Efficacy of Lower Fixed Dose Pembrolizumab in the Treatment of Non-Small Cell Lung Cancer Patients in a Lower-Middle Income Country: Jordan Experience

Author Info

Layla Abbasi Adnan Almallah Nedal F Al-Rawashdeh Salah Abbasi

Corresponding Author

Salah Abbasi
Department of Medicine, Al-Khalidi Medical Center, Amman, Jordan

A B S T R A C T

Background: Pembrolizumab was approved as first line treatment of advanced non-small cell lung cancer (NSCLC) at standard dose of 200mg every 3 weeks. We aim to assess the efficacy of a lower fixed dose of 100mg and review the Jordanian experience in first line setting. Methods: We conducted a retrospective study of 88 NSCLC patients, including 27 who received low fixed dose pembrolizumab (Pem100) and 61 received standard fixed dose (Pem200) from September 2016 to February 2022. Results: Objective response rate was (48.8%), including (5.6%) with complete response, and (43.2%) with partial response. The median progression free survival (PFS) and median overall survival (OS) for this Jordanian population were consistent with published clinical trials; 8.00 months (95% CI, 7.19 to 8.80) and 17.48 months (95 CI, 15.53 to 19.44), respectively. The PFS and OS were not statistically different between the Pem100 and Pem200 groups (8.00 vs. 8.00 months, p=0.73, and 17.02 vs 17.60 months, p=0.66, respectively). PFS and OS were significantly affected by the programmed cell death ligand (PD-L1) tumor proportion score (TPS) (12.40 vs. 8.00 vs. 5.80 months, p<0.001, and 22.70 vs. 16.47 vs. 12.71 months, p<0.001, in TPS ≥ 50% vs. TPS 1-49% vs. TPS < 1%, respectively). OS was not statistically different according to age, gender, histology, or smoking status. Conclusion: Lower fixed dose pembrolizumab (100mg 3-weekly) appears to be effective in first line NSCLC. A randomized trial should be done to investigate this low dose with significant cost reduction potential.

Article Info

Article Type

Research Article

Publication history

Received: Tue 19, Apr 2022
Accepted: Wed 04, May 2022
Published: Wed 18, May 2022

Copyright

© 2023 Salah Abbasi. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Hosting by Science Repository.
DOI: 10.31487/j.ACO.2022.02.01