Safety and antitumor activity of the anti–PD-1 antibody pembrolizumab in patients with advanced, PD-L1–positive papillary or follicular thyroid cancer
Abstract Background Treatment options for advanced thyroid cancer refractory to standard therapies are limited. The safety and efficacy of pembrolizumab were evaluated in patients with advanced differentiated thyroid cancer expressing programmed death ligand 1 (PD-L1). Methods Patients with advanced...
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doaj-ef601229f665405fbfaf2b01ef5460632020-11-25T02:29:25ZengBMCBMC Cancer1471-24072019-03-011911910.1186/s12885-019-5380-3Safety and antitumor activity of the anti–PD-1 antibody pembrolizumab in patients with advanced, PD-L1–positive papillary or follicular thyroid cancerJanice M. Mehnert0Andrea Varga1Marcia S. Brose2Rahul R. Aggarwal3Chia-Chi Lin4Amy Prawira5Filippo de Braud6Kenji Tamura7Toshihiko Doi8Sarina A. Piha-Paul9Jill Gilbert10Sanatan Saraf11Pradeep Thanigaimani12Jonathan D. Cheng13Bhumsuk Keam14Rutgers Cancer Institute of New JerseyInstitut Gustave RoussyDepartment of Otorhinolaryngology, Head and Neck Surgery and the Abramson Cancer Center at the University of PennsylvaniaUniversity of California, San Francisco Cancer CenterDepartment of Oncology, National Taiwan University HospitalDivision of Medical Oncology and Hematology, Princess Margaret Cancer CentreDepartment of Oncology, University of Milan and Fondazione IRCCS Istituto Nazionale Tumori MilanoDepartment of Breast and Medical Oncology, National Cancer Center Hospital TokyoDepartment of Gastrointestinal Oncology, National Cancer Center Hospital EastDepartment of Investigational Cancer Therapeutics, The University of Texas MD Anderson Cancer CenterHematology/Oncology, Vanderbilt University School of MedicineMerck & Co., Inc.Merck & Co., Inc.Merck & Co., Inc.Department of Internal Medicine, Seoul National University HospitalAbstract Background Treatment options for advanced thyroid cancer refractory to standard therapies are limited. The safety and efficacy of pembrolizumab were evaluated in patients with advanced differentiated thyroid cancer expressing programmed death ligand 1 (PD-L1). Methods Patients with advanced thyroid cancer were enrolled in the nonrandomized, phase Ib KEYNOTE-028 trial conducted to evaluate safety and antitumor activity of the anti–programmed death 1 (PD-1) antibody pembrolizumab in advanced solid tumors. Key eligibility criteria were advanced papillary or follicular thyroid cancer, failure of standard therapy, and PD-L1 expression in tumor or stroma cells (assessed by immunohistochemistry). Pembrolizumab 10 mg/kg was administered every 2 weeks up to 24 months or until confirmed progression or intolerable toxicity. The primary endpoint was objective response rate (ORR) per Response Evaluation Criteria in Solid Tumors, version 1.1. Results Twenty-two patients were enrolled: median age was 61 years; 59% were women; and 68% had papillary carcinoma. Median follow-up was 31 months (range, 7–34 months). Treatment-related adverse events were observed in 18 (82%) patients; those occurring in ≥15% of patients were diarrhea (n = 7) and fatigue (n = 4). One grade ≥ 3 treatment-related adverse event occurred (colitis, grade 3); no treatment-related discontinuations or deaths occurred. Two patients had confirmed partial response, for an ORR of 9% (95% confidence interval [CI], 1–29%); response duration was 8 and 20 months. Median progression-free survival was 7 months (95% CI, 2–14 months); median overall survival was not reached (95% CI, 22 months to not reached). Conclusions Results of this phase Ib proof-of-concept study suggest that pembrolizumab has a manageable safety profile and demonstrate evidence of antitumor activity in advanced differentiated thyroid cancer in a minority of patients treated. Further analyses are necessary to confirm these findings. Trial registration Clinicaltrials.gov identifier: NCT02054806. Registered 4 February 2014.http://link.springer.com/article/10.1186/s12885-019-5380-3Thyroid cancerImmunotherapyPembrolizumabAnti–PD-1PD-1PD-L1 |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Janice M. Mehnert Andrea Varga Marcia S. Brose Rahul R. Aggarwal Chia-Chi Lin Amy Prawira Filippo de Braud Kenji Tamura Toshihiko Doi Sarina A. Piha-Paul Jill Gilbert Sanatan Saraf Pradeep Thanigaimani Jonathan D. Cheng Bhumsuk Keam |
spellingShingle |
Janice M. Mehnert Andrea Varga Marcia S. Brose Rahul R. Aggarwal Chia-Chi Lin Amy Prawira Filippo de Braud Kenji Tamura Toshihiko Doi Sarina A. Piha-Paul Jill Gilbert Sanatan Saraf Pradeep Thanigaimani Jonathan D. Cheng Bhumsuk Keam Safety and antitumor activity of the anti–PD-1 antibody pembrolizumab in patients with advanced, PD-L1–positive papillary or follicular thyroid cancer BMC Cancer Thyroid cancer Immunotherapy Pembrolizumab Anti–PD-1 PD-1 PD-L1 |
author_facet |
Janice M. Mehnert Andrea Varga Marcia S. Brose Rahul R. Aggarwal Chia-Chi Lin Amy Prawira Filippo de Braud Kenji Tamura Toshihiko Doi Sarina A. Piha-Paul Jill Gilbert Sanatan Saraf Pradeep Thanigaimani Jonathan D. Cheng Bhumsuk Keam |
author_sort |
Janice M. Mehnert |
title |
Safety and antitumor activity of the anti–PD-1 antibody pembrolizumab in patients with advanced, PD-L1–positive papillary or follicular thyroid cancer |
title_short |
Safety and antitumor activity of the anti–PD-1 antibody pembrolizumab in patients with advanced, PD-L1–positive papillary or follicular thyroid cancer |
title_full |
Safety and antitumor activity of the anti–PD-1 antibody pembrolizumab in patients with advanced, PD-L1–positive papillary or follicular thyroid cancer |
title_fullStr |
Safety and antitumor activity of the anti–PD-1 antibody pembrolizumab in patients with advanced, PD-L1–positive papillary or follicular thyroid cancer |
title_full_unstemmed |
Safety and antitumor activity of the anti–PD-1 antibody pembrolizumab in patients with advanced, PD-L1–positive papillary or follicular thyroid cancer |
title_sort |
safety and antitumor activity of the anti–pd-1 antibody pembrolizumab in patients with advanced, pd-l1–positive papillary or follicular thyroid cancer |
publisher |
BMC |
series |
BMC Cancer |
issn |
1471-2407 |
publishDate |
2019-03-01 |
description |
Abstract Background Treatment options for advanced thyroid cancer refractory to standard therapies are limited. The safety and efficacy of pembrolizumab were evaluated in patients with advanced differentiated thyroid cancer expressing programmed death ligand 1 (PD-L1). Methods Patients with advanced thyroid cancer were enrolled in the nonrandomized, phase Ib KEYNOTE-028 trial conducted to evaluate safety and antitumor activity of the anti–programmed death 1 (PD-1) antibody pembrolizumab in advanced solid tumors. Key eligibility criteria were advanced papillary or follicular thyroid cancer, failure of standard therapy, and PD-L1 expression in tumor or stroma cells (assessed by immunohistochemistry). Pembrolizumab 10 mg/kg was administered every 2 weeks up to 24 months or until confirmed progression or intolerable toxicity. The primary endpoint was objective response rate (ORR) per Response Evaluation Criteria in Solid Tumors, version 1.1. Results Twenty-two patients were enrolled: median age was 61 years; 59% were women; and 68% had papillary carcinoma. Median follow-up was 31 months (range, 7–34 months). Treatment-related adverse events were observed in 18 (82%) patients; those occurring in ≥15% of patients were diarrhea (n = 7) and fatigue (n = 4). One grade ≥ 3 treatment-related adverse event occurred (colitis, grade 3); no treatment-related discontinuations or deaths occurred. Two patients had confirmed partial response, for an ORR of 9% (95% confidence interval [CI], 1–29%); response duration was 8 and 20 months. Median progression-free survival was 7 months (95% CI, 2–14 months); median overall survival was not reached (95% CI, 22 months to not reached). Conclusions Results of this phase Ib proof-of-concept study suggest that pembrolizumab has a manageable safety profile and demonstrate evidence of antitumor activity in advanced differentiated thyroid cancer in a minority of patients treated. Further analyses are necessary to confirm these findings. Trial registration Clinicaltrials.gov identifier: NCT02054806. Registered 4 February 2014. |
topic |
Thyroid cancer Immunotherapy Pembrolizumab Anti–PD-1 PD-1 PD-L1 |
url |
http://link.springer.com/article/10.1186/s12885-019-5380-3 |
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