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

Lung Cancer

James Chih-Hsin Yang, MD, PhD, on Metastatic Nonsquamous NSCLC: Evaluating Pemetrexed and Platinum With or Without Pembrolizumab

James Chih-Hsin Yang, MD, PhD, of the National Taiwan University Hospital and National Taiwan University Cancer Center, discusses the latest data from the phase III KEYNOTE-789 study, which evaluated the efficacy and safety of pemetrexed plus platinum chemotherapy (carboplatin or cisplatin) with or without pembrolizumab in the treatment of adults with EGFR tyrosine kinase inhibitor–resistant, EGFR–mutated, metastatic nonsquamous non–small cell lung cancer (NSCLC) (Abstract LBA9000).

Lymphoma

Manali K. Kamdar, MD, on Primary Refractory and Early Relapsing DLBCL: Therapeutic Options

Manali K. Kamdar, MD, of University of Colorado Hospital, discusses the treatment landscape for the 30% to 40% of patients with diffuse large B-cell lymphoma (DLBCL) whose disease will relapse. Patients who experience relapse within 1 year of chemoimmunotherapy have poor outcomes with autotransplantation, but chimeric antigen receptor T-cell therapy has shown efficacy and manageable toxicity.

Prostate Cancer

Alberto Bossi, MD, on Prostate Cancer: PEACE-1 Trial Findings on Radiotherapy Plus Systemic Treatment

Alberto Bossi, MD, of Institut Gustave Roussy, discusses phase III findings showing that combining prostate radiotherapy with systemic treatment did not improve overall survival in men with de novo metastatic castration-sensitive prostate cancer and low metastatic burden. However, best outcomes (radiographic progression–free-survival and overall survival) were observed in men receiving the standard of care plus abiraterone acetate plus prednisone with radiotherapy (Abstract LBA5000).

Breast Cancer

Lisa A. Carey, MD, and Dennis J. Slamon, MD, PhD, on Early Breast Cancer: Findings From the NATALEE Trial on Ribociclib Plus Endocrine Therapy

Lisa A. Carey, MD, of the University of North Carolina at Chapel Hill, and Dennis J. Slamon, MD, PhD, of the University of California, Los Angeles, discuss phase III study findings on ribociclib plus endocrine therapy as adjuvant treatment in patients with hormone receptor–positive, HER2-negative early breast cancer. When added to standard-of-care endocrine therapy, ribociclib improved invasive disease–free survival with a well-tolerated safety profile (Abstract LBA500).

Lymphoma

Nirav N. Shah, MD, on Mantle Cell Lymphoma: Follow-up Data on Pirtobrutinib in Pretreated Disease

Nirav N. Shah, MD, of the Medical College of Wisconsin, discusses the efficacy and safety of pirtobrutinib, a highly selective, noncovalent BTK inhibitor, studied for more than 3 years in the BRUIN trial. The results showed that the use of pirtobrutinib continues to have durable efficacy and a favorable safety profile in heavily pretreated patients with relapsed or refractory mantle cell lymphoma and prior BTK inhibitor therapy. Responses were observed in patients with high-risk disease features, including blastoid/pleomorphic variants, elevated Ki67 index, and TP53 mutations (Abstract 7514).

Advertisement

Advertisement




Advertisement