- In the KEYNOTE-028 trial, pembrolizumab, an anti-programmed death 1 receptor drug, provided meaningful antitumour activity in carcinoid and pancreatic neuroendocrine tumours.
Why this matters
- Programmed death-ligand 1 expression is associated with a more aggressive disease.
- Pembrolizumab provided an objective response rate of 12% in patients with carcinoid tumours and 6% in patients with pancreatic neuroendocrine tumour.
- The response was durable (more than 6 months) and median time to response was lower than 2 months in both cohorts.
- 276 patients with carcinoid tumours or well or moderately differentiated pancreatic neuroendocrine tumours and with previous failure of standard therapy were enrolled.
- 36% were positive for programmed death-ligand 1.
- Patients were treated with pembrolizumab for up to 2 years.
- Treatment was interrupted in case of confirmed progression, intolerable toxicity or consent withdrawal.
- The primary endpoint was objective response rate after the RECIST1.1 questionnaire (Response Evaluation Criteria In Solid Tumors).
- Funding: Royal Marsden NHS Foundation Trust and Institute of Cancer Research, London; Italian Ministry of Research, Italian Association for Cancer Research.
- 3 patients with carcinoid tumour (12%) had a partial response, 15 (60%) were stable (32% for more than 6 months), and 7 (28%) had progressive disease.
- 14 (88%) patients with pancreatic neuroendocrine tumours had stable disease (31% for more than 6 months), 1 (6%) showed a partial response, and 1 (6%) had progressive disease.
- The only pancreatic neuroendocrine tumours responder has an ongoing response of 17.6 months.