The role of irAEs, as a surrogate predictor of the efficacy of checkpoint inhibitors, has not yet been described in the setting of first-line, single-agent pembrolizumab for patients with metastatic NSCLC with a PD-L1. Therefore this study was conducted to check the  feasibility and the safety of first-line, single-agent pembrolizumab, in a large, real-world cohort of patients with NSCLC with PD-L1 expression ≥ 50%.

1010 total patients were included in the study who met the inclusion criteria for the study; after a 6-week landmark selection, 877 patients were included in the efficacy analysis. Any grade irAEs, grade 3/4 irAEs, leading to discontinuation irAEs, multiple-site and single-site irAEs, cutaneous irAEs, endocrine irAEs, pulmonary irAEs, and rheumatologic irAEs were significantly related to a higher objective response rate. Any grade irAEs, single-site irAEs, multiple-site irAEs, cutaneous irAEs, endocrine irAEs, gastrointestinal irAEs, and rheumatologic irAEs were significantly related to progression-free survival. Any grade irAEs, single-site irAEs, multiple-site irAEs, cutaneous irAEs, endocrine irAEs, and rheumatologic irAEs were significantly related to overall survival.

This study concluded that  the feasibility and the safety of first-line, single-agent pembrolizumab, in a large, real-world cohort of patients with NSCLC with PD-L1.

Reference: https://www.clinical-lung-cancer.com/article/S1525-7304(20)30204-7/fulltext