Pembrolizumab with or without chemotherapy in recurrent or metastatic head and neck squamous cell carcinoma: Opdated results of the phase III keynote-048 study

Harrington, Kevin J. and Burtness, Barbara and Greil, Richard and Soulieres, Denis and Tahara, Makoto and de Castro Jr, Gilberto and Psyrri, Amanda and Brana, Irene and Baste, Neus and Neupane, Prakash and Bratland, Ase and Fuereder, Thorsten and Hughes, Brett G. M. and Mesia, Ricard and Ngamphaiboon, Nuttapong and Rordorf, Tamara and Wan Ishak, Wan Zamaniah and Lin, Jianxin and Gumuscu, Burak and Swaby, Ramona F. and Rischin, Danny (2023) Pembrolizumab with or without chemotherapy in recurrent or metastatic head and neck squamous cell carcinoma: Opdated results of the phase III keynote-048 study. Journal of Clinical Oncology, 41 (4). 790+. ISSN 0732183X, DOI https://doi.org/10.1200/JCO.21.02508.

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Abstract

PURPOSEPembrolizumab and pembrolizumab-chemotherapy demonstrated efficacy in recurrent/metastatic head and neck squamous cell carcinoma in KEYNOTE-048. Post hoc analysis of long-term efficacy and progression-free survival on next-line therapy (PFS2) is presented.METHODSPatients were randomly assigned (1:1:1) to pembrolizumab, pembrolizumab-chemotherapy, or cetuximab-chemotherapy. Efficacy was evaluated in programmed death ligand 1 (PD-L1) combined positive score (CPS) >= 20, CPS >= 1, and total populations, with no multiplicity or alpha adjustment.RESULTSThe median study follow-up was 45.0 months (interquartile range, 41.0-49.2; n = 882). At data cutoff (February 18, 2020), overall survival improved with pembrolizumab in the PD-L1 CPS >= 20 (hazard ratio HR], 0.61; 95% CI, 0.46 to 0.81) and CPS >= 1 populations (HR, 0.74; 95% CI, 0.61 to 0.89) and was noninferior in the total population (HR, 0.81; 95% CI, 0.68 to 0.97). Overall survival improved with pembrolizumab-chemotherapy in the PD-L1 CPS >= 20 (HR, 0.62; 95% CI, 0.46 to 0.84), CPS >= 1 (HR, 0.64; 95% CI, 0.53 to 0.78), and total (HR, 0.71; 95% CI, 0.59 to 0.85) populations. The objective response rate on second-course pembrolizumab was 27.3% (3 of 11). PFS2 improved with pembrolizumab in the PD-L1 CPS >= 20 (HR, 0.64; 95% CI, 0.48 to 0.84) and CPS >= 1 (HR, 0.79; 95% CI, 0.66 to 0.95) populations and with pembrolizumab-chemotherapy in the PD-L1 CPS >= 20 (HR, 0.64; 95% CI, 0.48 to 0.86), CPS >= 1 (HR, 0.66; 95% CI, 0.55 to 0.81), and total (HR, 0.73; 95% CI, 0.61 to 0.88) populations. PFS2 was similar after pembrolizumab and longer after pembrolizumab-chemotherapy on next-line taxanes and shorter after pembrolizumab and similar after pembrolizumab-chemotherapy on next-line nontaxanes.CONCLUSIONWith a 4-year follow-up, first-line pembrolizumab and pembrolizumab-chemotherapy continued to demonstrate survival benefit versus cetuximab-chemotherapy in recurrent/metastatic head and neck squamous cell carcinoma. Patients responded well to subsequent treatment after pembrolizumab-based therapy.

Item Type: Article
Funders: Merck Sharp and Dohme
Uncontrolled Keywords: Antineoplastic Combined Chemotherapy Protocols; B7-H1 Antigen; Cetuximab; Head and Neck Neoplasms; Humans; Neoplasm Recurrence, Local; Squamous Cell Carcinoma of Head and Neck
Subjects: R Medicine > R Medicine (General)
R Medicine > RC Internal medicine > RC0254 Neoplasms. Tumors. Oncology (including Cancer)
Divisions: Faculty of Medicine > Clinical Oncology Department
Depositing User: Ms Zaharah Ramly
Date Deposited: 12 Nov 2024 07:40
Last Modified: 12 Nov 2024 07:40
URI: http://eprints.um.edu.my/id/eprint/38695

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