Abstract | BACKGROUND: METHODS: We retrospectively reviewed the charts of ATC patients initiated on pembrolizumab in combination with KI at the time of progression on kinase inhibitors at MD Anderson Cancer Center between August 2016 and August 2017. Efficacy was evaluated with best overall response (BOR) using RECISTv1.1 criteria. Progression free survival (PFS) from the start of pembrolizumab and overall survival (OS) from the start of kinase inhibitors, as well as from the time of addition of pembrolizumab were calculated. RESULTS: Twelve patients were treated with combination kinase inhibitors plus pembrolizumab at the time of progression on their KI therapy. Median age at initiation of pembrolizumab was 60 years (range 47-84 years). BOR was as follows: 5/12 (42%) had partial response, 4/12 (33%) had stable disease and 3/12 (25%) had progressive disease. Median OS from the start of kinase inhibitor was 10.43 months (95% CI = 6.02, 14.83, range 5.4-40 months). Median OS and PFS from the addition of pembrolizumab were 6.93 months (95% CI = 1.7, 12.15, range 3-15.9 months) and 2.96 months (95% CI = 2.2, 3.7, range 0.57-13.14 months), respectively. Fatigue, anemia and hypertension were the most common AEs encountered on these combinations. Therapy had to be discontinued in 2 patients due to drug induced rash and altered mental status likely from progression of disease. CONCLUSION: In a subset of ATC patients, pembrolizumab may be an effective salvage therapy added to kinase inhibitors at the time of progression on these drugs. However, better treatment strategies aimed at incorporating immunotherapy in patients with ATC should be explored. Frontline combination of KI with immunotherapy should be studied in prospective clinical trials.
|
Authors | Priyanka C Iyer, Ramona Dadu, Maria Gule-Monroe, Naifa L Busaidy, Renata Ferrarotto, Mouhammed Amir Habra, Mark Zafereo, Michelle D Williams, G Brandon Gunn, Horiana Grosu, Heath D Skinner, Erich M Sturgis, Neil Gross, Maria E Cabanillas |
Journal | Journal for immunotherapy of cancer
(J Immunother Cancer)
Vol. 6
Issue 1
Pg. 68
(07 11 2018)
ISSN: 2051-1426 [Electronic] England |
PMID | 29996921
(Publication Type: Journal Article, Research Support, N.I.H., Extramural)
|
Chemical References |
- Antibodies, Monoclonal, Humanized
- Protein Kinase Inhibitors
- pembrolizumab
|
Topics |
- Aged
- Aged, 80 and over
- Antibodies, Monoclonal, Humanized
(administration & dosage)
- Antineoplastic Combined Chemotherapy Protocols
(adverse effects, therapeutic use)
- Female
- Humans
- Male
- Middle Aged
- Protein Kinase Inhibitors
(administration & dosage)
- Retrospective Studies
- Salvage Therapy
- Thyroid Carcinoma, Anaplastic
(drug therapy, metabolism, pathology)
- Thyroid Neoplasms
(drug therapy, metabolism, pathology)
- Treatment Outcome
|