Kei Muro1, Hyun Cheol Chung2, Veena Shankaran3, Ravit Geva4, Daniel Catenacci5, Shilpa Gupta6, Joseph Paul Eder7, Talia Golan8, Dung T Le9, Barbara Burtness10, Autumn J McRee11, Chia-Chi Lin12, Kumudu Pathiraja13, Jared Lunceford13, Kenneth Emancipator13, Jonathan Juco13, Minori Koshiji13, Yung-Jue Bang14. 1. Aichi Cancer Center Hospital, Nagoya, Japan. Electronic address: kmuro@aichi-cc.jp. 2. Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, South Korea. 3. University of Washington, Seattle, WA, USA. 4. Tel Aviv Sourasky Medical Center, Tel Aviv, Israel. 5. University of Chicago, Chicago, IL, USA. 6. University of Minnesota, Minneapolis, MN, USA. 7. Yale University, New Haven, CT, USA. 8. Sheba Medical Center, Ramat Gan, Israel. 9. Kimmel Cancer Center, Johns Hopkins University, Baltimore, MD, USA. 10. Fox Chase Cancer Center, Philadelphia, PA, USA. 11. University of North Carolina Lineberger Comprehensive Cancer Center, Chapel Hill, NC, USA. 12. National Taiwan University Hospital, Taipei, Taiwan. 13. Merck & Co, Kenilworth, NJ, USA. 14. Seoul National University College of Medicine, Seoul, South Korea.
Abstract
BACKGROUND: Expression of PD-L1 has been shown to be upregulated in some patients with gastric cancer. As part of the phase 1b KEYNOTE-012 study, we aimed to assess the safety and activity of the anti-PD-1 antibody pembrolizumab in patients with PD-L1-positive recurrent or metastatic adenocarcinoma of the stomach or gastro-oesophageal junction. METHODS: This study was a multicentre, open-label, phase 1b trial done at 13 cancer research centres in the USA, Israel, Japan, South Korea, and Taiwan. We enrolled patients with PD-L1-positive recurrent or metastatic adenocarcinoma of the stomach or gastro-oesophageal junction. Patients received intravenous pembrolizumab at 10 mg/kg once every 2 weeks for 24 months or until progression or unacceptable toxic effects occurred. Response was assessed every 8 weeks in accordance with Response Evaluation Criteria in Solid Tumors version 1.1. The primary objectives were safety in patients who received at least one dose of pembrolizumab and the proportion of patients achieving overall responses in patients who received at least one pembrolizumab dose and who either had a post-baseline scan or who discontinued therapy because of clinical disease progression or a treatment-related adverse event before the first post-baseline scan. The study is registered with ClinicalTrials.gov, number NCT01848834, and is ongoing but no longer enrolling patients. FINDINGS: From Oct 23, 2013, to May 5, 2014, 39 patients were enrolled. 36 were evaluable for response by central assessment. Eight (22%, 95% CI 10-39) patients were judged to have had an overall response at central review; all responses were partial. All 39 patients were included in the safety analyses. Five (13%) patients had a total of six grade 3 or 4 treatment-related adverse events, consisting of two cases of grade 3 fatigue, one case each of grade 3 pemphigoid, grade 3 hypothyroidism, and grade 3 peripheral sensory neuropathy, and one case of grade 4 pneumonitis. No treatment-related deaths occurred. INTERPRETATION: In this population of patients with recurrent or metastatic PD-L1-positive gastric cancer, pembrolizumab had a manageable toxicity profile and promising antitumour activity, warranting further study in phase 2 and 3 trials. FUNDING: Merck & Co.
BACKGROUND: Expression of PD-L1 has been shown to be upregulated in some patients with gastric cancer. As part of the phase 1b KEYNOTE-012 study, we aimed to assess the safety and activity of the anti-PD-1 antibody pembrolizumab in patients with PD-L1-positive recurrent or metastatic adenocarcinoma of the stomach or gastro-oesophageal junction. METHODS: This study was a multicentre, open-label, phase 1b trial done at 13 cancer research centres in the USA, Israel, Japan, South Korea, and Taiwan. We enrolled patients with PD-L1-positive recurrent or metastatic adenocarcinoma of the stomach or gastro-oesophageal junction. Patients received intravenous pembrolizumab at 10 mg/kg once every 2 weeks for 24 months or until progression or unacceptable toxic effects occurred. Response was assessed every 8 weeks in accordance with Response Evaluation Criteria in Solid Tumors version 1.1. The primary objectives were safety in patients who received at least one dose of pembrolizumab and the proportion of patients achieving overall responses in patients who received at least one pembrolizumab dose and who either had a post-baseline scan or who discontinued therapy because of clinical disease progression or a treatment-related adverse event before the first post-baseline scan. The study is registered with ClinicalTrials.gov, number NCT01848834, and is ongoing but no longer enrolling patients. FINDINGS: From Oct 23, 2013, to May 5, 2014, 39 patients were enrolled. 36 were evaluable for response by central assessment. Eight (22%, 95% CI 10-39) patients were judged to have had an overall response at central review; all responses were partial. All 39 patients were included in the safety analyses. Five (13%) patients had a total of six grade 3 or 4 treatment-related adverse events, consisting of two cases of grade 3 fatigue, one case each of grade 3 pemphigoid, grade 3 hypothyroidism, and grade 3 peripheral sensory neuropathy, and one case of grade 4 pneumonitis. No treatment-related deaths occurred. INTERPRETATION: In this population of patients with recurrent or metastatic PD-L1-positive gastric cancer, pembrolizumab had a manageable toxicity profile and promising antitumour activity, warranting further study in phase 2 and 3 trials. FUNDING: Merck & Co.
Authors: Lillian L Siu; S Percy Ivy; Erica L Dixon; Amy E Gravell; Steven A Reeves; Gary L Rosner Journal: Clin Cancer Res Date: 2017-09-01 Impact factor: 12.531
Authors: Daphne Day; Arta M Monjazeb; Elad Sharon; S Percy Ivy; Eric H Rubin; Gary L Rosner; Marcus O Butler Journal: Clin Cancer Res Date: 2017-09-01 Impact factor: 12.531
Authors: Charles S Fuchs; Toshihiko Doi; Raymond W Jang; Kei Muro; Taroh Satoh; Manuela Machado; Weijing Sun; Shadia I Jalal; Manish A Shah; Jean-Phillipe Metges; Marcelo Garrido; Talia Golan; Mario Mandala; Zev A Wainberg; Daniel V Catenacci; Atsushi Ohtsu; Kohei Shitara; Ravit Geva; Jonathan Bleeker; Andrew H Ko; Geoffrey Ku; Philip Philip; Peter C Enzinger; Yung-Jue Bang; Diane Levitan; Jiangdian Wang; Minori Rosales; Rita P Dalal; Harry H Yoon Journal: JAMA Oncol Date: 2018-05-10 Impact factor: 31.777