KEYNOTE-799: Phase 2 trial of pembrolizumab plus platinum chemotherapy and radiotherapy for unresectable, locally advanced, stage 3 NSCLC.

Authors

null

Salma K. Jabbour

Department of Radiation Oncology, Rutgers Cancer Institute of New Jersey, Robert Wood Johnson Medical School, Rutgers University, New Brunswick, NJ

Salma K. Jabbour , Ki Hyeong Lee , Nicolaj Frost , Valeriy Vladimirovich Breder , Dariusz M. Kowalski , Issam Abdelkarim Alawin , Evgeny Levchenko , Noemi Reguart , Alex Martinez-Marti , Baerin Houghton , Jean-Baptiste Paoli , Sufia Safina , Keunchil Park , Takefumi Komiya , Amy Sanford , Vishal Boolell , Hong Liu , Ayman Samkari , Steven M. Keller , Martin Reck

Organizations

Department of Radiation Oncology, Rutgers Cancer Institute of New Jersey, Robert Wood Johnson Medical School, Rutgers University, New Brunswick, NJ, Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju, South Korea, Department of Infectious Diseases and Respiratory Medicine, Charité–Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany, N.N. Blokhin Russian Cancer Research Center, Moscow, Russian Federation, The Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland, Southwestern Regional Medical Center, Inc., Cancer Treatment Centers of America, Tulsa, OK, Petrov Research Institution of Oncology, Saint-Petersburg, Russian Federation, Thoracic Oncology Unit, Hospital Clínic de Barcelona, Barcelona, Spain, Vall d’Hebron Institute of Oncology (VHIO), Hospital Universitari Vall d’Hebron, Barcelona, Spain, Mid North Coast Cancer Institute, Port Macquarie Base Hospital, Port Macquarie, NSW, Australia, Radiotherapie, Clinique Clairval, Marseille, France, Medical Oncology, Republican Dispensary of Tatarstan MoH, Kazan, Russian Federation, Division of Hematology/Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea, Hematology/Medical Oncology, Parkview Cancer Institute, Fort Wayne, IN, Sanford Health, Sioux Falls, SD, Ballarat Health Services, Ballarat, VIC, Australia, Merck & Co., Inc., Kenilworth, NJ, LungenClinic, Airway Research Center North, German Center for Lung Research, Grosshansdorf, Germany

Research Funding

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

Background: KEYNOTE-799 (NCT03631784) is an ongoing study of the anti‒PD-1 antibody pembrolizumab (pembro) plus concurrent chemoradiation therapy (cCRT) in patients (pts) with unresectable, locally advanced stage III NSCLC. Prior results from this study in a subset of pts (primary efficacy population) showed an ORR of 69.6% in cohort A (squamous and nonsquamous, n = 112) and 70.5% in cohort B (nonsquamous, n = 61), and grade ≥3 pneumonitis in 8.0% and 7.9% of pts, respectively. Here, we present results for all pts enrolled in KEYNOTE-799. Methods: This nonrandomized, multisite, open-label phase 2 trial enrolled pts aged ≥18 y with previously untreated, unresectable, pathologically confirmed, stage IIIA‒C NSCLC with measurable disease per RECIST v1.1. Pts in cohort A (squamous and nonsquamous) received 1 cycle of carboplatin AUC 6 and paclitaxel 200 mg/m2 and pembro 200 mg. After 3 wks, pts received carboplatin AUC 2 and paclitaxel 45 mg/m2 QW for 6 wks and 2 cycles of pembro 200 mg Q3W plus standard thoracic radiotherapy (TRT). Pts in cohort B (nonsquamous only) received 3 cycles of cisplatin 75 mg/m2, pemetrexed 500 mg/m2,and pembro 200 mg Q3W, and TRT in cycles 2 and 3. All pts received an additional 14 cycles of pembro 200 mg Q3W. Primary endpoints were ORR per RECIST v1.1 by blinded independent central review (BICR) and the incidence of grade ≥3 pneumonitis (per NCI CTCAE v4.0). Efficacy and safety were assessed in all pts as-treated. Results: Of 216 pts enrolled in KEYNOTE-799 (cohort A, n = 112; cohort B, n = 104), 112 in cohort A and 102 in cohort B received treatment. As of October 28, 2020, the median (range) time from first dose to database cutoff was 18.5 (13.6–23.8) mo in cohort A and 13.7 (2.9–23.5) mo in cohort B. ORR (95% CI) was 70.5% (61.2%‒78.8%) in cohort A and 70.6% (60.7%‒79.2%) in cohort B. Median DOR was not reached in either cohort (Table). ORR was similar regardless of PD-L1 status ([TPS <1% and TPS ≥1%]; Cohort A, 66.7% and 75.8%; Cohort B, 71.4% and 72.5%) and tumor histology (Cohort A, squamous, 71.2% and nonsquamous, 69.2%). Grade ≥3 pneumonitis occurred in 9 pts (8.0%) in cohort A and 7 (6.9%) in cohort B. Grade 3‒5 treatment-related AEs occurred in 72 pts (64.3%) in cohort A and 51 (50.0%) in cohort B. Conclusions: Pembro plus cCRT continues to demonstrate promising antitumor activity, regardless of PD-L1 TPS and tumor histology, and manageable safety in pts with previously untreated, locally advanced, stage III NSCLC with longer follow-up. Clinical trial information: NCT03631784


Cohort A

n = 112
Cohort B

n = 102
ORR, % (95% CI)
70.5 (61.2‒78.8)
70.6 (60.7‒79.2)
Median DOR, mo (range)
NR (1.7+ to 19.7+)
NR (1.8+ to 21.4+)
DOR ≥12 mo, %
79.7
75.6
Median PFS, mo (95% CI)
NR (16.6‒NR)
NR (NR‒NR)
12-mo PFS rate, %
67.1
71.6
Median OS, mo (95% CI)
NR (NR‒NR)
NR (21.9‒NR)
12-month OS rate, %
81.3
87.0

NR, not reached. “+” indicates no PD since the time of last disease assessment.

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Abstract Details

Meeting

2021 ASCO Annual Meeting

Session Type

Poster Discussion Session

Session Title

Lung Cancer—Non-Small Cell Local-Regional/Small Cell/Other Thoracic Cancers

Track

Lung Cancer

Sub Track

Local-Regional Non–Small Cell Lung Cancer

Clinical Trial Registration Number

NCT03631784

Citation

J Clin Oncol 39, 2021 (suppl 15; abstr 8512)

DOI

10.1200/JCO.2021.39.15_suppl.8512

Abstract #

8512

Abstract Disclosures