Data May Support Pembrolizumab/Chemo as New SOC in Endometrial Cancer

Commentary
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Although immature, overall survival data from the KEYNOTE-868 trial may support the use of pembrolizumab plus chemotherapy in patients with endometrial cancer.

Findings may help usher in pembrolizumab (Keytruda) plus chemotherapy as a treatment option for patients with endometrial cancer and establish a “new standard” for this population, said Ramez N. Eskander, MD.

Eskander, an assistant professor of obstetrics, gynecology, and reproductive sciences at the University of California San Diego Health, spoke with CancerNetwork® about how findings from the phase 3 NRG-GY018/KEYNOTE-868 trial (NCT03914612) may impact the standard of care for patients with endometrial cancer. He presented these results at the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer.

Although overall survival (OS) data were immature at the time of the analysis, Eskander highlighted a benefit associated with the pembrolizumab combination in the trial. He stated that he was optimistic these OS data combined with prior progression-free survival (PFS) findings would support pembrolizumab plus chemotherapy as a treatment for those with mismatch repair deficient (dMMR) or mismatch repair proficient (pMMR) disease.

According to data presented at the meeting, the median OS among patients in the pMMR population was 27.96 months (95% CI, 21.42-not reached [NR]) with pembrolizumab plus chemotherapy vs 27.37 months (95% CI, 19.52-NR) with placebo plus chemotherapy (HR, 0.79; 95% CI, 0.53-1.17; P = .1157). Additionally, the median OS was not reached in either arm among those with dMMR disease (HR, 0.55; 95% CI, 0.25-1.19; P = .0617).

Transcript:

We’re optimistic about the totality of the evidence as it relates to both the progression-free survival advantage, which was highly significant and clinically beneficial, in combination with the data that we shared showing that the overall survival is also directionally favorable but immature, with only an 18% and 27% information fraction. We’re hopeful that these data, in combination, are going to help usher in this therapeutic strategy for both [patients with] mismatch repair deficient and mismatch repair proficient [disease]. If that’s the case, and we have access to this combinatorial approach, that may define a new standard for these patients.

Reference

Eskander RN, Sill M, Miller A, et al. Overall survival, progression-free survival by PD-L1 status, and blinded independent central review results with pembrolizumab plus carboplatin/paclitaxel (CP) versus placebo plus CP in patients with endometrial cancer: results from the NRG GY018 trial. Presented at: Society of Gynecologic Oncology 2024 Annual Meeting for Women’s Cancer; March 16-18, 2024; San Diego, CA.

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