Room for a positive.

For patients with resected NSCLC, adding adjuvant osimertinib (for EGFR-mutated) and atezolizumab (for PD-L1+) improve disease free survival when added to adjuvant chemotherapy. In PEARLS/KEYNOTE-091, 1177 patients with resected stage IB-IIIA NSCLC were randomized to receive adjuvant pembrolizumab or placebo in addition to strongly recommended (but not protocol mandated) chemotherapy. The majority did receive adjuvant chemo (86%). Overall, pembrolizumab significantly improved DFS from 42 to 53.6 months. Unexpectedly, although it’s still early in follow-up, the benefit of pembrolizumab was not significant in the subgroup with PD-L1 ≥50%. Longer follow-up will determine if this lack of benefit persists and if there is an overall survival benefit from adjuvant pembro. | O’Brien, Lancet Oncol 2022