Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Nov 2;28(11):969-977.
doi: 10.1093/oncolo/oyad182.

Pembrolizumab Every 6 Weeks Versus Every 3 Weeks in Advanced Non-Small Cell Lung Cancer

Maude Dubé-Pelletier  1 , Catherine Labbé  1 , Jimmy Côté  1 , Audrey-Ann Pelletier-St-Pierre  1
Affiliations

Pembrolizumab Every 6 Weeks Versus Every 3 Weeks in Advanced Non-Small Cell Lung Cancer

Maude Dubé-Pelletier et al. Oncologist. .

Abstract

Background: The survival benefits and adverse effects of pembrolizumab 2 mg/kg intravenously (IV) every 3 weeks (Q3W) in advanced non-small lung cancer (NSCLC) are well documented in the literature. Based on pharmacokinetic models, a pembrolizumab 4 mg/kg IV every 6 weeks (Q6W) dosing regimen is also approved in some countries. To date, there is no direct comparison in the literature between these 2 regimens in advanced NSCLC.

Methods: This retrospective study included 80 patients with advanced NSCLC who received pembrolizumab monotherapy 4 mg/kg Q6W between March 1, 2020 and December 31, 2021 and 80 patients with advanced NSCLC who received pembrolizumab monotherapy 2 mg/kg Q3W between January 1, 2017 and January 15, 2019 at Institut universitaire de cardiologie et de pneumologie de Québec (IUCPQ). The primary outcomes of this study were to compare overall survival (OS), progression-free survival (PFS) as well as the occurrence and severity of immune-mediated adverse events (AEs) in patients with advanced NSCLC who received pembrolizumab Q6W vs Q3W. Data cutoff date was December 15, 2022.

Results: Median follow-up was 14.5 ± 8.6 months in the Q6W group and 18.3 ± 19.6 months in the Q3W group. Median PFS was 6.9 months (CI 95% 5.0-10.7) in the Q6W group vs 8.9 months (CI 95% 5.6-14.1) in the Q3W group (adjusted HR 1.27 (CI 95% 0.85-1.89), P = .25). Median OS was not reached in the Q6W group vs 20.5 months (CI 95% 13.7-29.8) in the Q3W group (adjusted HR 0.80 (CI 95% 0.50-1.29), P = .36). Immune-mediated AEs of grade ≥ 3 occurred in 18% of patients in the Q6W group and in 19% of those in the Q3W group.

Conclusions: In this unicentric retrospective study, the pembrolizumab Q6W dosing regimen was comparable to the Q3W in terms of OS, PFS, and toxicity.

Keywords: advanced non-small cell lung cancer; pembrolizumab 2 mg/kg every 3 weeks; pembrolizumab 4 mg/kg every 6 weeks.

PubMed Disclaimer

Conflict of interest statement

Catherine Labbé has received honoraria from Amgen, AstraZeneca, Brystol-Myers Squibb, Merck, Pfizer, and Roche. She has also received payment for expert testimony from Jazz Pharmaceuticals, Pfizer, and Roche. She has also been on advisory boards for Amgen, Astra Zeneca, Brystol-Myers Squibb, Jazz Pharmaceuticals, LEO Pharma, Lilly, Merck, Novartis, Pfizer, Roche, and Sanofi Genzyme. The other authors indicated no financial relationships.

Figures

Figure 1.
Figure 1.
CONSORT diagram. NSCLC = non-small cell lung cancer; PD-L1 = programmed death-ligand 1. *Patient can be in more than one category. **Data cutoff = December 15, 2022.
Figure 2.
Figure 2.
Adjusted progression-free survival of patients who received pembrolizumab Q6W versus patients who received pembrolizumab Q3W. Q3W = every 3 weeks; Q6W = every 6 weeks. *Pembrolizumab Q3W = reference group for HR calculation.
Figure 3.
Figure 3.
Adjusted overall survival of patients who received pembrolizumab Q6W versus patients who received pembrolizumab Q3W. Q3W = every 3 weeks; Q6W = every 6 weeks. *Pembrolizumab Q3W = reference group for HR calculation.
See this image and copyright information in PMC

References

    1. Hanna NH, Schneider BJ, Temin S, et al. . Therapy for stage IV non-small-cell lung cancer without driver alterations: ASCO and OH (CCO) joint guideline update. J Clin Oncol. 2020;38(14):1608-1632. 10.1200/JCO.19.03022. - DOI - PubMed
    1. Merck Canada Inc. Product monograph: Keytruda (pembrolizumab). 2020150 pp.
    1. European Medicines Agency. Annex 1: summary of product characteristics. 2019:166 pp.
    1. Medsafe. New Zealand Medecines and Medical Devices Safety Authority. New Zealand Datasheet: Keytruda (pembrolizumab). 2020:63 pp.
    1. Lala M, Li TR, de Alwis DP, et al. . A six-weekly dosing schedule for pembrolizumab in patients with cancer based on evaluation using modelling and simulation. Eur J Cancer. 2020;131(3062):68-75. 10.1016/j.ejca.2020.02.016. - DOI - PubMed

Substances