Pembrolizumab (pembro) plus docetaxel and prednisone in abiraterone (abi) or enzalutamide (enza)-pretreated patients (pts) with metastatic castrate resistant prostate cancer (mCRPC): Cohort B of the phase 1b/2 KEYNOTE-365 study.

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 M. Joshua , Mark David Linch , Michael Paul Kolinsky , Emanuela Romano , Srikala S. Sridhar , Henry Jacob Conter , Marinela Augustin , Helen 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, NSW, Australia, Catalan Cancer Institute, Barcelona, Spain, The Kinghorn Cancer Centre, St Vincent's 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, 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 activity as monotherapy in pretreated advanced mCRPC. Data are presented here from cohort B (pembro + docetaxel/prednisone) of KEYNOTE-365 (NCT02861573), a phase 1b/2 umbrella study to test combinations in mCRPC. Methods: Pts who progressed on or became intolerant to ≥4 wk of abi or enza in the prechemotherapy mCRPC state and progressed within 6 mo before screening were eligible. Pts received pembro 200 mg IV with docetaxel 75 mg/m2 IV Q3W plus prednisone 5 mg orally twice daily. The primary end points were safety and PSA response rate (confirmed PSA decrease ≥50%). Key secondary end points were 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 y; visceral disease, 36%; measurable disease, 50%) began pembro + docetaxel. Median (95% CI) follow-up was 10 (8-12) mo. Efficacy is outlined in the table. 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 from treatment-related AEs (pneumonitis). Most commonly reported immune-mediated AEs were infusion-related reactions (11%) and colitis (10%). Conclusions: Pembro + docetaxel/prednisone has activity in pts with mCRPC who previously progressed on second-generation hormone therapy. AEs were considered mild for the treatment combination. Clinical trial information: NCT02861573

PSA response, n/N (%)
Total population22/71 (31)
Measurable disease8/35 (23)
ORR, per RECIST v1.1 pts w/measurable disease, n/N (%)5/36 (14); 5 PRs
DCR per RECIST v1.1, n/N (%)
Total population41/72 (57)
Measurable disease18/36 (50)
Duration of response per RECIST v1.1, median (range), mo5 (4-8+)
Response ≥6 mo, n (%)1 (30)
Time to confirmed PSA progression in pts with measurable disease, median (95% CI), wk24 (15-30)
No confirmed PSA progression at 27 wk in pts with measurable disease, %45
rPFS per PCWG-modified RECIST, median (95% CI), mo8 (8-10)
OS, median (95% CI), moNot reached (13-not reached)

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Abstract Details

Meeting

2019 ASCO Annual Meeting

Session Type

Poster Session

Session Title

Genitourinary (Prostate) Cancer

Track

Genitourinary Cancer—Prostate, Testicular, and Penile

Sub Track

Prostate Cancer - Advanced Disease

Clinical Trial Registration Number

NCT02861573

Citation

J Clin Oncol 37, 2019 (suppl; abstr 5029)

DOI

10.1200/JCO.2019.37.15_suppl.5029

Abstract #

5029

Poster Bd #

141

Abstract Disclosures