When lung cancer has spread to other parts of the body, standard chemotherapy offers only a modest survival benefit. In a major advance described in September 2018 in The New England Journal of Medicine, an international team, including researchers from Albert Einstein College of Medicine and Montefiore Health System, reported that combining chemotherapy with the immunotherapy drug Keytruda extends the lives of people with metastatic squamous non-small cell lung cancer (NSCLC) by more than 40 percent compared with chemotherapy alone. This significant improvement should immediately change the standard of care.

“Immunotherapy is revolutionizing cancer care, and this study is further evidence of its power,” says Balazs Halmos, M.D., M.S., coauthor of the paper and director of the multidisciplinary thoracic oncology program at the Montefiore Einstein Center for Cancer Care and director of clinical cancer genetics at the Albert Einstein Cancer Center.

NSCLC is the most common type of lung cancer, accounting for 85 percent of all cases. There are two main types: squamous and non-squamous NSCLC. This double-blind, randomized controlled trial enrolled 559 patients with metastatic squamous NSCLC. Approximately half the patients were treated with standard chemotherapy involving two chemotherapy drugs plus placebo (the control group); the other half received two chemotherapy drugs plus Keytruda.

Compared with chemotherapy alone, adding Keytruda to chemotherapy improved patients’ median overall survival by 4.6 months (15.9 months vs. 11.3 months, or a 40.7 percent improvement) and extended by 1.6 months the time during which the disease did not progress (6.4 months vs. 4.8 months, or a 33 percent extension).