KEYNOTE-D46 — Pembrolizumab monotherapy versus sacituzumab govitecan plus pembrolizumab in first-line PD-L1-high NSCLC

Phase 3 · Non-Small Cell Lung Cancer

Population

Previously untreated metastatic NSCLC with PD-L1 TPS ≥50% and no actionable genomic alterations.

Primary Endpoint

Progression-free survival and overall survival

Rationale

Single-agent pembrolizumab is a standard first-line option for PD-L1-high NSCLC, but most patients eventually progress. KEYNOTE-D46 asks whether adding the TROP2-directed antibody-drug conjugate sacituzumab govitecan to pembrolizumab up front deepens and prolongs responses without the toxicity of platinum chemotherapy.

What It Could Change

Could offer a chemotherapy-free but intensified first-line option for the large PD-L1-high subgroup.