(Nasopharyngeal Cancer) Is Keytruda Effective in Platinum-Pretreated Recurrent or Metastatic Patients?

At the ESMO 2021 virtual congress (September 16–21), Anthony T.C. Chan et al. from The Chinese University of Hong Kong presented the efficacy and safety results of Keytruda (pembrolizumab) in platinum-pretreated, recurrent and metastatic nasopharyngeal carcinoma (NPC) from the KEYNOTE-122 Phase 3 trial.

Trial Design

KEYNOTE-122 randomized platinum-pretreated recurrent/metastatic NPC patients (N=233) in a 1:1 ratio to:

• Keytruda group (N=117)
• Chemotherapy group (N=116)

Primary endpoint: Overall survival (OS). Secondary endpoints: PFS, ORR, duration of response.

Efficacy Results

Overall survival (primary endpoint):

• All patients: Keytruda 17.2 months / Chemotherapy 15.3 months — no significant improvement
• PD-L1-positive patients: Keytruda 17.2 months / Chemotherapy 18.0 months
• 24-month survival rate: Keytruda 40.2% / Chemotherapy 32.2%

Secondary endpoints:

• Median PFS: Keytruda 4.1 months / Chemotherapy 5.5 months — no significant difference
• ORR (all patients): Keytruda 1.4% / Chemotherapy 23.3%
• ORR (PD-L1-positive patients): Keytruda 23.0% / Chemotherapy 26.0%
• Median duration of response: Keytruda 12.0 months / Chemotherapy 13.1 months

Safety Profile

• Overall adverse event rate: Keytruda 61.2% / Chemotherapy 87.5%
• Grade 3–5 adverse events: Keytruda 10.3% / Chemotherapy 43.8%

Conclusions

Based on KEYNOTE-122 Phase 3 results, Anthony T.C. Chan et al. concluded that pembrolizumab did not significantly improve overall survival compared to chemotherapy in platinum-pretreated recurrent/metastatic NPC patients. However, the safety profile was more favorable than chemotherapy, with lower adverse event rates within manageable limits.

Source: https://www.esmo.org/oncology-news/pembrolizumab-does-not-prolong-overall-survival-compared-to-chemotherapy-in-platinum-pretreated-recurrent-or-metastatic-nasopharyngeal-carcinoma

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