KEYNOTE-029: Efficacy and safety of pembrolizumab (pembro) plus ipilimumab (ipi) for advanced melanoma.

Authors

null

Matteo S. Carlino

Westmead and Blacktown Hospitals and Melanoma Institute Australia, Sydney, Australia

Matteo S. Carlino , Victoria Atkinson , Jonathan S. Cebon , Michael B. Jameson , Bernie M. Fitzharris , Catriona M. McNeil , Andrew G Hill , Antoni Ribas , Michael B. Atkins , John A. Thompson , Wen-Jen Hwu , F. Stephen Hodi , Alexander M. Menzies , Alexander David Guminski , Richard Kefford , Xinxin Shu , Nageatte Ibrahim , Blanca Homet Moreno , Georgina V. Long

Organizations

Westmead and Blacktown Hospitals and Melanoma Institute Australia, Sydney, Australia, Gallipoli Medical Research Foundation, Greenslopes Private Hospital, Brisbane, Australia, Olivia Newton-John Cancer Research Institute, Heidelberg, Australia, Regional Cancer Centre, Waikato Hospital, Hamilton, New Zealand, Canterbury District Health Board, Christchurch, New Zealand, Chris O'Brien Lifehouse, Sydney, Australia, Tasman Oncology Research Pty Ltd, Queensland, Australia, University of California, Los Angeles, Los Angeles, CA, Georgetown University Hospital, Lombardi Comprehensive Cancer Center, Washington, DC, University of Washington, Seattle, WA, MD Anderson Cancer Center, Houston, TX, Dana-Farber Cancer Institute, Boston, MA, Melanoma Institute Australia, The University of Sydney, Royal North Shore and Mater Hospitals, Sydney, Australia, Westmead Hospital, Melanoma Institute Australia, and Macquarie University, Sydney, Australia, Merck & Co., Inc., Kenilworth, NJ

Research Funding

Pharmaceutical/Biotech Company

Background: We previously showed that standard-dose pembro plus reduced-dose ipi has manageable safety and robust antitumor activity in patients (pts) with advanced melanoma. Here, we present more mature data, including 1-y landmark PFS and OS estimates. Methods: In the phase 1 KEYNOTE-029 expansion cohort (NCT02089685), pts with advanced melanoma, ECOG PS 0-1, no active brain metastases, and no prior immune checkpoint inhibitor therapy received pembro 2 mg/kg Q3W + ipi 1 mg/kg Q3W for 4 doses, then pembro alone for up to 2 y. Primary end point was safety. Efficacy end points were ORR, PFS, and DOR per RECIST v1.1 by independent central review and OS. Results: 153 pts were enrolled between Jan 13, 2015, and Sep 17, 2015. Median age was 60 y, 66% were male, 25% had elevated LDH, 56% had stage M1c disease, 36% were BRAFV600mutant, and 13% received ≥1 prior therapy. As of Oct 17, 2016, median follow-up was 17 mo, and 64 (42%) pts remained on pembro. 110 (72%) pts received all 4 ipi doses. There were no treatment-related (TR) deaths. TRAEs occurred in all pts, were grade 3/4 in 69 (45%), and led to discontinuation of pembro and ipi in 17 (11%), ipi alone in 11 (7%), and pembro alone after ipi completion or discontinuation in 19 (12%). PD occurred in 1/11 pts who discontinued ipi alone and 4/17 pts who discontinued ipi and pembro. Of the 11 pts who discontinued ipi alone for a TRAE, 0 experienced recurrence of the same TRAE during pembro monotherapy and 2 discontinued pembro for a different TRAE (both elevated lipase). Immune-mediated AEs occurred in 90 (59%) pts and were grade 3/4 in 39 (25%). With 7 mo additional follow-up, there were 6 additional responses for an ORR of 61% (95% CI, 53%-69%); the CR rate increased from 10% to 15%. Median DOR was not reached (range, 1.6+ to 18.1+ mo), with 86/93 responders (92%), including 23/23 (100%) with CR, alive and without subsequent PD at cutoff. Median PFS and OS were not reached; 1-y estimates were 69% for PFS and 89% for OS. Conclusions: Pembro 2 mg/kg plus 4 doses of ipi 1 mg/kg has a manageable toxicity profile and provides robust, durable antitumor activity in pts with advanced melanoma. Clinical trial information: NCT02089685

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Abstract Details

Meeting

2017 ASCO Annual Meeting

Session Type

Poster Session

Session Title

Melanoma/Skin Cancers

Track

Melanoma/Skin Cancers

Sub Track

Advanced/Metastatic Disease

Clinical Trial Registration Number

NCT02089685

Citation

J Clin Oncol 35, 2017 (suppl; abstr 9545)

DOI

10.1200/JCO.2017.35.15_suppl.9545

Abstract #

9545

Poster Bd #

153

Abstract Disclosures