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
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
C1 | C2 | C3 | |
---|---|---|---|
ORR per RECIST v1.1 per BICR, measurable disease, n/N | 8/133 (6%); 3 CR, 5 PR | 2/67 (3%); 2 PR | NA |
DCR (CR+PR+SD or non-CR/non-PD ≥6 mo), n/N | 14/133 (11%) | 4/67 (6%) | 12/58 (21%) |
Response ≥18 mo, n/N (%)a | 5/8 (63%) | 1/2 (50%) | NA |
PSA response rate, pts w/elevated baseline PSA, n/N | 7/116 (6%) | 5/60 (8%) | 0/53 (0%) |
Median rPFS per PCWG3-modified RECIST, mo (95% CI)a | 2 (2-2) | 2 (2-3) | 4 (2-4) |
Median OS, mo (95% CI)a | 10 (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 Disclosures
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