Merck announced that the pivotal Phase 3 KEYNOTE-189 trial investigating KEYTRUDA (pembrolizumab), Merck’s anti-PD-1 therapy, in combination with pemetrexed (Alimta) and cisplatin or carboplatin, for the first-line treatment of patients with metastatic non-squamous non-small cell lung cancer (NSCLC), met its dual primary endpoints of overall survival (OS) and progression-free survival (PFS). Based on an interim analysis conducted by the independent Data Monitoring Committee, treatment with KEYTRUDA in combination with pemetrexed plus platinum chemotherapy resulted in significantly longer OS and PFS than pemetrexed plus platinum chemotherapy alone. The safety profile of KEYTRUDA in this combination was consistent with that previously observed.
Results from KEYNOTE-189 will be presented at an upcoming medical meeting and submitted to regulatory authorities.
“KEYNOTE-189 showed significant improvement in overall survival and progression-free survival for patients receiving KEYTRUDA in the first-line setting in combination with traditional chemotherapy, compared with those receiving chemotherapy alone,” said Dr. Roger M. Perlmutter, president, Merck Research Laboratories. “We are deeply grateful to the KEYNOTE-189 patients and investigators for their important contributions to this landmark study, and we look forward to presenting the data in the near future.”
KEYNOTE-189 is a randomized, double blind, placebo controlled, Phase 3 study (ClinicalTrials.gov, NCT02578680) investigating KEYTRUDA (pembrolizumab) in combination with pemetrexed and cisplatin or carboplatin compared with pemetrexed and cisplatin or carboplatin alone in patients with advanced or metastatic nonsquamous non-small cell lung cancer, regardless of PD-L1 expression. Patients had no EGFR or ALK genomic tumor aberrations, and had not previously received systemic therapy for advanced disease. The KEYNOTE-189 study was done in collaboration with Eli Lilly and Company, the makers of pemetrexed. The dual primary endpoints are OS and PFS; secondary endpoints include overall response rate (ORR) and duration of response (DOR). The study enrolled 614 patients randomized 2:1 to receive either KEYTRUDA (200 mg fixed dose every three weeks) plus pemetrexed (500 mg/m2 ) (with vitamin supplementation) plus cisplatin (75 mg/m2) or carboplatin AUC 5 on day 1 every 3 weeks (Q3W) for 4 cycles followed by KEYTRUDA 200 mg plus pemetrexed (500 mg/m2 ) Q3W or KEYTRUDA placebo 200 mg plus pemetrexed (500 mg/m2) (with vitamin supplementation) plus cisplatin (75 mg/m2) or carboplatin AUC 5 on day 1 every 3 weeks (Q3W) for 4 cycles followed by KEYTRUDA placebo 200 mg plus pemetrexed (500 mg/m2) Q3W until disease progression, unacceptable toxicity, physician decision or consent withdrawal. Patients on the control arm who experienced disease progression, verified by central independent review, were permitted to undergo treatment assignment unblinding and crossover to receive open-label KEYTRUDA.