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Pembrolizumab After Two or More Lines of Previous Therapy in Patients With Recurrent or Metastatic SCLC: Results From the KEYNOTE-028 and KEYNOTE-158 Studies

Cited 53 time in Web of Science Cited 61 time in Scopus
Authors
Chung, Hyun Cheol; Piha-Paul, Sarina A.; Lopez-Martin, Jose; Schellens, Jan H. M.; Kao, Steven; Miller, Wilson H., Jr.; Delord, Jean-Pierre; Gao, Bo; Planchard, David; Gottfried, Maya; Zer, Alona; Jalal, Shadia I.; Penel, Nicolas; Mehnert, Janice M.; Matos, Ignacio; Bennouna, Jaafar; Kim, Dong-Wan; Xu, Lei; Krishnan, Suba; Norwood, Kevin; Ott, Patrick A.
Issue Date
2020-04
Citation
Journal of Thoracic Oncology, Vol.15 No.4, pp.618-627
Keywords
Third-line therapyPembrolizumabSCLCImmunotherapy
Abstract
Introduction: Pembrolizumab has shown clinical benefit in patients with previously treated recurrent or metastatic SCLC in the phase 1b multicohort study KEYNOTE-028 (NCT02054806) and the phase 2 multicohort study KEYNOTE-158 (NCT02628067). We present a pooled analysis of patients from KEYNOTE-028 and KEYNOTE-158 who had received two or more lines of previous therapy for SCLC. Methods: Eligible patients were aged 18 years and above, had histologically or cytologically confirmed incurable recurrent or metastatic SCLC, had an Eastern Cooperative Oncology Group performance status of 1 and below, and had received two or more lines of previous therapy. Patients in KEYNOTE-028 were required to have a programmed death ligand 1 ( PD-L1)-positive tumor. Patients received pembrolizumab (10 mg/kg every 2 weeks in KEYNOTE-028 or 200 mg every 3 weeks in KEYNOTE-158) for up to 2 years. The primary end point was objective response rate per Response Evaluation Criteria in Solid Tumors version 1.1, which is presented here per independent review. Results: Eighty-three patients who had received two or more lines of previous therapy (KEYNOTE-028, n = 19; KEYNOTE-158, n = 64) were included. Median follow-up duration was 7.7 (range, 0.5-48.7) months. Objective response rate was 19.3% (95% confidence interval: 11.4-29.4); two patients had complete response (one with a PD-L1-positive tumor), and 14 patients had partial response (13 with PD-L1-positive tumors). The median duration of response was not reached (range, 4.1-35.8+ mo; plus sign indicates ongoing response); 61% of responders had responses lasting 18 months or longer. Fifty-one patients (61.4%) experienced any-grade treatment-related adverse events; eight patients (9.6%) had grade 3 or higher events. Conclusions: Pembrolizumab exhibited durable antitumor activity in a subset of patients with recurrent or metastatic SCLC who had undergone two or more previous lines of therapy, regardless of PD-L1 expression. Pembrolizumab was well tolerated. (C) 2019 Published by Elsevier Inc. on behalf of International Association for the Study of Lung Cancer.
ISSN
1556-0864
URI
https://hdl.handle.net/10371/171823
DOI
https://doi.org/10.1016/j.jtho.2019.12.109
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College of Medicine/School of Medicine (의과대학/대학원)Internal Medicine (내과학전공)Journal Papers (저널논문_내과학전공)
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