# KEYNOTE-407

Source: https://onco.cc/trials/keynote-407/  
OnCo record `keynote-407` (Trial). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

KEYNOTE-407 showed that adding pembrolizumab to chemotherapy helped people with squamous lung cancer live longer whatever their PD-L1 level, and made chemo-immunotherapy the standard first treatment for this type.

## Summary

KEYNOTE-407 randomised 559 patients with untreated metastatic squamous non-small-cell lung cancer to carboplatin and either paclitaxel or nab-paclitaxel with pembrolizumab or with placebo, followed by pembrolizumab or placebo maintenance. Squamous tumours had been left behind by the targeted-therapy era and had no chemotherapy-free option beyond high-PD-L1 pembrolizumab.

Both primary endpoints, overall survival and progression-free survival, favoured the pembrolizumab arm, and the benefit was seen across PD-L1 expression groups. The combination was approved in the United States in October 2018 and became the first-line standard for squamous disease without a driver mutation.

## Fields

- Kind: Trial
- Status: positive
- Last checked: 2026-09-17
- Tags: subtype-trials
- Registry id: NCT02775435
- Phase: 3
- Setting: Untreated metastatic squamous non-small-cell lung cancer: carboplatin with paclitaxel or nab-paclitaxel, with pembrolizumab or placebo
- Sponsor: Merck & Co. (MSD)
- Enrolled: 559
- Result: Pembrolizumab plus carboplatin and a taxane improved overall and progression-free survival over chemotherapy alone across PD-L1 levels; approved in October 2018.
- Outcomes: Overall survival: Pembrolizumab + carboplatin + paclitaxel or nab-paclitaxel 15.9 months vs Placebo + carboplatin + paclitaxel or nab-paclitaxel 11.3 months, HR 0.64; Progression-free survival: Pembrolizumab + carboplatin + paclitaxel or nab-paclitaxel 6.4 months vs Placebo + carboplatin + paclitaxel or nab-paclitaxel 4.8 months, HR 0.56; Grade 3 or higher adverse events: Pembrolizumab + carboplatin + paclitaxel or nab-paclitaxel 69.8% vs Placebo + carboplatin + paclitaxel or nab-paclitaxel 68.2%; Discontinuation for adverse events: Pembrolizumab + carboplatin + paclitaxel or nab-paclitaxel 13.3% vs Placebo + carboplatin + paclitaxel or nab-paclitaxel 6.4%

## Sources

- ClinicalTrials.gov NCT02775435: https://clinicaltrials.gov/study/NCT02775435

## Connected records

- cancers: [Basaloid squamous cell carcinoma of the lung](https://onco.cc/cancers/basaloid-squamous-cell-carcinoma-lung/), [Lung cancer (all types)](https://onco.cc/cancers/lung-cancer/), [Non-small-cell lung cancer](https://onco.cc/cancers/nsclc/), [PD-L1-high non-small-cell lung cancer without a driver mutation](https://onco.cc/cancers/pdl1-high-nsclc/), [Squamous cell carcinoma of the lung](https://onco.cc/cancers/lung-squamous-cell-carcinoma/)
- technologies: [Immune checkpoint inhibitors](https://onco.cc/technologies/checkpoint-inhibitor/)
- drugs: [Carboplatin](https://onco.cc/drugs/carboplatin/), [Paclitaxel / nab-paclitaxel](https://onco.cc/drugs/paclitaxel/), [Pembrolizumab](https://onco.cc/drugs/pembrolizumab/)
- companies: [Merck & Co. (MSD)](https://onco.cc/companies/merck/)
- people: [Luis Paz-Ares](https://onco.cc/people/luis-paz-ares/)
- key papers: [Pembrolizumab plus Chemotherapy for Squamous Non-Small-Cell Lung Cancer](https://onco.cc/key-papers/paper-keynote-407-n-engl-j-med-2018/), [Pembrolizumab Plus Chemotherapy in Squamous Non-Small-Cell Lung Cancer: 5-Year Update of the Phase III KEYNOTE-407 Study](https://onco.cc/key-papers/paper-keynote-407-j-clin-oncol-2023-update/)
- trials: [SQUIRE](https://onco.cc/trials/squire/)

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