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Lung cancer trialist behind KEYNOTE-010 and the ADAURA adjuvant osimertinib trial.
Roy Herbst (Yale Cancer Center) led KEYNOTE-010, the trial that established pembrolizumab for previously treated PD-L1-positive NSCLC, and was co-principal investigator of ADAURA, which showed adjuvant osimertinib dramatically cuts recurrence and improves survival in resected EGFR-mutant lung cancer. He co-led the Lung-MAP master protocol and the early atezolizumab biomarker work. His current focus is adjuvant and neoadjuvant targeted therapy.
| Title | Journal | Year |
|---|---|---|
| Pembrolizumab versus docetaxel for previously treated, PD-L1-positive, advanced non-small-cell lung cancer (KEYNOTE-010) | Lancet | 2016 |
| Adjuvant osimertinib for resected EGFR-mutated NSCLC: overall survival (ADAURA) | NEJM | 2023 |
| ADAURA: three years of osimertinib after surgery for EGFR-mutated lung cancer | New England Journal of Medicine | 2020 |
The survival benefit first reported in 2023 has held five years after the last dose of adjuvant osimertinib, which answers the worry that a three-year course only delays relapse. Patients with an exon 19 deletion gained most; the L858R estimate crosses one and is less certain. Nothing here changes the recommendation, which already rests on the 2023 analysis, but it tightens the case for testing every resected non-squamous tumour for EGFR mutations.
For the minority of patients whose tumours express a lot of PD-L1, a single antibody outperforms chemotherapy and is far easier to take. The word minority is the point: the same drug in the same disease at lower PD-L1 gives much less.
Every resected non-squamous lung cancer should be tested for EGFR mutations, because patients who carry one live longer if they take osimertinib for three years after surgery. The trial does not tell us whether adjuvant chemotherapy can be omitted, nor what happens on relapse after osimertinib, and the three-year duration was chosen empirically.
Alongside the CheckMate trials this study replaced docetaxel with PD-1 blockade as second-line treatment for most lung cancers, and its PD-L1 threshold of 1% became the basis of pembrolizumab's label in previously treated disease.
Shares PD-L1-high non-small-cell lung cancer without a driver mutation, Atezolizumab, PD-1, Pembrolizumab and the tags lung, immunotherapy.
Shares Resectable stage I to III non-small-cell lung cancer, PD-1, Non-small-cell lung cancer and the tags lung, immunotherapy.
Shares PD-L1-high non-small-cell lung cancer without a driver mutation, Non-small-cell lung cancer and the tags lung, immunotherapy.
Shares PD-1, Pembrolizumab and the tags immunotherapy, adjuvant.
Shares PD-1 and the tags immunotherapy, adjuvant.
Shares PD-1 and the tags immunotherapy, adjuvant.
Shares Non-small-cell lung cancer and the tags lung, immunotherapy.
Shares Yale Cancer Center / Smilow Cancer Hospital, EGFR, PD-1, Pembrolizumab and the tag immunotherapy.