LUNG CANCER: Early data from a small (n=109) randomised trial suggest the addition of allogenic NK cells (KIR mismatched) to PD-1 inhibition (pembrolizumab) improves outcomes in PD-L1+ (≥1%) NSCLC (OS 15.5 months versus 13.3 months)

Kevin Sovet

May 18, 2020

SCIENTIFIC

LUNG CANCER

Early data from a small (n=109) randomised trial suggest the addition of allogenic NK cells (KIR mismatched) to PD-1 inhibition (pembrolizumab) improves outcomes in PD-L1+ (≥1%) NSCLC (OS 15.5 months versus 13.3 months)

 

Pembrolizumab plus allogeneic NK cells in advanced non–small cell lung cancer patients

10.1172/JCI132712

 

Abstract

 

BACKGROUND

 The anti–programmed cell death 1 (anti–PD-1) antibody pembrolizumab is clinically active against non–small cell lung cancer (NSCLC). In addition to T cells, human natural killer (NK) cells, reported to have the potential to prolong the survival of patients with advanced NSCLC, also express PD-1. This study aimed to investigate the safety and efficacy of pembrolizumab plus allogeneic NK cells in patients with previously treated advanced NSCLC.

 

METHODS 

In total, 109 enrolled patients with a programmed death ligand 1 (PD-L1) tumor proportion score (TPS) of 1% or higher were randomly allocated to group A (n = 55 patients given pembrolizumab plus NK cells) or group B (n = 54 patients given pembrolizumab alone). The patients received i.v. pembrolizumab (10 mg/kg) once every 3 weeks and continued treatment until the occurrence of tumor progression or unacceptable toxicity. The patients in group A continuously received 2 cycles of NK cell therapy as 1 course of treatment.

 

RESULTS

 In our study, patients in group A had longer survival than did patients in group B (median overall survival [OS]: 15.5 months vs. 13.3 months; median progression-free survival [PFS]: 6.5 months vs. 4.3 months; P < 0.05). In group A patients with a TPS of 50% or higher, the median OS and PFS was significantly longer. Moreover, the patients in group A treated with multiple courses of NK cell infusion had better OS (18.5 months) than did those who received a single course of NK cell infusion (13.5 months).

 

CONCLUSION

Pembrolizumab plus NK cell therapy yielded improved survival benefits in patients with previously treated PD-L1+ advanced NSCLC.

 

TRIAL REGISTRATION

ClinicalTrials.gov NCT02843204.

 

FUNDING

This work was supported by grants from the National Natural Science Foundation of China (NSFC) – Guangdong Joint Foundation of China (no. U1601225); the NSFC (no. 81671965); the Guangdong Provincial Key Laboratory Construction Project of China (no. 2017B030314034); and the Key Scientific and Technological Program of Guangzhou City (no. 201607020016).

 

more info: https://www.jci.org/articles/view/132712