A large randomized trial called EVOKE-03 tested whether adding the antibody-drug conjugate sacituzumab govitecan to the immunotherapy drug pembrolizumab could improve outcomes in metastatic non-small cell lung cancer. While progression-free survival improved by about four months numerically, the difference was not statistically significant. Overall survival actually trended slightly worse in the combination arm. The combination also caused more serious side effects and treatment discontinuations. Experts concluded that pembrolizumab alone remains the standard of care for patients whose tumors express high levels of PD-L1, and the combination should not be used outside clinical trials. The findings highlight the challenge of improving on already-effective immunotherapy backbones in lung cancer.
