Update on KEYNOTE-199, cohorts 1-3: Pembrolizumab (pembro) for docetaxel-pretreated metastatic castration-resistant prostate cancer (mCRPC).

Authors

null

Emmanuel S. Antonarakis

Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD

Emmanuel S. Antonarakis , Josep M. Piulats , Marine Gross-Goupil , Jeffrey C. Goh , Ulka N. Vaishampayan , Ronald De Wit , Tuomo Alanko , Satoshi Fukasawa , Kenichi Tabata , Susan Feyerabend , Raanan Berger , Helen Wu , Jeri Kim , Charles Schloss , Johann S. De Bono

Organizations

Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD, Instituto Catalan de Oncologia, Hospital Duran i Reynals, Hospitalet de Llobregat, Barcelona, Spain, Bergonie Institute Cancer Center, Bordeaux, France, Royal Brisbane & Women's Hospital, Herston, QLD, Australia, Karmanos Cancer Institute, Wayne State University, Detroit, MI, Erasmus University Hospital, Rotterdam, Netherlands, Docrates Cancer Center, Helsinki, Finland, Chiba Cancer Center, Chiba, Japan, Kitasato University School of Medicine, Kanagawa, Japan, Studienpraxis Urologie, Nürtingen, Germany, Chaim Sheba Medical Center at Tel HaShomer, Ramat Gan, Israel, Merck & Co., Inc., Kenilworth, NJ, The Royal Marsden NHS Foundation Trust, London, United Kingdom

Research Funding

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

Background: The KEYNOTE-199 multicohort phase 2 study (NCT02787005) showed that pembro monotherapy has antitumor activity and acceptable safety in patients (pts) with mCRPC previously treated with a next-generation hormonal agent (NHA) and docetaxel in cohort 1 (C1) (RECIST-measurable, PD-L1+ disease), C2 (RECIST-measurable, PD-L1 disease), and C3 (bone-predominant disease, irrespective of PD-L1). Updated results with additional follow-up for C1-3 are presented. Methods: Pts previously received ≥1 NHAs and 1 or 2 chemotherapies, including docetaxel. Pts received pembro 200 mg Q3W for 35 cycles or until progression or intolerable toxicity. Primary end point was ORR. Key secondary end points were DCR, DOR, PSA (≥50%) response rate, rPFS, OS, and safety. Results: Of 258 pts enrolled (C1=133; C2=67; C3=58), 6 completed (C1=4; C3=2) and 252 discontinued (C1=129; C2=67; C3=56) therapy, primarily due to progression (C1=106; C2=61; C3=45). Median follow-up was 9.6 mo (C1, 9.5; C2, 7.9; C3, 14.2). ORR (95% CI) for pts with measurable disease was 6% (2.6-11.5) in C1 and 3% (0.4-10.4) in C2 (Table; includes other efficacy results). Treatment-related AEs of any grade/grade 3-5 occurred in 57%/16% in C1, 60%/15% in C2, and 71%/17% in C3. 1 pt in each cohort died of a treatment-related AE (C1, sepsis; C2, unknown; C3, immune-related pneumonitis). Conclusions: With additional follow-up, pembro monotherapy continued to show antitumor activity and disease control in pts with RECIST-measurable and bone-predominant mCRPC previously treated with both NHA and docetaxel. Pts experienced durable responses. Safety was consistent with the known safety profile of pembro. Clinical trial information: NCT02787005

C1C2C3
ORR per RECIST v1.1 per BICR, measurable disease, n/N8/133 (6%); 3 CR, 5 PR2/67 (3%); 2 PRNA
DCR (CR+PR+SD or non-CR/non-PD ≥6 mo), n/N14/133 (11%)4/67 (6%)12/58 (21%)
Response ≥18 mo, n/N (%)a5/8 (63%)1/2 (50%)NA
PSA response rate, pts w/elevated baseline PSA, n/N7/116 (6%)5/60 (8%)0/53 (0%)
Median rPFS per PCWG3-modified RECIST, mo (95% CI)a2 (2-2)2 (2-3)4 (2-4)
Median OS, mo (95% CI)a10 (6-12)8 (6-10)14 (11-18)
OS at 24 mo, %22%16%21%

aProduct-limit (Kaplan-Meier) method for censored data

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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

NCT02787005

Citation

J Clin Oncol 38, 2020 (suppl 6; abstr 104)

Abstract #

104

Poster Bd #

E6

Abstract Disclosures