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

Authors

null

Peter C.C. Fong

Auckland City Hospital, Auckland, New Zealand

Peter C.C. Fong , Margitta Retz , Alexandra Drakaki , Christophe Massard , William R. Berry , Emanuela Romano , Johann S. De Bono , Susan Feyerabend , Leonard Joseph Appleman , Henry Jacob Conter , Srikala S. Sridhar , Neal D. Shore , Mark David Linch , Anthony M. Joshua , Howard Gurney , Helen Wu , Charles Schloss , Christian Heinrich Poehlein , Evan Y. Yu

Organizations

Auckland City Hospital, Auckland, New Zealand, Rechts der Isar University Hospital, Technical University of Munich, Munich, Germany, University of California, Los Angeles, Los Angeles, CA, Gustave Roussy Cancer Campus and Université Paris-Sud, Villejuif, France, Duke University School of Medicine, Cary, NC, Institut Curie, Paris, France, Royal Marsden Hospital, London, United Kingdom, Studienpraxis Urologie, Nürtingen, Germany, University of Pittsburgh Medical Center, Pittsburgh, PA, University of Western Ontario, Brampton, ON, Canada, The Princess Margaret Cancer Centre, Toronto, ON, Canada, Carolina Urologic Research Center, Myrtle Beach, SC, University College London Cancer Institute, London, United Kingdom, The Kinghorn Cancer Centre, St Vincent's Hospital, Sydney, Australia, Macquarie University Hospital, Sydney, NSW, Australia, Merck & Co., Inc., Kenilworth, NJ, University of Washington, Seattle, WA

Research Funding

Pharmaceutical/Biotech Company

Background: Pembro has activity as monotherapy in pts with pretreated advanced mCRPC. A phase 2 study suggested that pembro + enza after progression on enza may have clinical activity. Data from cohort C (pembro + enza) of KEYNOTE-365 (NCT02861573), a phase 1b/2 umbrella study to test combinations in mCRPC, are presented. Methods: Pts who were unsuccessful with or became intolerant to ≥4 weeks of abi in the prechemotherapy mCRPC state, with either PSA or radiologic progression within 6 mo before screening were included. Pts received pembro 200 mg IV Q3W with enza 160 mg/day orally. Primary end points were safety and PSA response rate (confirmed PSA decrease ≥50%). Key secondary end points were investigator-assessed ORR (RECIST v1.1), disease control rate (DCR: CR+PR+SD ≥6 mo), time to PSA progression, rPFS, and OS. Results: 69 pts began treatment (median age, 69 y; visceral disease, 26%; measurable disease, 36%). Median (95% CI) follow-up was 9 (7-13) mo. Efficacy is outlined in the table. Treatment-related AEs occurred in 63 (91%) pts; most frequent (≥20%) were fatigue (30%), rash (23%), and nausea (22%). Grade 3/4 treatment-related AEs occurred in 28 (41%) pts; most common was rash (10%); no deaths were from treatment-related AEs. Conclusions: The pembro + enza combination showed sustained activity in abi-pretreated chemotherapy-naive mCRPC. AEs were considered tolerable for the treatment combination; incidence of rash resolved with standard-of-care treatment. Clinical trial information: NCT02861573

PSA response, n/N (%)
Total population18/67 (27)
Measurable disease10/25 (40)
ORR, per RECSIT v1.1 pts w/measurable disease, n/N (%)5/25 (20); 2 CR, 3 PR
DCR per RECIST v1.1, n/N (%)
Total population23/69 (33)
Measurable disease8/25 (32)
Duration of response per RECIST v1.1, median (range), mo8.3 (0.0+ to 13.0+)
DOR, ≥6 mo, n (%)3 (75)
Time to confirmed PSA progression in pts with measurable disease, median (95% CI), wk18 (15-48)
No confirmed PSA progression at 27 wk in pts with measurable disease, %50
rPFS, PCWG-modified RECIST, median (95% CI), mo6 (4-8)
OS, median (95% CI), moNot reached (12 to not reached)

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Abstract Details

Meeting

2019 ASCO Annual Meeting

Session Type

Poster Discussion 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 5010)

DOI

10.1200/JCO.2019.37.15_suppl.5010

Abstract #

5010

Poster Bd #

122

Abstract Disclosures