b'VA Study Endorses Extended-Interval Dosing of Single-Agent Pembrolizumab ANNARBOR,MIEventhoughextended-intervaldosingofsingle-agentpembrolizumabThe authors said their findings isnt often used, despite approval from the U.S.support the [time to treatment Food and Drug Administration, the practice hasdiscontinuation] equivalence potential health system and public health bene-fits, according to a VA study. of standard- and extended-The FDA approved extended-interval dosing ofinterval pembrolizumab across pembrolizumab (400 mg every 6 weeks) in Aprilindications and provides 2020 as an alternative to standard-interval dos- further support for extended-ing of 200 mg every 3 weeks. Extended-intervalinterval pembrolizumab dosing.dosingmayenhanceaccess,alleviatepatient and health system financial toxicity and improve patientqualityoflife,particularlyduringthe COVID-19 pandemic, according to a report inThe study results indicated that extended-inter-JAMAOncology,whichaddedthattheeffectsval adoption reached its steady-state plateau of have not been adequately described. 1 approximately35%byJanuary2021;65%of To remedy that, researchers from the Ann Arbor,participants who began standard-interval single-MI, VAMC, the University of Michigan and col- agentpembrolizumabreceivedonlystandard-leaguesconductedaretrospectivecohortstudyintervaldosingduringthetreatmentcourse.In that used data from the VHA. Included were vet- analysisconsistentwiththeintention-to-treat erans who were prescribed single-agent pembro- principle, no differences in TTD were observed lizumab within the VHA between April 1, 2020,between standard- and extended-interval dosing and July 1, 2021. A subcohort of veterans within either the all-diseases cohort (HR, 1.00; 95% non-smallcelllungcancer(NSCLC)wasalsoCI, 1.00-1.00) or the NSCLC cohort (HR, 1.00; identified using claims-based codes. 95% CI, 1.00-1.00).The study excluded patients receiving combi- Theauthorspointedoutthatextended-inter-nations of pembrolizumab and cytotoxic chemo- val dosing made up a minority of single-agent therapy or tyrosine kinase inhibitors. pembrolizumabprescriptionsdespitetheFDA Thestudyteamwasfocusedonthenumberapprovalandpotentialbenefits.Thefindings andproportionofsingle-agentpembrolizumabsupporttheTTDequivalenceofstandard-and prescriptions that were extended compared withextended-interval pembrolizumab across indica-standardinterval.Theresearchersdescribedtions, complementing clinical pharmacology and effectiveness in terms of time-to-treatment dis- single-arm clinical trial data in melanoma, they continuation (TTD) and extended- to standard- wrote. This study provides further support for interval pembrolizumab prescriptions. extended-interval pembrolizumab dosing.Of the 835 veterans (mean age [SD], 70.9 [8.7]1Strohbehn GW, Holleman R, Burns J, Klamerus ML, et. al. years; 809 [96.9%] men) who began single-agentAdoption of Extended-Interval Dosing of Single-Agent Pem-pembrolizumab during the study period (all-dis- brolizumab and Comparative Effectiveness vs Standard Dosing eases cohort), 234 has NSCL. Those patients hadin Time-to-Treatment Discontinuation. JAMA Oncol. 2022 Nov 1;8(11):1663-1667. doi: 10.1001/jamaoncol.2022.4109. PMID: a mean age of 71.6 and were 96.2% male. 36136314; PMCID: PMC9501784.103'