Lancet respir med: Pembrolizumab combined radiotherapy is used for the treatment of patients with metastasis non-small cell lung cancer.

Radiotherapy enhances the systemic anti-tumor response of immunotherapy.
In PEMBRO-RT (Phase 2) and MDACC (Phase 1/2) trials, patients with metastasis non-small cell lung cancer were randomly assigned to receive immunotherapy (Pembrolizumab) with or without radiotherapy, the researchers published the results of the study.
the PEMBRO-RT and MDACC trials were included in patients with metastasis non-small cell lung cancer.
in the PEMBRO-RT trial, the patient had previously received chemotherapy, while in the MDACC trial, the patient's treatment history was not limited, but the patient had not received immunotherapy.
in the PEMBRO-RT trial, patients were strated according to their smoking status . . . . . . . . . . . . . . . . . . . . . . .≥ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
in MDACC trials, stratization is based on the feasibility of radiation therapy.
two trials, Pembrolizumab (200mg every 3 weeks) was administered intravenously, whether radiotherapy or not.
In the PEMBRO-RT trial, patients received the first Pembrolizumab treatment within 1 week of the last radiotherapy (total dose 24Gy, divided into 3 sessions), while in the MDACC trial, Pembrolizumab was treated simultaneously with the first radiotherapy (50 Gy, 4 or 45 Gy, 15 times).
the main endpoints of the study were treatment response rate (ARR), disease control rate (ACR), 12-week ARR, 12-week ACR, progress-free survival rate, and total survival rate.
148 patients participated in the study, 76 of whom received only Pembrolizumab treatment and 72 patients received Pembrolizumab combined radiotherapy.
follow-up time for all patients was 33 months.
124 (84%) of the 148 patients had non-scaly histological characteristics and 111 (75%) had received chemotherapy.
the best ARR in the Pembrolizumab group was 19.7% (15 out of 76 cases), while the Pembrolizumab plus radiotherapy group was 41.7% (30 out of 72 cases, with an advantage over the or 2.9) 6) the ;P ACR in the embrolizumab group was 43.4% (33 out of 76) and the Pembrolizumab plus radiotherapy group was 65.3% (47 out of 72, OR=2.51).
the medium progress-free lifetime of the Pembrolizumab group was 4.4 months, and the combined radiotherapy group of Pembrolizumab was 9.0 months (risk ratio of 0.67).
total survival of the Pembrolizumab group was 8.7 months, while the combined radiotherapy group of Pembrolizumab was 19.2 months (HR=0.67).
no new security incidents occurred.
study concluded that pembrolizumab immunotherapy combined radiotherapy significantly improved response and prognostication in patients with metastasis non-small cell lung cancer.
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