Pembrolizumab Added to SBRT Fails to Improve EFS in NSCLC

KEYNOTE-867, a phase III randomized double-blind trial, tested adding pembrolizumab or placebo to stereotactic body radiotherapy (SBRT) in 448 participants with inoperable or surgery-declined stage I or II non-small cell lung cancer. The trial reported no significant improvement in event-free survival with pembrolizumab (median 31.2 vs 28.3 months; hazard ratio 0.92, P=.2932), while grade 3-5 treatment-related adverse events were more frequent with pembrolizumab (20.4% vs 3.7%), including five treatment-related deaths, all in the pembrolizumab arm. The trial authors state it was stopped early based on this benefit-risk profile.

Most relevant for: Patients with inoperable stage I or II non-small cell lung cancer, or those who have declined surgery, being considered for SBRT.

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