Keynote-365 cohort b: Pembrolizumab (pembro) plus docetaxel and prednisone in abiraterone (abi) or enzalutamide (enza)-pretreated patients (pts) with metastatic castrate resistant prostate cancer (mCRPC).

Authors

null

Christophe Massard

Gustave Roussy Cancer Campus and University Paris-Sud, Villejuif, France

Christophe Massard , Margitta Retz , Peter Hammerer , Fernando Quevedo , Peter C.C. Fong , William R. Berry , Howard Gurney , Josep M. Piulats , Anthony Joshua , Mark David Linch , Michael Kolinsky , Emanuela Romano , Srikala S. Sridhar , Henry Jacob Conter , Marinela Augustin , Haiyan Wu , Charles Schloss , Christian Heinrich Poehlein , Evan Y. Yu

Organizations

Gustave Roussy Cancer Campus and University Paris-Sud, Villejuif, France, Rechts der Isar University Hospital, Technical University of Munich, Munich, Germany, Academic Hospital Braunschweig, Braunschweig, Germany, Mayo Clinic, Rochester, MN, Auckland City Hospital, Auckland, New Zealand, Duke University School of Medicine, Cary, NC, Macquarie University Hospital, Sydney, Australia, Catalan Cancer Institute, Barcelona, Spain, Kinghorn Cancer Centre, St. Vincents Hospital, Sydney, Australia, University College London Cancer Institute, London, United Kingdom, Cross Cancer Institute, Edmonton, AB, Canada, Institut Curie, Paris, France, The Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada, University of Western Ontario, Brampton, ON, Canada, Klinikum Nürnberg, Nürnberg, Germany, Merck & Co., Inc., Kenilworth, NJ, University of Washington, Seattle, WA

Research Funding

Pharmaceutical/Biotech Company

Background: Pembro had antitumor activity as monotherapy in pretreated advanced mCRPC (KEYNOTE-028; KEYNOTE-199). KEYNOTE-365 (NCT02861573) is a phase 1b/2 umbrella study testing combinations in mCRPC; we report early results from cohort B combining pembro + docetaxel in mCRPC. Methods: Pts who failed or became intolerant to ≥4 weeks of abi or enza in the pre-chemotherapy mCRPC state received pembro 200 mg IV with docetaxel 75 mg/m2 IV Q3W plus prednisone 5 mg orally twice daily. Pts also progressed within 6 months prior to screening as determined by either PSA progression or radiologic progression in bone or soft tissue. Response was evaluated by PSA levels Q3W and imaging Q9W for first year and Q12W thereafter. Primary end points: safety and PSA response rate (confirmed PSA decline ≥50%). Key secondary end points: investigator-determined ORR (RECIST v1.1), disease control rate (DCR: CR+PR+SD ≥6 mo), time to PSA progression, rPFS, and OS. Results: 72 pts (median age 68 years; PD-L1+ 29%; visceral disease 36%; measurable disease 50%) initiated pembro + docetaxel. Median (95% CI) follow-up was 10 (8-12) mo. Efficacy is outlined in table below. Treatment-related AEs occurred in 69 (96%) pts; most frequent (≥30%) were alopecia (43%), fatigue (40%), and diarrhea (39%). Grade 3-5 treatment-related AEs occurred in 27 (38%) pts, including 2 deaths due to treatment-related AEs (pneumonitis). Conclusions: Combination of pembro + docetaxel/prednisone has activity in pts with mCRPC previously failing anti-hormonal therapy. Observed safety profile for the combination was consistent with known safety profile of each component. Clinical trial information: NCT02861573

PSA response, pts w/elevated PSA at baseline, n/N (%)22/66 (33)
ORR, pts w/measurable disease, n/N (%)5/36 (14); 5 PRs
DCR, n/N (%)
Measurable disease18/36 (50)
Nonmeasurable disease23/36 (64)
Total41/72 (57)
Median (range) duration of response, RECIST v1.1, mo4.9 (4.0-8.3+)
Median (95% CI) time to PSA progression, wk24 (15,30)
No confirmed PSA progression at 27 wk, %48
Median (95% CI) rPFS per PCWG-modified RECIST, mo8 (8, 10)
Median (95% CI) OS, moNot reached (12.9, not reached)

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Abstract Details

Meeting

2019 Genitourinary Cancers Symposium

Session Type

Poster Session

Session Title

Poster Session A: Prostate Cancer

Track

Prostate Cancer,Prostate Cancer

Sub Track

Prostate Cancer - Advanced Disease

Clinical Trial Registration Number

NCT02861573

Citation

J Clin Oncol 37, 2019 (suppl 7S; abstr 170)

DOI

10.1200/JCO.2019.37.7_suppl.170

Abstract #

170

Poster Bd #

G13

Abstract Disclosures