Pembrolizumab, Chemotherapy Maintain HRQOL in Advanced Esophageal Cancer

Both of those chemotherapy and pembrolizumab monotherapy managed health and fitness-similar excellent of daily life (HRQOL) in people with highly developed esophageal most cancers on the KEYNOTE-181 demo, according to investigate posted in the Journal of Scientific Oncology.1

HRQOL was equivalent with the two second-line treatment plans in sufferers with squamous cell carcinoma (SCC), these with a PD-L1 mixed positive rating (CPS) ≥10, and sufferers with SCC and a CPS ≥10.

In the stage 3 KEYNOTE-181 demo ( Identifier: NCT02564263), scientists in contrast pembrolizumab monotherapy to investigator’s decision of paclitaxel, docetaxel, or irinotecan in people with advanced esophageal or gastroesophageal junction carcinoma that experienced progressed immediately after initially-line remedy. Earlier posted success confirmed that pembrolizumab extended in general survival for patients with a PD-L1 CPS ≥ 10.2

Proceed Looking at

In the existing assessment, scientists measured HRQOL applying 3 questionnaires. The examination involved 568 patients in full, 387 patients with SCC, 218 sufferers with a CPS ≥ 10, and 166 patients with SCC and a CPS ≥10. All sufferers obtained a lot more than 1 dose of research remedy and experienced done at the very least 1 HRQOL questionnaire by the info cutoff (Oct 15, 2018).

Clients completed the questionnaires electronically at baseline, at quite a few time points concerning weeks 2 and 45, at the finish of cure, and at the 30-day protection abide by-up visit. For all 3 questionnaires, compliance and completion charges had been identical in both equally treatment teams at baseline and at the prespecified week 9 endpoint.


The researchers noticed no “clinically meaningful” distinctions among the pembrolizumab and chemotherapy arms for the modify in international wellbeing status/high quality of everyday living (GHS/QOL) scores from baseline to 7 days 9 in any of the subgroups.

In the SCC team, signify GHS/QOL scores decreased to a lesser degree in the pembrolizumab arm than in the chemotherapy arm (minimum-squares indicate [LSM] change, 2.80 95% CI, -1.48 to 7.08). There had been comparable designs in the CPS ≥ 10 group (LSM difference, 3.68 95% CI, -2.28 to 9.64) and the CPS ≥ 10 SCC team (LSM change, 6.55 95% CI, .01 to 13.10).

“Descriptive analyses of imply rating improve from baseline shown that GHS/QOL scores were being steady when compared with baseline at each time stage by means of week 45 throughout each therapy teams and all 3 subgroups,” the scientists wrote.

In the SCC subgroup, the time to deterioration was identical among the treatment method arms for discomfort (hazard ratio [HR], 1.22 95% CI, .79-1.89), reflux (HR, 2.38 95% CI, 1.33-4.25), and dysphagia (HR, 1.53 95% CI, 1.02-2.31). Comparable trends were being observed in the CPS ≥ 10 and CPS ≥ 10 SCC subgroups.

The scientists concluded that pembrolizumab preserved HRQOL in all subgroups and the overall populace.

“Given the constrained HRQOL facts in patients with innovative EC [esophageal cancer] acquiring next-line remedy, the present-day assessment from KEYNOTE-181 assists address the unmet will need for therapies that sustain or enhance HRQOL in addition to delivering a survival reward,” the scientists wrote.

Disclosures: This analysis was supported by Merck Sharp & Dohme Corp. Some study authors declared affiliations with biotech, pharmaceutical, and/or system firms. Make sure you see the primary reference for a comprehensive checklist of disclosures.


  1. Adenis A, Kulkarni AS, Girotto GC, et al. Effects of pembrolizumab vs . chemotherapy as 2nd-Line therapy for sophisticated esophageal cancer on well being-linked top quality of everyday living in KEYNOTE-181. J Clin Oncol. Revealed on line November 03, 2021 doi:10.1200/JCO.21.00601
  2. Kojima T, Shah MA, Muro K, et al. Randomized phase III KEYNOTE-181 analyze of pembrolizumab vs . chemotherapy in advanced esophageal most cancers. J Clin Oncol. 202038(35):4138-4148. doi:10.1200/JCO.20.01888

Leave a Reply