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
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 population | 18/67 (27) |
Measurable disease | 10/25 (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 population | 23/69 (33) |
Measurable disease | 8/25 (32) |
Duration of response per RECIST v1.1, median (range), mo | 8.3 (0.0+ to 13.0+) |
DOR, ≥6 mo, n (%) | 3 (75) |
Time to confirmed PSA progression in pts with measurable disease, median (95% CI), wk | 18 (15-48) |
No confirmed PSA progression at 27 wk in pts with measurable disease, % | 50 |
rPFS, PCWG-modified RECIST, median (95% CI), mo | 6 (4-8) |
OS, median (95% CI), mo | Not reached (12 to not reached) |
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Abstract Disclosures
2024 ASCO Genitourinary Cancers Symposium
First Author: Amit Bahl
2020 Genitourinary Cancers Symposium
First Author: William R. Berry
2019 Genitourinary Cancers Symposium
First Author: Peter C.C. Fong
2019 ASCO Annual Meeting
First Author: Christophe Massard