Charles G. Drake, MD, PhD

“Bringing pembrolizumab (Keytruda) early into therapy is a bold move,” commented the invited discussant of this trial, Charles G. Drake, MD, PhD, Professor of Oncology and Immunology at the Herbert Irving Cancer Center at Columbia University, New York. The study enrolled patients who can be cured with chemoradiotherapy alone (and perhaps surgery). If the addition of an anti–programmed cell death protein 1 agent induces toxicity and impedes the curative potential, “you are not doing a good thing,” he added.

“Dr. Powell did a wonderful job showing there’s no additional safety signal from what you would expect beyond chemoradiotherapy, which in itself can be a challenging regimen to give. The ability to get all patients through this regimen is laudable…. The study showed that you can give all three things concurrently, and that’s important,” he added.

“As for activity, there is a very nice early signal. The survival data, with one patient experiencing disease progression, are clear. They are early data but very impressive,” commented Dr. Drake.

Cautious Optimism

However, Dr. Drake cautioned that encouraging results in phase II studies of immunotherapies have not always heralded success in the end. “Does the addition of pembrolizumab increase the activity of chemoradiotherapy? That’s the question. Although these data are wonderful, we won’t really know for sure until a later-stage randomized trial is done. I’m very much looking forward to that.” ■

DISCLOSURE: Dr. Drake is a consultant for Lilly, MedImmune, Dendreon, Roche/Genentech, Janssen Oncology, Agenus, Merck, and Pierre Fabre; has received research funding from Bristol-Myers Squibb, Aduro Biotech, and Janssen Oncology; and has ownership interests with Compugen, Harpoon Therapeutics, Kleo Pharmaceuticals, Potenza Therapeutics, and Tizona Therapeutics.