plus chemotherapy for patients with metastatic non-squamous NSCLC: Real-world evidenceIrina Surovtsova0Felix J. F. Herth1Daria B. Kokh2Philipp Morakis3Clinical State Registry Baden-Württemberg GmbH, Baden-Württemberg Cancer Registry (BWCR), Stuttgart, GermanyDepartment of Pneumology and Critical Care Medicine, Thoraxklinik and Translational Lung Research Center, University of Heidelberg, Heidelberg, GermanyClinical State Registry Baden-Württemberg GmbH, Baden-Württemberg Cancer Registry (BWCR), Stuttgart, GermanyQuality Conferences Office at the Clinical State Registry Baden-Württemberg GmbH, Baden-Württemberg Cancer Registry (BWCR), Stuttgart, GermanyBackground Pembrolizumab with chemotherapy (immunochemotherapy) has shown encouraging overall survival (OS) benefits in non-squamous mNSCLC, as demonstrated by the KEYNOTE-189 trial. However, randomised controlled trials may not fully capture the diversity of real-world patients. This study aims to evaluate immunochemotherapy outcomes in a real-world setting, including subgroups underrepresented in the KEYNOTE-189 trial.Methods Patients diagnosed with non-squamous mNSCLC 2011-2022 and recorded in Cancer Registry Database of the German Federal State Baden-Württemberg (BWCR), were analysed. OS was assessed using Kaplan-Meier and multivariable Cox models, adjusted for major clinical parameters. Results were compared with KEYNOTE-189.Results Among 2630 eligible cases, 1314 patients received chemotherapy alone and 1316 received immunochemotherapy. Median OS (mOS) was 14.1 months (95%CI: 13.1–15.4) for immunochemotherapy and 10.4 months (95%CI: 9.7–11.2) for chemotherapy alone, with an HR of 0.7 (95%CI: 0.64–0.77). A significant benefit was seen in M1c stage (HR 0.7, 95%CI: 0.63–0.79). No significant OS improvement was observed in patients with ECOG 2–3 or bone metastases.Conclusion This real-world evidence suggests that immunochemotherapy generally improves OS in mNSCLC. Subgroup analysis showed no survival benefit for patients with ECOG >1 or bone metastasis, but a benefit for patients with M1c stage.https://www.tandfonline.com/doi/10.1080/25310429.2025.2457856mNSCLCKEYNOTE 189real world datacancer registrybone metastases |
| spellingShingle | Irina Surovtsova Felix J. F. Herth Daria B. Kokh Philipp Morakis Outcomes of Pembrolizumab plus chemotherapy for patients with metastatic non-squamous NSCLC: Real-world evidence Pulmonology mNSCLC KEYNOTE 189 real world data cancer registry bone metastases |
| title | Outcomes of Pembrolizumab plus chemotherapy for patients with metastatic non-squamous NSCLC: Real-world evidence |
| title_full | Outcomes of Pembrolizumab plus chemotherapy for patients with metastatic non-squamous NSCLC: Real-world evidence |
| title_fullStr | Outcomes of Pembrolizumab plus chemotherapy for patients with metastatic non-squamous NSCLC: Real-world evidence |
| title_full_unstemmed | Outcomes of Pembrolizumab plus chemotherapy for patients with metastatic non-squamous NSCLC: Real-world evidence |
| title_short | Outcomes of Pembrolizumab plus chemotherapy for patients with metastatic non-squamous NSCLC: Real-world evidence |
| title_sort | outcomes of pembrolizumab plus chemotherapy for patients with metastatic non squamous nsclc real world evidence |
| topic | mNSCLC KEYNOTE 189 real world data cancer registry bone metastases |
| url | https://www.tandfonline.com/doi/10.1080/25310429.2025.2457856 |
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