KEYNOTE-365 cohort C updated results: Pembrolizumab (pembro) plus enzalutamide (enza) in abiraterone (abi)-pretreated patients (pts) with metastatic castrate-resistant prostate cancer (mCRPC).

Authors

null

William R. Berry

Duke Cancer Center Cary, Cary, NC

William R. Berry , Peter C.C. Fong , Josep M. Piulats , Leonard Joseph Appleman , Henry Jacob Conter , Susan Feyerabend , Neal D. Shore , Gwenaelle Gravis , Brigitte Laguerre , Howard Gurney , Margitta Retz , Emanuela Romano , Loic Mourey , Johann S. De Bono , Audrey E. Kam , Urban Emmenegger , Helen Wu , Charles Schloss , Christian Heinrich Poehlein , Evan Y. Yu

Organizations

Duke Cancer Center Cary, Cary, NC, Auckland City Hospital, Auckland, New Zealand, Catalan Institute of Oncology, Barcelona, Spain, University of Pittsburgh Medical Center, Pittsburgh, PA, University of Western Ontario, Brampton, ON, Canada, Studienpraxis Urologie, Nürtingen, Germany, Carolina Urologic Research Center, Myrtle Beach, SC, CLCC Institut Paoli Calmettes, Paris, France, Centre Eugène Marquis, Rennes, France, Macquarie University Hospital, Sydney, NSW, Australia, Rechts der Isar University Hospital, Technical University of Munich, Munich, Germany, Institut Curie, Paris, France, SIOG, Toulouse, France, Royal Marsden Hospital, London, United Kingdom, Rush University Medical Center, Chicago, IL, Sunnybrook Research Institute, Toronto, ON, Canada, Merck & Co., Inc., Kenilworth, NJ, University of Washington, Seattle, WA

Research Funding

Pharmaceutical/Biotech Company
Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc., Kenilworth, NJ, USA

Background: KEYNOTE-365 (NCT02861573) is a phase 1b/2 study evaluating pembro in combination with other agents in mCRPC. An earlier report of cohort C showed activity and acceptable safety with pembro + enza. Updated results from cohort C are reported. Methods: Pts who failed or became intolerant to ≥4 wks of abi in prechemotherapy mCRPC state and whose disease progressed within 6 mo of screening per PSA progression or radiologic bone or soft tissue progression enrolled. Pts received pembro 200 mg IV Q3W with enza 160 mg/day PO. Primary end points: safety, PSA response rate (confirmed PSA decline ≥50%), and objective response rate (ORR) per blinded independent central review. Key secondary end points: disease control rate (DCR), duration of response (DOR), time to PSA progression, rPFS, and OS. Results: Of 102 treated pts, 73 discontinued, primarily due to progression (60%). Median age was 70 y (range, 43-87), 29% were PD-L1+, 17% had visceral disease, and 39% had measurable disease. Median follow up was 13 mo for all patients (n=102) and 17 mo for patients with ≥27 wks’ follow-up (n=69). See Table for efficacy outcomes. Treatment-related AEs occurred in 92 pts (90%); most frequent (≥20%) were fatigue (38%), nausea (22%), and rash (20%). Grade 3-5 treatment-related AEs occurred in 40 pts (39%). Three pts died of AEs (1 AE was treatment related [cause unknown]). Conclusions: With additional follow-up, pembro + enza continued to show activity in pts with abi-pretreated mCRPC. Safety of the combination was consistent with known profiles of pembro and enza. Clinical trial information: NCT02861573

n/N (%)
PSA response rate per BICR, pts with PSA at baseline22/101 (22)
ORR, RECIST v1.1 per BICR, measurable diseasea3/25 (12); 2 CR, 1 PR
DCR, RECIST v1.1 per BICR (CR+PR+SD+non-CR/non-PD ≥6 mo)a
    Measurable disease8/25 (32)
    Nonmeasurable disease16/44 (36)
    Total24/69 (35)
Median (range) DOR RECIST v1.1 per BICR, moaNot reached (0.0+-24.4+)b
Response ≥12 mo, n (%)1 (100)
Median (95% CI)
Time to confirmed PSA progression, wks15.0 (12.4-17.4)
rPFS, PCWG-modified RECIST, mo6.1 (4.4-6.5)
OS, mo20.4 (15.5-not reached)

aWith ≥27 wks’ follow-up

b‘+’ indicates ongoing responder

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Abstract Details

Meeting

2020 Genitourinary Cancers Symposium

Session Type

Poster Session

Session Title

Poster Session A: Prostate Cancer

Track

Prostate Cancer - Advanced,Prostate Cancer - Localized

Sub Track

Therapeutics

Clinical Trial Registration Number

NCT02861573

Citation

J Clin Oncol 38, 2020 (suppl 6; abstr 102)

Abstract #

102

Poster Bd #

E4

Abstract Disclosures