Combining pembrolizumab and platinum chemotherapy plus pemetrexed doubles survival in patients with nonsquamous non-small cell lung cancer (NSNSCLC) without EGFR or ALK gene mutations, according to the results of a study published in the New England Journal of Medicine.

In the phase III international trial, 616 patients with untreated, metastatic NSNSCLC were randomly assigned to two treatment groups: 405 to receive pembrolizumab and platinum chemotherapy plus pemetrexed (combination treatment group), and 202 to receive platinum chemotherapy plus pemetrexed and placebo (standard treatment group).

Patients in the combination treatment group had a 51% reduced risk of death and 48% lower chance of progression or death compared to those receiving standard treatment. Both groups had a similar risk of severe side effects (67.2% for combination and 65.8% for standard treatment) except for acute kidney injury, where the risk was 5.2% for combination and 0.5% for standard treatment. The most common side effects in both groups were nausea, anemia, and fatigue.

The researchers said that their findings may suggest a new standard of care.

For more information and resources on managing adverse events from immunotherapy, which differs from management techniques for chemotherapy side effects, visit ONS’s Putting Evidence Into Practice resources.