Pembrolizumab in Asia-Pacific patients with advanced head and neck squamous cell carcinoma: Analyses from KEYNOTE-012

Makoto Tahara, Kei Muro, Yasuhisa Hasegawa, Hyun Cheol Chung, Chia-Chi Lin, Bhumsuk Keam, Kenichi Takahashi, Jonathan D Cheng, Yung-Jue Bang, Makoto Tahara, Kei Muro, Yasuhisa Hasegawa, Hyun Cheol Chung, Chia-Chi Lin, Bhumsuk Keam, Kenichi Takahashi, Jonathan D Cheng, Yung-Jue Bang

Abstract

KEYNOTE-012 was a phase Ib, multicohort study designed to investigate efficacy and safety of pembrolizumab in advanced solid tumors. Results from the subset of patients with recurrent/metastatic head and neck squamous cell carcinoma (HNSCC) from the Asia-Pacific region are reported. Patients with recurrent/metastatic HNSCC, measurable disease (RECIST version 1.1), and ECOG performance status (PS) 0-1 were eligible for enrollment in the HNSCC expansion cohort. Patients received pembrolizumab 200 mg every 3 weeks. Response was assessed every 8 weeks. Co-primary end-points were safety and overall response rate (RECIST version 1.1, central review). Secondary end-points included overall survival and response duration. Patients enrolled at any of the five centers throughout the Asia-Pacific region were included in these analyses. Twenty-six patients with HNSCC from the Asia-Pacific region received pembrolizumab. The median age was 62 years, 65% of patients had ECOG PS 1, and 62% had received two or more prior therapies for recurrent/metastatic disease. Sixteen (62%) patients experienced a treatment-related adverse event of any grade, including two (8%) patients who experienced one or more events of grade 3 severity. No treatment-related deaths occurred. The overall response rate was 19% (95% confidence interval, 7%-39%). After a median follow-up of 12 months (range, 2-21 months), a median response duration was not reached (range, 6 to 17+ months); four of five responses lasted ≥6 months. Median overall survival was 11.6 months (95% confidence interval, 4.7-17.7 months). Pembrolizumab was well tolerated and had durable antitumor activity in patients with HNSCC from the Asia-Pacific region. (Trial registration no. NCT01848834.).

Keywords: Asia-Pacific; PD-1; PD-L1; Pembrolizumab; head and neck squamous cell carcinoma.

© 2017 The Authors. Cancer Science published by John Wiley & Sons Australia, Ltd on behalf of Japanese Cancer Association.

Figures

Figure 1
Figure 1
Efficacy of pembrolizumab, based on RECIST version 1.1 by central imaging vendor review. Data shown are the maximum percentage change from baseline in target lesions (n = 25) (A), change from baseline in tumor size over time (n = 25) (B), treatment exposure and response duration (n = 25) (C), and Kaplan–Meier estimate of overall survival (n = 26) (D). PD, progressive disease; PR, partial response

References

    1. Ferlay J, Soerjomataram I, Dikshit R, et al. Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012. Int J Cancer. 2015;136:E359‐E386.
    1. Gupta B, Johnson NW, Kumar N. Global epidemiology of head and neck cancers: a continuing challenge. Oncology. 2016;91:13‐23.
    1. Mahdavifar N, Ghoncheh M, Mohammadian‐Hafshejani A, Khosravi B, Salehiniya H. Epidemiology and inequality in the incidence and mortality of nasopharynx cancer in Asia. Osong Public Health Res Perspect. 2016;7:360‐372.
    1. Pelucchi C, Gallus S, Garavello W, Bosetti C, La VC. Cancer risk associated with alcohol and tobacco use: focus on upper aero‐digestive tract and liver. Alcohol Res Health. 2006;29:193‐198.
    1. Denaro N, Russi EG, Adamo V, Merlano MC. State‐of‐the‐art and emerging treatment options in the management of head and neck cancer: news from 2013. Oncology. 2014;86:212‐229.
    1. Liao CT, Chang JT, Wang HM, et al. Analysis of risk factors of predictive local tumor control in oral cavity cancer. Ann Surg Oncol. 2008;15:915‐922.
    1. Fang CY, Huang SY, Wu CC, et al. The synergistic effect of chemical carcinogens enhances Epstein‐Barr virus reactivation and tumor progression of nasopharyngeal carcinoma cells. PLoS ONE. 2012;7:e44810.
    1. World Health Organization . Relevance of N‐Nitroso compounds to human cancer: Exposers and mechanisms. Proceedings of the IXth International Symposium on N‐Nitroso Compounds; September 1‐5, 1986; Baden, Austria; 1987.
    1. D'Cruz A, Lin T, Anand AK, et al. Consensus recommendations for management of head and neck cancer in Asian countries: a review of international guidelines. Oral Oncol. 2013;49:872‐877.
    1. Vermorken JB, Mesia R, Rivera F, et al. Platinum‐based chemotherapy plus cetuximab in head and neck cancer. N Engl J Med. 2008;359:1116‐1127.
    1. Patel AN, Mehnert JM, Kim S. Treatment of recurrent metastatic head and neck cancer: focus on cetuximab. Clin Med Insights Ear Nose Throat. 2012;5:1‐16.
    1. Seiwert TY, Burtness B, Mehra R, et al. Safety and clinical activity of pembrolizumab for treatment of recurrent or metastatic squamous cell carcinoma of the head and neck (KEYNOTE‐012): an open‐label, multicentre, phase 1b trial. Lancet Oncol. 2016;17:956‐965.
    1. Chow LQ, Haddad R, Gupta S, et al. Antitumor activity of pembrolizumab in biomarker‐unselected patients with recurrent and/or metastatic head and neck squamous cell carcinoma: results from the phase Ib KEYNOTE‐012 expansion cohort. J Clin Oncol. 2016;34:3838‐3845.
    1. Ferris RL, Blumenschein G Jr, Fayette J, et al. Nivolumab for recurrent squamous‐cell carcinoma of the head and neck. N Engl J Med. 2016;375:1856‐1867.
    1. Bauml J, Seiwert TY, Pfister DG, et al. Pembrolizumab for platinum‐ and cetuximab‐refractory head and neck cancer: results from a single‐arm, phase II study. J Clin Oncol. 2017;35:1542‐1549.
    1. Merck & Co., Inc . Keytruda [package insert]. Whitehouse Station, NJ: Merck & Co., Inc.; 2017.
    1. Plimack ER, Bellmunt J, Gupta S, et al. Safety and activity of pembrolizumab in patients with locally advanced or metastatic urothelial cancer (KEYNOTE‐012): a non‐randomised, open‐label, phase 1b study. Lancet Oncol. 2017;18:212‐220.
    1. Muro K, Chung HC, Shankaran V, et al. Pembrolizumab for patients with PD‐L1‐positive advanced gastric cancer (KEYNOTE‐012): a multicentre, open‐label, phase 1b trial. Lancet. 2016;17:717‐726.
    1. Garon EB, Rizvi NA, Hui R, et al. Pembrolizumab for the treatment of non‐small‐cell lung cancer. N Engl J Med. 2015;372:2018‐2028.
    1. Hamid O, Robert C, Daud A, et al. Safety and tumor responses with lambrolizumab (anti‐PD‐1) in melanoma. N Engl J Med. 2013;369:134‐144.
    1. Robert C, Ribas A, Wolchok JD, et al. Anti‐programmed‐death‐receptor‐1 treatment with pembrolizumab in ipilimumab‐refractory advanced melanoma: a randomised dose‐comparison cohort of a phase 1 trial. Lancet. 2014;384:1109‐1117.
    1. Nanda R, Chow LQ, Dees EC, et al. Pembrolizumab in patients with advanced triple‐negative breast cancer: phase Ib KEYNOTE‐012 study. J Clin Oncol. 2016;34:2460‐2467.
    1. Urba S, Hong RL, Hossain AM, Cheng R, Orlando M. Pemetrexed in combination with cisplatin versus cisplatin monotherapy in East Asian patients with recurrent or metastatic head and neck cancer: results of an exploratory subgroup analysis of a phase III trial. Asia Pacific J Clin Oncol. 2013;9:331‐341.
    1. Guo Y, Shi M, Yang A, et al. Platinum‐based chemotherapy plus cetuximab first‐line for Asian patients with recurrent and/or metastatic squamous cell carcinoma of the head and neck: Results of an open‐label, single‐arm, multicenter trial. Head Neck. 2015;37:1081‐1087.

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