Merkel cell carcinoma: pembrolizumab boosts survival, tumor control

  • Nghiem P & al.
  • J Clin Oncol
  • 6 Feb 2019

  • curated by Brian Richardson, PhD
  • Univadis Clinical Summaries
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Takeaway

  • Front-line pembrolizumab was associated with 56% objective response rate (ORR) and 24-month OS of 68.7% in a multicenter, phase 2 trial of 50 patients with advanced Merkel cell carcinoma (MCC; Cancer Immunotherapy Trials Network-09/Kenote-017).

Why this matters

  • Pembrolizumab yielded better responses and longer survival than expected with conventional front-line chemotherapy.

Key results

  • The ORR to pembrolizumab was 56% (24% complete response and 32% partial response).
    • The ORR was 59% in virus-positive tumors and 53% in virus-negative tumors (P=.765).
  • 24-month PFS was 48.3%; median PFS was 16.8 months.
  • 24-month OS was 68.7%; median OS was not reached.
  • 28% of patients experienced grade 3+ treatment-related adverse events
  • 14% of patients discontinued because of treatment-related adverse events
  • 1 patient experienced treatment-related mortality.

Study design

  • 50 patients with advanced MCC with Eastern Cooperative Oncology Group performance status 0/1 and naive to systemic therapy received pembrolizumab 2 mg/kg every 3 weeks for up to 2 years.
  • Funding: National Cancer Institute; MCC Patient Gift Fund at University of Washington; Kelsey Dickson MCC Challenge Grant from the Prostate Cancer Foundation; Merck & Co., Inc., Kenilworth, NJ, USA.

Limitations

  • Small patient sample size.
  • No control population.

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