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Poster display session

3251 - Early safety from phase 1b/3, multicenter, open-label, randomized trial of talimogene laherparepvec (T-VEC) + pembrolizumab (pembro) for recurrent or metastatic squamous cell carcinoma of the head and neck (R/M SCCHN): MASTERKEY-232

Date

10 Sep 2017

Session

Poster display session

Presenters

Kevin Harrington

Citation

Annals of Oncology (2017) 28 (suppl_5): v428-v448. 10.1093/annonc/mdx377

Authors

K. Harrington1, A. Kong2, N. Mach3, T. Rordorf4, J. Corral5, V. Espeli6, S. Treichel7, J. Cheng8, J.J. Kim9, J. Chesney10

Author affiliations

  • 1 The Institute Of Cancer Research, Royal Marsden Hospital NHS Foundation Trust, SW3 6JJ - London/GB
  • 2 Institute Of Cancer And Genomics Science, University of Birminghan, Birminghan/GB
  • 3 Oncology, Hôpitaux Universitaires de Genève, 1211 - Geneva/CH
  • 4 Department Of Oncology, Universitätsspital Zürich, 8091 - Zürich/CH
  • 5 Medical Oncology, University Hospital Virgen del Rocio, Seville/ES
  • 6 Iosi, Oncology Institute of Southern Switzerland, Bellinzona/CH
  • 7 Biostatistics, Amgen Inc., South San Francisco/US
  • 8 Medical Oncology, Merck & Co., Inc., Kenilworth/US
  • 9 Hematology/oncology, Amgen Inc., Thousand Oaks/US
  • 10 Department Of Medicine, University of Louisville, Louisville/US
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Resources

Abstract 3251

Background

T-VEC is the first FDA-approved oncolytic immunotherapy designed to activate antitumor immune responses. Pembro is a mAb against human programmed death receptor-1 that can stimulate inactivated anticancer T cells and is approved for the treatment (tx) of SCCHN. This combination of agents may further enhance antitumor immune response. This phase 1b/3 study will evaluate the safety and efficacy of T-VEC and pembro in patients (pts) with R/M SCCHN progressing after platinum (NCT02626000).

Methods

The primary objective for phase 1b is to assess dose-limiting toxicities (DLTs). Key secondary objectives include objective response rate, best overall response, and safety. Key eligibility criteria include histologically confirmed R/M SCCHN unsuitable for resection/radiotherapy, progressing after platinum tx, and injectable lesions. T-VEC was given by intralesional injection ≤ 8 mL of 106 PFU/mL on day 1, then after 3 w, ≤ 8 mL of 108 PFU/mL Q3W; pembro was given IV at 200 mg Q3W. Approximately 18 pts in the safety cohort and an additional 22 pts for long-term safety and efficacy will be enrolled into phase 1b.

Results

28 pts have been enrolled; 16 are DLT evaluable: 12 (75%) male, median age 57.5 y (range: 35, 77), ECOG 1 (75%). There was a DLT in 1 pt after 2 doses of both drugs: fatal arterial hemorrhage (AH). Grade 3/4 AEs were seen in 6 (38%) of pts - none led to tx discontinuation. There were 2 grade 5 AEs: AH (DLT) and disease progression. Incidence of SAEs possibly related to T-VEC was 5 (31.3%: chills, pyrexia, stridor, odynophagia, AH) and to pembro was 2 (12.5%: eczema, pyrexia) - none led to tx discontinuation.Table:

1252P

All DLT Evaluable* (N = 16)Non-DLT Evaluable (N = 12)All Pts (N = 28)
All tx-emergent AEs15 (93.8)11 (91.7)26 (92.9)
Grade 35 (31.2)2 (16.7)7 (25)
Grade 41 (6.3)1 (8.3)2 (7.1)
Grade 52 (12.5)7 (58.3)9 (32.1)
AEs related to T-VEC11 (68.8)2 (16.7)13 (46.4)
Grade 34 (25)1 (8.3)5 (17.9)
Grade 40 (0)0 (0)0 (0)
AEs related to pembro9 (56.3)1 (8.3)10 (35.7)
Grade 31 (6.3)1 (8.3)2 (7.1)
Grade 40 (0)0 (0)0 (0)
*

To be DLT evaluable, pt must have had ≥ 6 w of follow up from the initial dosing and have received ≥ 2 doses of T-VEC and pembro in combination, or have a DLT during the DLT evaluation period after at least 1 dose of T-VEC and pembro.

Conclusions

There was 1 DLT of 16 evaluable pts. The combination regimen was deemed safe to continue into the phase 1b efficacy portion. The protocol was amended to exclude pts who have received reirradiation to the neck and are at high risk for AH.

Clinical trial identification

NCT02626000

Legal entity responsible for the study

Amgen Inc.

Funding

Amgen Inc. and Merck

Disclosure

K. Harrington: Corporate-sponsored research from AstraZeneca, Merck Sharp Dohme; Consulting fees from Amgen, AstraZeneca, Bristol-Myers Squib, Merck, Merck Sharp Dohme, Pfizer; Speakers Bureau from Amgen, AstraZeneca, Bristol-Myers Squib, Merck, Merck Sharp Dohme. S. Treichel, J.J. Kim: Employee and stock shareholder of Amgen Inc. J. Cheng: Employee and stock shareholder of Merck. J. Chesney: Consulting fees from Amgen Inc. All other authors have declared no conflicts of interest.

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