Evidence map›Paper›PMID 30138764›Full record

ArticleJournal of thoracic oncology : official publication of the International Association for the Study of Lung Cancer2019

24-Month Overall Survival from KEYNOTE-021 Cohort G: Pemetrexed and Carboplatin with or without Pembrolizumab as First-Line Therapy for Advanced Nonsquamous Non-Small Cell Lung Cancer.

Hossein Borghaei, Corey J Langer, Shirish Gadgeel, Vassiliki A Papadimitrakopoulou, Amita Patnaik, Steven F Powell, Ryan D Gentzler, Renato G Martins, James P Stevenson, Shadia I Jalal and 9 more

Registry-linked trialAbstract read
PubMed Publisher
In one paragraph

Article in Journal of thoracic oncology : official publication of the International Association for the Study of Lung Cancer, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02039674 (A Phase I/II Study of MK-3475), which is not on this map. Cited by 98 papers, 16 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
98citing papers in PubMed, 16 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT02039674 phase1 / phase2completednot on this map

A Phase I/II Study of MK-3475 (SCH900475) in Combination With Chemotherapy or Immunotherapy in Patients With Locally Advanced or Metastatic Non-Small Cell Lung Carcinoma

TypeinterventionalSponsorMerck Sharp & Dohme LLCRan2014 to 2021Enrolled267ConditionsNon-small Cell Lung CarcinomaArmsPembrolizumab, Paclitaxel, Carboplatin, Bevacizumab, Pemetrexed
3 · Its place in the literature

Who cites it

98 citing papers in PubMed, 16 syntheses or guidelines pooled it.

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  2. Pemetrexed and platinum with or without pembrolizumab for advanced non-small-cell lung cancer (NSCLC): a systematic review and meta-analysis.Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico · 2025
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  19. Five-Year Outcomes With Pembrolizumab Versus Chemotherapy for Metastatic Non-Small-Cell Lung Cancer With PD-L1 Tumor Proportion Score ≥ 50.Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2021
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38 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

19 authors.

Hossein BorghaeiHematology and Oncology, Fox Chase Cancer Center, Philadelphia, Pennsylvania. Electronic address: Hossein.borghaei@fccc.edu.
Corey J LangerDepartment of Medicine, Abramson Cancer Center, University of Pennsylvania, Philadelphia, Pennsylvania.
Shirish GadgeelThoracic Oncology, Karmanos Cancer Institute/Wayne State University, Detroit, Michigan.
Vassiliki A PapadimitrakopoulouThoracic/Head and Neck Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Amita PatnaikClinical Research, START Center for Cancer Care, San Antonio, Texas.
Steven F PowellOncology, Sanford Health, Sioux Falls, South Dakota.
Ryan D GentzlerHematology/Oncology, University of Virginia, Charlottesville, Virginia.
Renato G MartinsMedicine, University of Washington, Seattle, Washington.
James P StevensonTaussig Cancer Institute, Cleveland Clinic, Cleveland, Ohio.
Shadia I JalalInternal Medicine, Indiana University School of Medicine, Indianapolis, Indiana.
Amit PanwalkarHematology/Oncology, Sanford Roger Maris Cancer Center, Fargo, North Dakota.
James Chih-Hsin YangDepartment of Oncology, National Taiwan University Hospital, Taipei, Republic of China.
Matthew GubensMedical Oncology, University of California San Francisco, San Francisco, California.
Lecia V SequistHematology/Oncology, Massachusetts General Hospital, Boston, Massachusetts.
Mark M AwadThoracic Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts.
Joseph FioreOncology Clinical Development, Merck & Co., Inc., Kenilworth, New Jersey.
Sanatan SarafOncology Clinical Development, Merck & Co., Inc., Kenilworth, New Jersey.
Steven M KellerOncology Clinical Development, Merck & Co., Inc., Kenilworth, New Jersey.
Leena GandhiLaura and Isaac Perlmutter Cancer Center, New York University Langone Medical Center, New York, New York.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionCohort G of KEYNOTE-021 (NCT02039674) evaluated the efficacy and safety of pembrolizumab plus pemetrexed-carboplatin (PC) versus PC alone as first-line therapy for advanced nonsquamous NSCLC. At the primary analysis (median follow-up time 10.6 months), pembrolizumab significantly improved objective response rate (ORR) and progression-free survival (PFS); the hazard ratio (HR) for overall survival (OS) was 0.90 (95% confidence interval [CI]: 0.42‒1.91). Herein, we present an updated analysis.

methodsA total of 123 patients with previously untreated stage IIIB/IV nonsquamous NSCLC without EGFR and/or ALK receptor tyrosine kinase gene (ALK) aberrations were randomized 1:1 to four cycles of PC with or without pembrolizumab, 200 mg every 3 weeks. Pembrolizumab treatment continued for 2 years; maintenance pemetrexed was permitted in both groups. Eligible patients in the PC-alone group with radiologic progression could cross over to pembrolizumab monotherapy. p Values are nominal (one-sided p < 0.025).

resultsAs of December 1, 2017, the median follow-up time was 23.9 months. The ORR was 56.7% with pembrolizumab plus PC versus 30.2% with PC alone (estimated difference 26.4% [95% CI: 8.9%‒42.4%, p = 0.0016]). PFS was significantly improved with pembrolizumab plus PC versus PC alone (HR = 0.53, 95% CI: 0.33‒0.86, p = 0.0049). A total of 41 patients in the PC-alone group received subsequent anti‒programmed death 1/anti‒programmed death ligand 1 therapy. The HR for OS was 0.56 (95% CI: 0.32‒0.95, p = 0.0151). Forty-one percent of patients in the pembrolizumab plus PC group and 27% in the PC-alone group had grade 3 to 5 treatment-related adverse events.

conclusionsThe significant improvements in PFS and ORR with pembrolizumab plus PC versus PC alone observed in the primary analysis were maintained, and the HR for OS with a 24-month median follow-up was 0.56, favoring pembrolizumab plus PC.

Indexed as

Antibodies, Monoclonal, HumanizedAntineoplastic Combined Chemotherapy ProtocolsCarboplatinCarcinoma, Non-Small-Cell LungFemaleHumansLung NeoplasmsMalePemetrexedProgression-Free SurvivalSurvival RateTime FactorsAntibodies, Monoclonal, HumanizedCarboplatinpembrolizumabPemetrexedChemotherapyCombination therapyNonsquamous non‒small cell lung cancerPembrolizumab

Identifiers

PMID30138764

What OpenQuestion holds

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.