KEYNOTE-062: phase 3 study of pembrolizumab alone or in combination with chemotherapy versus chemotherapy alone as first-line therapy for advanced gastric or gastroesophageal junction (GEJ) adenocarcinoma.

Authors

Josep Tabernero

Josep Tabernero

Vall d'Hebron University Hospital, Barcelona, Spain

Josep Tabernero , Yung-Jue Bang , Charles S. Fuchs , Atsushi Ohtsu , Uma Kher , Baohoang Lam , Minori Koshiji , Eric Van Cutsem

Organizations

Vall d'Hebron University Hospital, Barcelona, Spain, Seoul National University Hospital, Seoul, Korea, The Republic of, Dana-Farber Cancer Institute, Boston, MA, National Cancer Center Hospital East, Kashiwa, Japan, Merck & Co., Inc., Kenilworth, NJ, Merck & Co., Inc., Rahway, NJ, Leuven Cancer Institute, University Hospitals Leuven, Leuven, Belgium

Research Funding

Pharmaceutical/Biotech Company

Background: Pembrolizumab (pembro) is a monoclonal antibody against PD-1 designed to block its interaction with PD-L1 and PD-L2 and permit an antitumor immune response. In KEYNOTE-012, pembro showed a 22% ORR (RECIST v1.1, central review) and manageable safety profile in patients (pts) with advanced gastric cancer. The randomized, phase 3 KEYNOTE-062 study (NCT02494583) is designed to compare the efficacy and safety of pembro alone or in combination with cisplatin + fluoropyrimidine with those of cisplatin + fluoropyrimidine as first-line therapy for PD-L1+/HER2 advanced gastric or GEJ adenocarcinoma. Methods: Key eligibility criteria include age ≥ 18 y, locally advanced/metastatic PD-L1+/HER2 gastric or GEJ adenocarcinoma, ECOG PS 0-1, no active autoimmune disease, brain metastases, or prior therapy for advanced disease. Pts are randomized 1:1:1 to pembro 200 mg Q3W (arm 1), pembro + cisplatin 80 mg/m2 Q3W + 5-fluorouracil (5-FU) 800 mg/m2 on days 1-5 of each Q3W cycle (arm 2), or placebo Q3W + cisplatin + 5-FU (arm 3); 5-FU may be replaced with capecitabine 1000 mg/m2 twice daily on days 1-14 of each cycle. Randomization is stratified by region (Europe/North America/Australia vs Asia vs rest of world), disease status (locally advanced vs metastatic), and chosen fluoropyrimidine (5-FU vs capecitabine). Arm 1 is open label; in arms 2 and 3, assignment to pembro vs placebo is double blind. All treatments will continue for 35 cycles or until progressive disease, unacceptable toxicity, or pt/investigator decision. Response will be evaluated every 6 wk per RECIST v1.1 by central imaging vendor review and per RECIST adapted for immunotherapy response patterns; eligible pts may continue treatment beyond initial RECIST-defined progression. AEs will be assessed throughout treatment and for 30 d thereafter (90 d for serious AEs) and graded per NCI CTCAE v4.0. Pts will be followed for survival every 3 mo. OS and PFS per RECIST v1.1 are the primary study end points; secondary end points include ORR and duration of response. Enrollment in KEYNOTE-062 is ongoing and will continue until ~750 pts have enrolled. Clinical trial information: NCT02494583

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Abstract Details

Meeting

2016 ASCO Annual Meeting

Session Type

Poster Session

Session Title

Gastrointestinal (Noncolorectal) Cancer

Track

Gastrointestinal Cancer—Gastroesophageal, Pancreatic, and Hepatobiliary

Sub Track

Esophageal or Gastric Cancer

Clinical Trial Registration Number

NCT02494583

Citation

J Clin Oncol 34, 2016 (suppl; abstr TPS4138)

DOI

10.1200/JCO.2016.34.15_suppl.TPS4138

Abstract #

TPS4138

Poster Bd #

126b

Abstract Disclosures