1. Pembrolizumab in Relapsed or Refractory Primary Mediastinal Large B-Cell Lymphoma
- Author
-
Jasmine Zain, Robert Orlowski, Philippe Armand, Guilherme Fleury Perini, Arun Balakumaran, Jakub Svoboda, Jing Ouyang, Pier Luigi Zinzani, Pei-Hsuan Chen, Vincent Ribrag, Catherine Thieblemont, Vladimir Melnichenko, Gayane Tumyan, Azra H. Ligon, Gilles Salles, Margaret A. Shipp, Maria D Caballero, Muhit Ozcan, Beth Christian, Zafer Gulbas, Donna Neuberg, Jan Walewski, Robert A. Redd, Arkendu Chatterjee, Sanjay R. Patel, Sergio Portino, Scott J. Rodig, Kamal Bouabdallah, Laura Fogliatto, Armand, Philippe, Rodig, Scott, Melnichenko, Vladimir, Thieblemont, Catherine, Bouabdallah, Kamal, Tumyan, Gayane, Özcan, Muhit, Portino, Sergio, Fogliatto, Laura, Caballero, Maria D, Walewski, Jan, Gulbas, Zafer, Ribrag, Vincent, Christian, Beth, Perini, Guilherme Fleury, Salles, Gille, Svoboda, Jakub, Zain, Jasmine, Patel, Sanjay, Chen, Pei-Hsuan, Ligon, Azra H, Ouyang, Jing, Neuberg, Donna, Redd, Robert, Chatterjee, Arkendu, Balakumaran, Arun, Orlowski, Robert, Shipp, Margaret, and Zinzani, Pier Luigi
- Subjects
Adult ,Male ,Oncology ,Cancer Research ,medicine.medical_specialty ,Poor prognosis ,Lymphoma, B-Cell ,Time Factors ,Pembrolizumab ,Antibodies, Monoclonal, Humanized ,Mediastinal Neoplasms ,Risk Assessment ,Unmet needs ,Young Adult ,Antineoplastic Agents, Immunological ,Refractory ,Risk Factors ,Internal medicine ,Hematologic Malignancy ,medicine ,Humans ,Primary Mediastinal Large B-Cell Lymphoma ,Progression-free survival ,Pembrolizumab, Relapsed, Refractory Primary Mediastinal Large B-Cell Lymphoma ,business.industry ,ORIGINAL REPORTS ,Middle Aged ,South America ,medicine.disease ,Progression-Free Survival ,United States ,Lymphoma ,Europe ,Editorial Commentary ,Drug Resistance, Neoplasm ,Monoclonal ,Disease Progression ,Female ,Neoplasm Recurrence, Local ,business - Abstract
PURPOSE Patients with relapsed or refractory primary mediastinal large B-cell lymphoma (rrPMBCL) have a poor prognosis, and their treatment represents an urgent and unmet need. Because PMBCL is associated with genetic aberrations at 9p24 and overexpression of programmed cell death-1 (PD-1) ligands (PD-L1), it is hypothesized to be susceptible to PD-1 blockade. METHODS In the phase IB KEYNOTE-013 (ClinicalTrials.gov identifier: NCT01953692 ) and phase II KEYNOTE-170 (ClinicalTrials.gov identifier: NCT02576990 ) studies, adults with rrPMBCL received pembrolizumab for up to 2 years or until disease progression or unacceptable toxicity. The primary end points were safety and objective response rate in KEYNOTE-013 and objective response rate in KEYNOTE-170. Secondary end points included duration of response, progression-free survival, overall survival, and safety. Exploratory end points included association between biomarkers and pembrolizumab activity. RESULTS The objective response rate was 48% (7 complete responses; 33%) among 21 patients in KEYNOTE-013 and 45% (7 complete responses; 13%) among 53 patients in KEYNOTE-170. After a median follow-up time of 29.1 months in KEYNOTE-013 and 12.5 months in KEYNOTE-170, the median duration of response was not reached in either study. No patient with complete response experienced progression, including 2 patients with complete response for at least 1 year off therapy. Treatment-related adverse events occurred in 24% of patients in KEYNOTE-013 and 23% of patients in KEYNOTE-170. There were no treatment-related deaths. Among 42 evaluable patients, the magnitude of the 9p24 gene abnormality was associated with PD-L1 expression, which was itself significantly associated with progression-free survival. CONCLUSION Pembrolizumab is associated with high response rate, durable activity, and a manageable safety profile in patients with rrPMBCL.
- Published
- 2019