Antoinette Wozniak, MD

Formal discussant Antoinette Wozniak, MD, of UPMC Hillman Cancer Center, Pittsburgh, said, “KEYNOTE-407 is a very positive trial, showing improved overall and progression-free survival with the addition of pembrolizumab (Keytruda) to standard chemotherapy.” In her opinion, evidence from this and other trials does not support the superiority of one taxane over the other.

“There is more hematologic toxicity with nanoparticle albumin-bound (nab)-paclitaxel (Abraxane) and more infusion reactions with paclitaxel, but these differences are not enough to recommend one drug over another,” she stated. She also said that she believes steroids did not impact the outcome in this trial, since there was a significant amount of steroid use in patients receiving nab-paclitaxel as well as in those receiving paclitaxel.

“There are three take-home messages from this trial. The addition of pembrolizumab improves overall survival with either taxane in metastatic squamous non–small cell lung cancer. Toxicity of both drugs is similar except for some insignificant differences between hematologic toxicity and infusion reactions between the taxanes. And steroids do not make a difference,” she said. ■

DISCLOSURE: Dr. Wozniak reported no conflicts of interest.