Title :

Pembrolizumab in patients with rare and ultra-rare sarcomas (AcSé Pembrolizumab): analysis of a subgroup from a non-randomised, open-label, phase 2, basket trial.

Author(s) :

Blay, Jean-Yves [Auteur]
Université Claude Bernard Lyon 1 [UCBL]
Centre Léon Bérard [Lyon]
Chevret, Sylvie [Auteur]
Hopital Saint-Louis [AP-HP] [AP-HP]
Le Cesne, Axel [Auteur]
Institut Gustave Roussy [IGR]
Brahmi, Mehdi [Auteur]
Université Claude Bernard Lyon 1 [UCBL]
Centre Léon Bérard [Lyon]
Penel, Nicolas [Auteur]
METRICS : Evaluation des technologies de santé et des pratiques médicales - ULR 2694
Cousin, Sophie [Auteur]
Institut Bergonié [Bordeaux]
Bertucci, Francois [Auteur]
Institut Paoli-Calmettes [IPC]
Bompas, Emmanuelle [Auteur]
CRLCC René Gauducheau
Ryckewaert, Thomas [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Soibinet, Pauline [Auteur]
CRLCC Jean Godinot
Boudou-Rouquette, Pascaline [Auteur]
Hôpital Cochin [AP-HP]
Saada Bouzid, Esma [Auteur]
Centre Hospitalier Universitaire de Nice [CHU Nice]
Soulie, Patrick [Auteur]
CRLCC - Centre Paul Papin [CRLCC Paul Papin]
Valentin, Thibaud [Auteur]
Centre de Recherches en Cancérologie de Toulouse [CRCT]
Lotz, Jean-Pierre [Auteur]
CHU Tenon [AP-HP]
Tosi, Diego [Auteur]
UNICANCER - Institut régional du Cancer Montpellier Val d'Aurelle [ICM]
Neviere, Zoé [Auteur]
Université de Caen Normandie - UFR Santé [UNICAEN Santé]
Cancel, Mathilde [Auteur]
Hôpital Bretonneau
Ray-Coquard, Isabelle [Auteur]
Université Claude Bernard Lyon 1 [UCBL]
Centre Léon Bérard [Lyon]
Gambotti, Laetitia [Auteur]
Institut national du cancer [INCa]
Legrand, Frédéric [Auteur]
Institut national du cancer [INCa]
Lamrani-Ghaouti, Assia [Auteur]
UNICANCER
Simon, Clotilde [Auteur]
UNICANCER
Even, Caroline [Auteur]
Institut Gustave Roussy [IGR]
Massard, Christophe [Auteur]
CRLCC Eugène Marquis [CRLCC]

Journal title :

Lancet Oncology

Abbreviated title :

Lancet Oncol

Publication date :

2023-07-12

ISSN :

1474-5488

English abstract : [en]

Background Sarcoma is a heterogeneous group of diseases with few treatment options. Immunotherapy has shown little activity in studies including unselected sarcomas, but immune checkpoint blockers have shown activity in ...
Show more >Background Sarcoma is a heterogeneous group of diseases with few treatment options. Immunotherapy has shown little activity in studies including unselected sarcomas, but immune checkpoint blockers have shown activity in specific histotypes. We evaluated the activity of pembrolizumab in rare and ultra-rare sarcomas. Methods AcSé Pembrolizumab is an ongoing phase 2, basket, multitumour study investigating the activity of pembrolizumab monotherapy in rare cancers. Here, we report the results obtained in patients with selected histotypes of rare sarcomas (incidence of less than one case per 1 000 000 people per year) recruited at 24 French hospitals. Key inclusion criteria were age 15 years or older, Eastern Cooperative Oncology Group performance status of 0–1, and advanced disease that was untreated and resistant to treatment. Patients were given pembrolizumab 200 mg intravenously on day 1 of every 21-day cycle for a maximum of 24 months. The primary endpoint was objective response rate at week 12 using Response Evaluation Criteria in Solid Tumours version 1.1, assessed by local investigators. The primary endpoint and safety were analysed in the intention-to-treat population. The AcSé Pembrolizumab study is registered with ClinicalTrials.gov, NCT03012620. Findings Between Sept 4, 2017, and Dec 29, 2020, 98 patients were enrolled, of whom 97 received treatment and were included in analyses (median age 51 years [IQR 35–65]; 53 [55%] were male; 44 [45%] were female; no data were collected on race or ethnicity). 34 (35%) patients had chordomas, 14 (14%) had alveolar soft part sarcomas, 12 (12%) had SMARCA4-deficient sarcomas or malignant rhabdoid tumours, eight (8%) had desmoplastic small round cell tumours, six (6%) had epithelioid sarcomas, four (4%) had dendritic cell sarcomas, three (3%) each had clear cell sarcomas, solitary fibrous tumours, and myxoid liposarcomas, and ten (10%) had other ultra-rare histotypes. As of data cutoff (April 11, 2022), median follow-up was 13·1 months (range 0·1–52·8; IQR 4·3–19·7). At week 12, objective response rate was 6·2% (95% CI 2·3–13·0), with no complete responses and six partial responses in the 97 patients. The most common grade 3–4 adverse events were anaemia (eight [8%] of 97), alanine aminotransferase and aspartate aminotransferase increase (six [6%]), and dyspnoea (five [5%]). 86 serious adverse events were reported in 37 patients. Five deaths due to adverse events were reported, none of which were determined to be related to treatment (two due to disease progression, two due to cancer, and one due to unknown cause). Interpretation Our data show the activity and manageable toxicity of pembrolizumab in some rare and ultra-rare sarcoma histotypes, and support the PD-1/PD-L1 pathway as a potential therapeutic target in selected histotypes. The completion of the basket study will provide further evidence regarding the activity and toxicity of pembrolizumab in identified rare types of cancer. Funding The Ligue contre le cancer, INCa, MSD. Translation For the French translation of the abstract see Supplementary Materials section.Show less >

Language :

Anglais

Audience :

Internationale

Popular science :

Non

Administrative institution(s) :

Université de Lille
CHU Lille

Collections :

• METRICS : Evaluation des technologies de santé et des pratiques médicales - ULR 2694

Submission date :

2024-01-20T22:11:38Z
2024-04-08T15:12:40Z