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Vol.61 No.4 contents

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- Original Article -

The Effect of Pembrolizumab Plus Platinum-based Chemotherapy on the Progression-free Survival of Non-small-cell Lung Cancer with a High PD-L1 Expression and Large Baseline Tumor Size

Yuki Fukushiro¹, Yusuke Takayama¹, Shinji Kakumoto¹, Masahiko Sumii¹, Shohei Mishima¹, Ken Masuda¹, Hiroyasu Shoda¹, Yasuo Iwamoto^2
1Department of Respiratory Medicine, ²Department of Oncology, Hiroshima City Hiroshima Citizens Hospital, Japan

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Background/Aim. Both pembrolizumab monotherapy and PD-1/PD-L1 inhibitor plus platinum-based chemotherapy are recommended for the first-line treatment of advanced non-small-cell lung cancer (NSCLC) with a high PD-L1 expression. However, which therapy is more useful in clinical practice is unclear. We examined the efficacy and safety of each therapy based on the clinical experience at our hospital. Study Design. We retrospectively reviewed 55 NSCLC patients with a high PD-L1 expression between March 2017 and September 2020. Of these 55 patients, 34 underwent pembrolizumab monotherapy (monotherapy), and 21 underwent pembrolizumab plus platinum-based chemotherapy (combination therapy) as their initial treatment. Results. The median progression-free survival (PFS) for patients who underwent combination therapy was longer than that for patients who underwent monotherapy (median: 9.2 vs. 7.7 months) (p=0.762), but there were no significant differences between the groups. In addition, the response rate tended to be higher and the proportion of PD cases lower in the combination group than in the monotherapy group in patients with a large baseline tumor size (BTS). Conclusion. Combination therapy may be more effective than monotherapy for NSCLC with a high PD-L1 expression, especially in cases with a large BTS.
key words: Pembrolizumab, Non-small-cell lung cancer, High PD-L1 expression, Immune checkpoint inhibitor, Baseline tumor size

Received: March 4, 2021
Accepted: April 8, 2021

JJLC 61 (4): 289-296, 2021