Advertisement


Bradley J. Monk, MD, on Cervical Cancer: Findings on Pembrolizumab Plus Chemotherapy

2023 ASCO Annual Meeting

Advertisement

Bradley J. Monk, MD, of the University of Arizona, Phoenix, and Creighton University, discusses phase III findings from the KEYNOTE-826 study of overall survival results in patients with persistent, recurrent, or metastatic cervical cancer. Study participants received first-line treatment of pembrolizumab plus chemotherapy, with or without bevacizumab, which reduced the risk of death by up to 40% in three different subsets of patients (Abstract 5500).



Transcript

Disclaimer: This video transcript has not been proofread or edited and may contain errors.
I'd like to share with you my perspective about the treatment of women with recurrent metastatic or persistent cervical cancer. This is a group of patients that we call as the first line treatment. Now, this is a very serious problem. This is the number four cause of cancer death worldwide, and in this country, it causes more than 4,000 deaths. So historically, the treatment has been doublet chemotherapy, platinum, and taxane. And then in 2014, we added bevacizumab to it with a small improvement in overall survival of only three to four months. And here we've sat, since 2014, chemotherapy with or without bevacizumab. Now, immune therapy is everywhere. It got a very limited conditional approval in the second line in 2018, but we wanted to move it to the first line with chemotherapy, with or without bevacizumab. So on behalf of the 151 sites in 19 countries, I'd like to share with you the results of Keynote 826, which randomized 617 patients one-to-one, chemotherapy with or without bevacizumab, to pembrolizumab or placebo. And that trial led to FDA approval in October 2021, but it was an interim result. It was very preliminary, and now I'd like to share with you the final result. And the final result is that when pembrolizumab is added to chemotherapy versus placebo, there was a 40% improvement in overall survival. What does that mean? That means they live a year longer. A terminal disease that now, average age of 50, live a year longer. And we might even be curing some patients. It's too early to tell. But this is a two-year treatment, six doses of chemotherapy, and then two years of total immune therapy. And then at three years, a third of the patients are now without progression and a year without treatment. There is a plateau, 30% of the patients or so. So this is a major step forward. This confirms two things. Number one, that the preliminary result is real with a year improvement overall survival. And second, that pembrolizumab is best used in the front line rather than in the second line. And these are patients who have PD-L1 high expressing tumors according to the 22C3 antibody CPS greater than equal to one, which is 89% of the patients. So this is an opportunity for almost all patients with first line cervical cancer to add pembrolizumab to chemotherapy with or without bevacizumab at the discretion of their provider.

Related Videos

Lymphoma
Immunotherapy

Tycel J. Phillips, MD, and Swetha Kambhampati, MD, on Mantle Cell Lymphoma: Real-World Outcomes With Brexucabtagene Autoleucel

Tycel J. Phillips, MD, and Swetha Kambhampati, MD, both of City of Hope National Medical Center, discuss new findings showing that the real-world effectiveness and safety of brexucabtagene autoleucel were similar to data from the pivotal ZUMA-2 trial in patients with relapsed or refractory mantle cell lymphoma, regardless of prior BTK inhibition, bendamustine, or autologous stem cell transplantation (Abstract 7507).

Skin Cancer
Immunotherapy

Georgina V. Long, MD, PhD, on Resected Melanoma: Biomarkers for and Efficacy of Adjuvant Nivolumab vs Placebo

Georgina V. Long, MD, PhD, of Melanoma Institute Australia and The University of Sydney, discusses new data showing that patients with resected stage IIB/C melanoma who were treated with adjuvant nivolumab had prolonged recurrence-free survival compared with placebo across all biomarker subgroups. The baseline biomarkers most predictive of prolonged recurrence-free survival with nivolumab were high interferon gamma score, high tumor mutational burden, CD8 T-cell infiltration, and low C-reactive protein (Abstract 9504).

Lymphoma

Nirav N. Shah, MD, on DLBCL: New Data on Split-Dose R-CHOP for Older Patients

Nirav N. Shah, MD, of the Medical College of Wisconsin, discusses phase II results showing that split-dose R-CHOP offers older patients with diffuse large B-cell lymphoma (DLBCL) an equivalent dose intensity as R-CHOP-21 through a fractionated dosing schedule, improving tolerability. At the end of treatment for these older patients, a complete response rate of 71% was comparable to outcomes with R-CHOP in younger patients with the disease (Abstract 7554).

Lung Cancer
Immunotherapy

Narjust Florez, MD, and Heather A. Wakelee, MD, on Early-Stage NSCLC: Phase III Findings From KEYNOTE-671 on Pembrolizumab and Platinum-Based Chemotherapy

Narjust Florez, MD, of Dana-Farber Cancer Institute, and Heather A. Wakelee, MD, of Stanford University, Stanford Cancer Institute, discuss new data supporting neoadjuvant pembrolizumab plus chemotherapy followed by surgery and adjuvant pembrolizumab as a promising new treatment option for patients with resectable stage II, IIIA, or IIIB (N2) non–small cell lung cancer (NSCLC) (Abstract LBA100).

Leukemia

Sarah K. Tasian, MD, on Hematologic Malignancies in Children: Expert Commentary

Sarah K. Tasian, MD, of Children’s Hospital of Philadelphia, summarizes three studies presented at ASCO: genomic determinants of outcome in acute lymphoblastic leukemia (ALL), a phase III trial of inotuzumab ozogamicin for high-risk B-cell ALL, and preliminary results from the first-in-child phase II trial of bosutinib in pediatric patients with newly diagnosed chronic myeloid leukemia (Abstracts 10015, 10016, and 10017).

Advertisement

Advertisement




Advertisement