This video series and advertorial are fully funded and developed by MSD.
Click the following links for prescribing information for Keytruda® (pembrolizumab):
Great Britain; Northern Ireland
Licensed indications for Keytruda in metastatic non-small cell lung cancer (NSCLC) are also listed at the end of this advertorial.
For UK healthcare professionals only.
Peer-to-peer KEYLearning series: Optimising care for metastatic non-small cell lung cancer (NSCLC) patients with Keytruda® (pembrolizumab) plus chemotherapy
MSD is delighted to announce a new continuing professional development (CPD)-accredited peer-to-peer video learning series, aimed at supporting nurses in the day-to-day management of patients with metastatic NSCLC treated with Keytruda plus chemotherapy combination therapy.
How has the treatment landscape evolved in metastatic NSCLC?
Patients with metastatic NSCLC can undergo rapid clinical deterioration as the disease progresses and less than half of these patients receive second-line therapy (Davies et al, 2017), so having knowledge of the range of treatment options available, and how to manage their respective toxicities, is key for the whole multidisciplinary team (MDT) to ensure the appropriate care is provided for each patient.
First-line treatment for metastatic NSCLC aims to provide patients with survival benefits, while also controlling symptoms to ensure minimal impact on quality of life (QoL) (Sculier and Moro-Sibilot, 2009). Chemotherapy has been the standard of care for the treatment of metastatic NSCLC for many years. Advancements in our understanding of the immune-system pathways involved in the disease have led to the development of targeted immunotherapies as an additional first-line treatment option (Barnet et al, 2018).
In recent years, experimental models have identified that immunotherapy plus chemotherapy combination treatment may act together to target tumours through enhancing the immune response and increasing tumour cell death, which potentially could therefore improve patient outcomes (Opzoomer et al, 2019; Barnet et al, 2018; Gandhi et al, 2018; Paz-Ares et al, 2018; Lichty et al, 2014; Chen and Mellman, 2013).
As a result of these studies, some combinations, such as Keytruda plus chemotherapy, have become first-line treatment options for patients with metastatic NSCLC, who do not harbour epidermal growth factor receptor (EGFR) or anaplastic lymphoma kinase (ALK) mutations (EMC, 2021a; 2021b; 2021c; Paz-Ares et al, 2021; 2018; Socinski et al, 2020; Barnet et al, 2018; Cappuzzo et al, 2018; Gandhi et al, 2018; Reck et al, 2016).
Why is it important that nurses and the wider MDT are confident managing patients with metastatic NSCLC treated with immunotherapy plus chemotherapy?
Patients receiving immunotherapy-based regimes may experience immune-related adverse events (AEs), which can differ from chemotherapy-related AEs and require alternative identification assessments (Brahmer et al, 2018). Knowing how to effectively triage these AEs will allow nurses and the MDT to effectively manage patients to support improvements in treatment outcomes, while maintaining QoL and minimising toxicities (Daniels et al, 2019; Gordon et al, 2017).
How will the peer-to-peer KEYLearning video series support nurses?
The peer-to-peer KEYLearning video series was developed with experienced nurses, oncologists and registrars to provide peer-to-peer training on the day-to-day management of patients with metastatic NSCLC treated with Keytruda plus chemotherapy. Click on the video above to hear Rachel Thomas, a lung cancer clinical nurse specialist involved in the project, provide an overview of the KEYLearning video series.
This CPD-accredited series will provide knowledge and understanding of AE management by covering a range of topics, including:
- The importance of providing the appropriate Keytruda regimen to eligible patients to ensure the best possible treatment outcomes are achieved;
- Real-world experience of patient management through discussions on the treatment journey, from initiation to end of treatment and beyond;
- Ways of supporting the MDT to optimise treatment outcomes, treatment adherence and AE management.
Summary
This CPD-accredited peer-to-peer KEYLearning video series will facilitate learning by giving you an overview of your patients’ journey, ensuring you are well equipped to provide meaningful insight in discussions of patients with metastatic NSCLC being treated with Keytruda plus chemotherapy.
For further guidance on the management of immune-related AEs relating to Keytruda, please refer to the Keytruda Summary of Product Characteristics, available at: Great Britain; Northern Ireland (EMC, 2021a).
To subscribe to MSD communications, including updates about the KEYLearning series and additional resources, please click here (this link will take you to an MSD website, which will request your consent for receiving marketing or promotional emails from MSD about its products, services and events).
For access to other learning tools, including more videos from this CPD-accredited series, please visit the KEYLearning Hub on MSD Connect by clicking here (this link will take you to an MSD website, which contains promotional content).
Licensed indications for Keytruda in metastatic NSCLC (EMC, 2021a)
Keytruda as a monotherapy is indicated for first-line treatment of metastatic NSCLC in adults whose tumours express programmed death-ligand 1 (PD-L1) with a ≥50% tumour proportion score (TPS) with no EGFR- or ALK-positive tumour mutations; also locally advanced or metastatic NSCLC in adults whose tumours express PD-L1 with a ≥1% TPS and who have received at least one prior chemotherapy regimen. Patients with EGFR- or ALK-positive tumour mutations should also have received targeted therapy before receiving Keytruda.
Keytruda, in combination with pemetrexed and platinum chemotherapy, is indicated for the first-line treatment of metastatic non-squamous NSCLC in adults whose tumours have no EGFR- or ALK- positive mutations; also, in combination with carboplatin and either paclitaxel or nab-paclitaxel, for the first-line treatment of metastatic squamous NSCLC in adults.
Adverse events should be reported. Reporting forms and information can be found at https://yellowcard.mhra.gov.uk or search for MHRA Yellow Card in the Google Play or Apple App Store. Adverse events should also be reported to Merck Sharp & Dohme (UK) Limited
(Tel: 0208 1548000).
Job number: GB-PDO-01763
Date of preparation: November 2021
This promotional advertorial was fully funded and developed by MSD.
References
Barnet MB et al (2018) Immunotherapy in non-small cell lung cancer: shifting prognostic paradigms. Journal of Clinical Medicine; 7: 6, 151.
Brahmer JR et al (2018) Management of immune-related adverse events in patients treated with immune checkpoint inhibitor therapy: American Society of Clinical Oncology clinical practice guideline. Journal of Clinical Oncology; 36: 17, 1714-1768.
Cappuzzo F et al (2018) IMpower130: Progression-free survival (PFS) and safety analysis from a randomised phase III study of carboplatin 1 nab-paclitaxel (CnP) with or without atezolizumab (atezo) as first-line (1L) therapy in advanced non-squamous NSCLC. Annals of Oncology; 29: 8 Supp: 742-743.
Chen DS, Mellman I (2013) Oncology meets immunology: the cancer-immunity cycle. Immunity; 39: 1, 1-10.
Daniels GA et al (2019) Challenge of immune-mediated adverse reactions in the emergency department. Emergency Medicine Journal; 36: 6, 369-377.
Davies J et al (2017) Real-world treatment patterns for patients receiving second-line and third-line treatment for advanced non-small cell lung cancer: A systematic review of recently published studies. PLoS One; 12: 4, e0175679.
EMC (2021a) KEYTRUDA (pembrolizumab) Summary of Product Characteristics. Available at: GB: https://www.medicines.org.uk/emc/product/2498/smpc; NI: https://www.emcmedicines.com/en-gb/northernireland/medicine?id=ce680467-8438-4e60-ab4f-dfab6767ccbe&type=smpc
EMC (2021b) OPDIVO (nivolumab). Summary of Product Characteristics. All GB SmPCs available at: www.medicines.org.uk. All NI SmPCs available at: https://www.emcmedicines.com/en-gb/northernireland
EMC (2021c) TECENTRIQ (atezolizumab). Summary of Product Characteristics. All GB SmPCs available at: www.medicines.org.uk. All NI SmPCs available at: https://www.emcmedicines.com/en-gb/northernireland
Gandhi L et al (2018) Pembrolizumab plus chemotherapy in metastatic non–small-cell lung cancer. The New England Journal of Medicine; 378: 22, 2078–2092.
Gordon RA et al (2017) Checkpoint inhibitors: common immune-related adverse events and their management. The Clinical Journal of Oncology Nursing; 21: 2 Supp, 45-52.
Lichty BD et al (2014) Going viral with cancer immunotherapy. Nature Reviews Cancer; 14: 8, 559-67.
Opzoomer JW et al (2019) Cytotoxic chemotherapy as an immune stimulus: a molecular perspective on turning up the immunological heat on cancer. Frontiers in Immunology; 10: 1654.
Paz-Ares L et al (2021) First-line nivolumab plus ipilimumab combined with two cycles of chemotherapy in patients with non-small-cell lung cancer (CheckMate 9LA): an international, randomised, open-label, phase 3 trial. The Lancet Oncology; 22: 2, 198-211.
Paz-Ares L et al (2018) Pembrolizumab plus chemotherapy for squamous non-small-cell lung cancer. The New England Journal of Medicine; 379: 21, 2040–2051.
Reck M et al (2016) Pembrolizumab versus chemotherapy for PD-L1-positive non-small-cell lung cancer. The New England Journal of Medicine; 375: 19,1823–1833.
Sculier JP, Moro-Sibilot D (2009) First- and second-line therapy for advanced nonsmall cell lung cancer. European Respiratory Journal; 33: 4, 915–930.
Socinski MA et al (2020) IMPower150 Final Analysis: Efficacy of Atezolizumab and Chemotherapy ± Bevacizumab in First-Line Metastatic Non-Squamous Non-Small Cell Lung Cancer Across Key Subgroups. Presented at AACR 2020. Abstract CT216.
