Pembrolizumab plus chemotherapy for advanced HER2-negative gastric or gastroesophageal junction cancer: KEYNOTE-859 Q-TWiST analysis - PubMed
3 hours ago
- #gastric cancer
- #Q-TWiST analysis
- #pembrolizumab
- In KEYNOTE-859, pembrolizumab plus chemotherapy significantly improved overall survival versus placebo plus chemotherapy for advanced HER2-negative gastric or gastroesophageal junction adenocarcinoma.
- A post hoc analysis assessed Quality-adjusted Time Without Symptoms of disease progression or Toxicity of treatment (Q-TWiST), dividing survival into TOX (time with grade ≥3 adverse events before progression), TWiST (time without progression or grade ≥3 AEs), and REL (time from progression to death).
- Q-TWiST was calculated by weighting restricted mean survival time (RMST) in each state using utilities from the EQ-5D-5L questionnaire, with relative gains ≥15% considered clearly clinically important.
- Results showed longer RMST in TOX (2.30 months) and TWiST (1.90 months) and shorter in REL (-0.28 months) for pembrolizumab plus chemotherapy versus chemotherapy at month 56, leading to relative Q-TWiST gains of 20.90% (US algorithm) or proinflammatory.
- A clearly clinically important Q-TWiST gain was observed with pembrolizumab plus chemotherapy in all participants, indicating improved quality-adjusted survival and benefit-to-risk balance from a patient-centered perspective.