Primary mediastinal large B-cell lymphoma: pembrolizumab delivers high, durable response

  • Armand P & al.
  • J Clin Oncol
  • 14 Oct 2019

  • curated by David Reilly
  • Univadis Clinical Summaries
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Takeaway

  • Pembrolizumab delivered high and durable response in patients with relapsed/refractory (R/R) primary mediastinal large B-cell lymphoma (PMBCL).

Why this matters

  • R/R PMBCL is associated with poor prognosis, particularly in those ineligible for, or who relapse after, second-line autologous stem cell transplantation.

Study design

  • Outcomes with pembrolizumab for 53 patients with R/R PMBCL from the phase 2 KEYNOTE-170 study and extended follow-up of 21 patients with R/R PMBCL from the phase 1b KEYNOTE-013 study.
  • Funding: MSD; Harold and Virginia Lash Foundation; Leukemia and Lymphoma Society; Center for Immumo-Oncology of the Dana-Farber Cancer Institute.

Key results

  • Objective response rate (ORR):
    • KEYNOTE-013: 48% (95% CI, 26%-70%); 33% complete response (CR).
    • KEYNOTE-170: 45% (95% CI, 32%-60%); 13% CR.
  • Median duration of response (DOR) was not reached in KEYNOTE-013 (range, 1.9+ to 39.8+ months) or in KEYNOTE-170 (range, 1.1+ to 22.0+ months).
  • 78% and 76% of patients had response durations of ≥12 months in KEYNOTE-013 and KEYNOTE-170, respectively.
  • Estimated PFS at 12 months:
    • KEYNOTE-013: 47%.
    • KEYNOTE-170: 38%.
  • Incidence of grade 3-4 adverse events:
    • KEYNOTE-013: 24%.
    • KEYNOTE-170: 23%.

Limitations

  • Responses were assessed using post hoc analysis for KEYNOTE-013.