Pembrolizumab in PD-L1–Positive Nasopharyngeal Carcinoma

Key Points

  • Response was observed in 25.9% of patients with recurrent or metastatic nasopharyngeal carcinoma who received pembrolizumab, with a median duration of 17.1 months.
  • Stable disease was observed in 51.9% of patients.

As reported by Hsu et al in the Journal of Clinical Oncology, pembrolizumab (Keytruda) has shown activity in programmed cell death ligand 1 (PD-L1)–positive recurrent or metastatic nasopharyngeal carcinoma, in a cohort of the phase Ib KEYNOTE-028 trial.

Study Details

In the study, 27 patients with PD-L1 expression of ≥ 1% tumor cells or tumor-infiltrating lymphocytes received pembrolizumab at 10 mg/kg every 2 weeks for up to 2 years or until disease progression or unacceptable toxicity. The primary endpoint was objective response rate on investigator review (Response Evaluation Criteria in Solid Tumors [RECIST] v1.1). Patients had a median age of 52 years, 63% were Asian, 93% had received prior treatment for recurrent or metastatic nasopharyngeal carcinoma, and 70% had received ≥ 3 prior therapies.

Responses and Survival

Partial response was observed in 7 patients (25.9%), with stable disease observed in an additional 14 patients (51.9%). The objective response rate on central review was 26.3%. Median duration of response was 17.1 months; at data cutoff, 2 patients remained on pembrolizumab, with response durations of 17.3+ and 22.1+ months. Median progression-free survival was 6.5 months; 6- and 12-month progression-free survival rates were 50.0% and 33.4%. Median overall survival was 16.5 months; 6- and 12-month overall survival rates were 85.2% and 63.0%.

Adverse Events

The most common drug-related adverse events of any grade were rash (25.9%), pruritus (25.9%), pain (22.2%), hypothyroidism (18.5%), and fatigue (18.5%). Grade ≥ 3 drug-related adverse events occurred in 29.6% of patients, with the most common being hepatitis (7.4%) and pneumonitis (7.4%). One patient died of a drug-related adverse event (sepsis).

The investigators concluded: “Pembrolizumab demonstrated antitumor activity and a manageable safety profile in patients with [recurrent or metastatic nasopharyngeal carcinoma].”

The study was supported by Merck & Co, Inc.

Chiun Hsu, MD, PhD, of the National Taiwan University Hospital, is the corresponding author of the Journal of Clinical Oncology article.

The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.


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