派姆单抗在中国血统微卫星不稳定性高/错配修复缺陷晚期实体瘤患者中的应用:KEYNOTE-158最终分析

IF 3.4 3区 医学 Q2 MEDICINE, RESEARCH & EXPERIMENTAL
Xiaohua Wu, Yimin Mao, Nong Xu, Yuxian Bai, Dong Wang, Xiaojun Chen, Xianli Yin, Yanhong Deng, Jianwei Yang, Jieqing Zhang, Jie Tang, Yi Huang, Jiayi Li, Suxia Luo, Hong Zheng, Weidong Zhao, Miaomiao Xu, Nan Li, Yixiang Mao, Alexander Gozman, Jianming Xu
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引用次数: 0

摘要

KEYNOTE-158 (NCT02628067)支持美国食品和药物管理局批准pembrolizumab用于微卫星不稳定性高(MSI-H)/错配修复缺陷(dMMR)晚期实体瘤。华裔患者的MSI-H/dMMR肿瘤发病率与西方人群相似。KEYNOTE-158的队列L评估了派姆单抗在既往治疗过MSI-H/dMMR肿瘤的中国血统患者中的应用。我们之前报道了来自L队列的20例患者的客观缓解率(ORR)为70%,这支持了派姆单抗在中国被批准用于MSI-H/dMMR实体瘤患者。在此,我们报告了30例患者中位随访18个月的最终分析结果。方法:确认不可切除或转移性MSI-H/dMMR肿瘤的符合条件的患者,以及先前的一条或多条治疗线,接受200mg pembrolizumab Q3W(最多35个周期),直到进展,毒性或停药。主要终点是RECIST 1.1的ORR。次要终点是反应持续时间(DOR)、无进展生存期(PFS)、总生存期(OS)和安全性。结果:30例患者入组;年龄≥65岁7例(23%),女性20例(67%)。中位随访18个月,ORR为66.7%。中位DOR未达到(NR), 12个月DOR率为85.9%。中位PFS为NR, 18个月PFS率为63.0%。中位OS为NR, 18个月OS率为78.8%。22例(73%)患者报告了治疗相关不良事件(AE)。7例(23%)患者发生3-4级治疗相关不良事件。11例(37%)患者发生免疫介导的不良事件,其中2例(7%)为3级不良事件。未发生≥4级免疫介导的不良事件。结论:Pembrolizumab继续为中国血统的MSI-H/dMMR晚期实体瘤患者提供具有临床意义的抗肿瘤活性和持久的反应,并具有可控的安全性。这些结果与在全球人群中报道的患者一致,并进一步支持派姆单抗在中国血统的MSI-H/dMMR肿瘤患者中的使用。试验注册号:nct02628067。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Pembrolizumab in Patients of Chinese Descent with Microsatellite Instability-high/Mismatch Repair Deficient Advanced Solid Tumors: KEYNOTE-158 Final Analysis

Introduction

KEYNOTE-158 (NCT02628067) supported the US Food and Drug Administration approval of pembrolizumab for microsatellite instability-high (MSI-H)/mismatch repair deficient (dMMR) advanced solid tumors. Incidence of MSI-H/dMMR tumors in patients of Chinese descent is similar to that of Western populations. Cohort L of KEYNOTE-158 evaluated pembrolizumab in patients of Chinese descent with previously treated MSI-H/dMMR tumors. We previously reported an objective response rate (ORR) of 70% in 20 patients from cohort L which supported the approval in China of pembrolizumab in patients with MSI-H/dMMR solid tumors. Here we present results of the final analysis for 30 patients with median follow-up of 18 months.

Methods

Eligible patients who had confirmed unresectable or metastatic MSI-H/dMMR tumors, and one or more prior lines of therapy, received 200 mg pembrolizumab Q3W (up to 35 cycles) until progression, toxicity, or withdrawal. Primary endpoint was ORR per RECIST 1.1 by central review. Secondary endpoints were duration of response (DOR), progression-free survival (PFS), overall survival (OS), and safety.

Results

Thirty patients were enrolled; 7 (23%) were aged ≥ 65 years, and 20 (67%) were female. With median follow-up of 18 months, ORR was 66.7%. Median DOR was not reached (NR), with 12-month DOR rate of 85.9%. Median PFS was NR, with 18-month PFS rate of 63.0%. Median OS was NR, with 18-month OS rate of 78.8%. Treatment-related adverse events (AE) were reported in 22 (73%) patients. Grade 3–4 treatment-related AEs occurred in 7 (23%) patients. Immune-mediated AEs occurred in 11 (37%) patients of which 2 (7%) had grade 3 AEs. No grade ≥ 4 immune-mediated AEs occurred.

Conclusion

Pembrolizumab continues to provide clinically meaningful antitumor activity and durable responses with a manageable safety profile in patients of Chinese descent with MSI-H/dMMR advanced solid tumors. These results are consistent with those reported for patients in the global population and further support the use of pembrolizumab in patients of Chinese descent with MSI-H/dMMR tumors.

Trial Registration Number

NCT02628067.

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来源期刊
Advances in Therapy
Advances in Therapy 医学-药学
CiteScore
7.20
自引率
2.60%
发文量
353
审稿时长
6-12 weeks
期刊介绍: Advances in Therapy is an international, peer reviewed, rapid-publication (peer review in 2 weeks, published 3–4 weeks from acceptance) journal dedicated to the publication of high-quality clinical (all phases), observational, real-world, and health outcomes research around the discovery, development, and use of therapeutics and interventions (including devices) across all therapeutic areas. Studies relating to diagnostics and diagnosis, pharmacoeconomics, public health, epidemiology, quality of life, and patient care, management, and education are also encouraged. The journal is of interest to a broad audience of healthcare professionals and publishes original research, reviews, communications and letters. The journal is read by a global audience and receives submissions from all over the world. Advances in Therapy will consider all scientifically sound research be it positive, confirmatory or negative data. Submissions are welcomed whether they relate to an international and/or a country-specific audience, something that is crucially important when researchers are trying to target more specific patient populations. This inclusive approach allows the journal to assist in the dissemination of all scientifically and ethically sound research.
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