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High clinical benefit rates of single agent pembrolizumab in selected rare sarcoma histotypes: First results of the AcSé Pembrolizumab study

Date

20 Sep 2020

Session

Proffered Paper - Sarcoma

Presenters

Jean-Yves Blay

Citation

Annals of Oncology (2020) 31 (suppl_4): S914-S933. 10.1016/annonc/annonc288

Authors

J. Blay1, S. Chevret2, N. Penel3, F. Bertucci4, E. Bompas5, E. Saada-Bouzid6, J. Eymard7, J. Lotz8, E. Coquan9, R. Schott10, P. Soulié11, C. Linassier12, A. Le Cesne13, M. Brahmi14, N. Hoog-Labouret15, F. Legrand16, C. Simon17, A. Lamrani-Ghaouti18, I.L. Ray-Coquard19, C. Massard20

Author affiliations

  • 1 Medicine Department, Centre Léon Bérard, 69008 - Lyon/FR
  • 2 Biostatisitics, Hopital St Louis, 75011 - Paris/FR
  • 3 General Oncology Department, Centre Oscar Lambret, 59020 - Lille/FR
  • 4 Medical Oncology, Institut Paoli Calmettes, 13273 - Marseille/FR
  • 5 Oncology, ICO Institut de Cancerologie de l'Ouest René Gauducheau, 44805 - Saint-Herblain/FR
  • 6 Medical Oncology, Centre Anticancer Antoine Lacassagne, Marseille/FR
  • 7 Medicine Department, Institut Jean Godinot, 51056 - Reims/FR
  • 8 Medical Oncology, Hospital Tenon Ap-Hp, 75020 - Paris/FR
  • 9 Medical Oncology, Centre Francois Baclesse, 14076 - Caen/FR
  • 10 Medicine Department, Centre Paul Strauss Centre de Lutte contre le Cancer, 67065 - Strasbourg/FR
  • 11 Medical Oncology, ICO ex Centre Paul Papin, 49055 - Angers/FR
  • 12 Medical Oncology, CHRU Bretonneau, 37044 - Tours/FR
  • 13 Medical Oncology, Gustave Roussy - Cancer Campus, 94805 - Villejuif/FR
  • 14 Medical Oncology, Centre Léon Bérard, 69008 - Lyon/FR
  • 15 Medical Oncology, institu national du cancer, 92500 - boulogne/FR
  • 16 Medical Oncology, Institut national du cancer, 92500 - boulogne/FR
  • 17 R&d Department, UNICANCER, 75654 - Paris/FR
  • 18 R&d, UNICANCER, 75654 - Paris/FR
  • 19 Medical Oncology Department, Centre Léon Bérard, 69008 - Lyon/FR
  • 20 Ditep, Gustave Roussy - Cancer Campus, 94805 - Villejuif/FR
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Resources

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Abstract 1619O

Background

AcSé Pembrolizumab is a phase II, non-randomized parallel arm, open-label, multicentric study investigating the efficacy and safety of pembrolizumab monotherapy in patients with rare cancers (NCT03012620). Here we report the results of pembrolizumab in the rare sarcoma cohort.

Methods

Selected histotypes were all rare sarcomas (incidence <0.2/100,000/year). Main inclusion criteria were age>18, PS≤1, and advanced disease resistant to standard treatment. Patients received pembrolizumab 200 mg IV as a 30-minute infusion on Day 1 of every 21-day cycle for a maximum of 2 years. The primary endpoint was the confirmed objective response rate according to RECIST v1.1. Secondary endpoints included clinical benefit rate, duration of response, progression-free survival (PFS), overall survival (OS), and safety. Five groups of patients were distinguished, namely chordoma, alveolar soft-part sarcoma (ASPS), desmoplastic small round cell tumor (DSRCT), smarca4-malignant rhabdoid tumor (SMBT) and the others.

Results

80 patients with rare sarcomas, including 24 with chordoma, 13 ASPS, 6 DSCRCT, 6 SMBT and 31 with other histotypes, were included from July 2017 to February 2020. The median number of cycles was 5 (range, 1 to 33) with 54 (67.5%) patients who discontinued the trial after a median of 4 cycles. Twenty-eight patients died after a median of 3 cycles (linked to cancer 27, other 1). Best response was PR in 13 patients (16.25%, 95%CI: 8.9 to 26.2%), and SD in 29 (36.25%). The occurrence of best response depended on the histotype, with 2 (8%) responses in chordoma, 5 (39%) in ASPS, 1 (17%) in DSCRCT, 3 (50%) in SMBT, and 2 (6%) in other histotypes (p=0.010). At data cut off, the 1-year PFS rates of the five histotype groups were 35%, 58%, 0, 62.5%, and 8%, with median times of 5.7 months, 14 months, 5, not reached, and 2.7 months respectively (p= 0.00016), while 1-year OS rates were 72%, 90%, 50%, 83% and 40% (p= 0.02). Median survival were only reached for chordoma (20 months), DSRCT (7.4 months), and other histotype group (5.4 months).

Conclusions

Pembrolizumab shows high levels of prolonged activity in selected subtypes of rare sarcomas.

Clinical trial identification

NCT03012620.

Editorial acknowledgement

none

Legal entity responsible for the study

Unicancer.

Funding

MSD.

Disclosure

J-Y. Blay: Honoraria (institution), Advisory/Consultancy, Research grant/Funding (institution): MSD; Honoraria (institution), Advisory/Consultancy, Research grant/Funding (institution): BMS; Honoraria (institution), Advisory/Consultancy, Research grant/Funding (institution): Roche; Honoraria (institution), Advisory/Consultancy, Research grant/Funding (institution): Astrazeneca. S. Chevret, N. Penel, F. Bertucci, E. Bompas, E. Saada-Bouzid, J-C. Eymard, J-P. Lotz, E. Coquan, R. Schott, P. Soulié, C. Linassier, A. Le Cesne, M. Brahmi, C. Simon, A. Lamrani-Ghaouti, C. Massard: Research grant/Funding (institution): MSD. I.L. Ray-Coquard: Honoraria (institution), Research grant/Funding (institution): MSD; Honoraria (institution), Advisory/Consultancy, Research grant/Funding (institution): Astrazeneca; Honoraria (institution), Advisory/Consultancy, Research grant/Funding (institution): Roche. All other authors have declared no conflicts of interest.

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Session: Proffered Paper - Sarcoma

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Q&A and live discussion

Presenter: Winette Van Der Graaf

Session: Proffered Paper - Sarcoma

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Webcast

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