Safety profile of pembrolizumab monotherapy based on an aggregate safety evaluation of 8937 patients.

Neoplasms Pembrolizumab Programmed cell death 1 receptor Safety

Journal

European journal of cancer (Oxford, England : 1990)
ISSN: 1879-0852
Titre abrégé: Eur J Cancer
Pays: England
ID NLM: 9005373

Informations de publication

Date de publication:
11 Jan 2024
Historique:
received: 08 12 2023
accepted: 01 01 2024
medline: 1 2 2024
pubmed: 1 2 2024
entrez: 31 1 2024
Statut: aheadofprint

Résumé

Pembrolizumab has a manageable safety profile as described in its label, which was primarily based on 2799 patients who participated in clinical trials for melanoma or non-small cell lung cancer. Here, we evaluated the safety of pembrolizumab in a broader population of patients from 31 advanced cancer clinical trials across 19 cancer types. Safety was analyzed in patients who received at least one dose of pembrolizumab (200 mg every 3 weeks [Q3W], 10 mg/kg Q2W or Q3W, or 2 mg/kg Q3W). Adverse events (AEs) and immune-mediated AEs and infusion reactions were evaluated. Safety data from 8937 patients in 31 trials of pembrolizumab monotherapy were pooled (median, seven administrations; range, 1-59). Median duration on treatment was 4.1 months (range, 0.03-40.1). AEs occurred in 96.6% of patients. Grade 3-5 AEs occurred in 50.6% of patients. AEs led to pembrolizumab discontinuation in 12.7% of patients and death in 5.9%. Immune-mediated AEs and infusion reactions occurred in 23.7% of patients (4.6% experienced multiple immune-mediated AEs/infusion reactions) and led to pembrolizumab discontinuation in 3.6% and death in 0.2%. Grade 3-5 immune-mediated AEs occurred in 6.3% of patients. Serious immune-mediated AEs and infusion reactions occurred in 6.0% of patients. Median time to immune-mediated AE onset was 85 days (range, 13-163). Of 2657 immune-mediated AEs, 22.3% were initially treated with prednisone ≥ 40 mg/day or equivalent, and 8.3% were initially treated with lower steroid doses. This pooled analysis of 31 clinical trials showed that pembrolizumab has a consistent safety profile across indications.

Sections du résumé

BACKGROUND BACKGROUND
Pembrolizumab has a manageable safety profile as described in its label, which was primarily based on 2799 patients who participated in clinical trials for melanoma or non-small cell lung cancer. Here, we evaluated the safety of pembrolizumab in a broader population of patients from 31 advanced cancer clinical trials across 19 cancer types.
METHODS METHODS
Safety was analyzed in patients who received at least one dose of pembrolizumab (200 mg every 3 weeks [Q3W], 10 mg/kg Q2W or Q3W, or 2 mg/kg Q3W). Adverse events (AEs) and immune-mediated AEs and infusion reactions were evaluated.
RESULTS RESULTS
Safety data from 8937 patients in 31 trials of pembrolizumab monotherapy were pooled (median, seven administrations; range, 1-59). Median duration on treatment was 4.1 months (range, 0.03-40.1). AEs occurred in 96.6% of patients. Grade 3-5 AEs occurred in 50.6% of patients. AEs led to pembrolizumab discontinuation in 12.7% of patients and death in 5.9%. Immune-mediated AEs and infusion reactions occurred in 23.7% of patients (4.6% experienced multiple immune-mediated AEs/infusion reactions) and led to pembrolizumab discontinuation in 3.6% and death in 0.2%. Grade 3-5 immune-mediated AEs occurred in 6.3% of patients. Serious immune-mediated AEs and infusion reactions occurred in 6.0% of patients. Median time to immune-mediated AE onset was 85 days (range, 13-163). Of 2657 immune-mediated AEs, 22.3% were initially treated with prednisone ≥ 40 mg/day or equivalent, and 8.3% were initially treated with lower steroid doses.
CONCLUSIONS CONCLUSIONS
This pooled analysis of 31 clinical trials showed that pembrolizumab has a consistent safety profile across indications.

Identifiants

pubmed: 38295556
pii: S0959-8049(24)00006-6
doi: 10.1016/j.ejca.2024.113530
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

113530

Informations de copyright

Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of Competing Interest The authors declare the following financial interests/personal relationships that may be considered as potential competing interests:

Auteurs

Julie R Brahmer (JR)

Johns Hopkins Kimmel Cancer Center, 1800 Orleans Street, Baltimore, MD 21287, USA. Electronic address: brahmju@jhmi.edu.

Georgina V Long (GV)

Melanoma Institute Australia, The University of Sydney, and Royal North Shore and Mater Hospitals, 40 Rocklands Road North Sydney, Sydney, NSW 2060, Australia. Electronic address: georgina.long@sydney.edu.au.

Omid Hamid (O)

Cedars-Sinai The Angeles Clinic and Research Institute, 11800 Wilshire Blvd #300, Los Angeles, CA 90025, USA. Electronic address: ohamid@theangelesclinic.org.

Edward B Garon (EB)

David Geffen School of Medicine at UCLA, 2825 Santa Monica Blvd., Suite 200, Santa Monica, CA 90404, USA. Electronic address: egaron@mednet.ucla.edu.

Roy S Herbst (RS)

Yale School of Medicine, 333 Cedar Street, New Haven, CT 06510, USA. Electronic address: roy.herbst@yale.edu.

Thierry Andre (T)

Sorbonne Université and Hôpital Saint-Antoine, 184 Rue du Faubourg Saint-Antoine, Paris 75012, France. Electronic address: thierry.andre@aphp.fr.

Philippe Armand (P)

Dana-Farber Cancer Institute, 450 Brookline Avenue, Boston, MA 02115, USA. Electronic address: philippe_armand@dfci.harvard.edu.

Dean Bajorin (D)

Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, USA. Electronic address: bajorind@MSKCC.ORG.

Joaquim Bellmunt (J)

Dana-Farber Cancer Institute and IMIM Lab, 450 Brookline Avenue, Boston, MA 02115, USA. Electronic address: bellmunt@broadinstitute.org.

Barbara Burtness (B)

Yale School of Medicine, 333 Cedar Street, New Haven, CT 06510, USA. Electronic address: barbara.burtness@yale.edu.

Toni K Choueiri (TK)

Dana-Farber Cancer Institute, 450 Brookline Ave, Boston, MA 02215, USA. Electronic address: toni_choueiri@dfci.harvard.edu.

Ezra E W Cohen (EEW)

Moores Cancer Center, UC San Diego Health, 3855 Health Sciences Drive, La Jolla, CA 92037, USA. Electronic address: ecohen@ucsd.edu.

Luis A Diaz (LA)

Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, USA. Electronic address: diazl5@mskcc.org.

Kohei Shitara (K)

National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Chiba 277-8577, Japan. Electronic address: kshitara@east.ncc.go.jp.

Girish Kulkarni (G)

Princess Margaret Cancer Centre, University Health Network, 610 University Avenue, Toronto, ON MG5 2C4, Canada. Electronic address: Girish.Kulkarni@uhn.ca.

David McDermott (D)

Beth Israel Deaconess Medical Center, 330 Brookline Ave, Boston, MA 02186, USA. Electronic address: dmcdermo@bidmc.harvard.edu.

Manish Shah (M)

Weill Cornell Medicine, 1300 York Avenue, New York, NY 10065, USA. Electronic address: mas9313@med.cornell.edu.

Josep Tabernero (J)

Vall d'Hebron Hospital Campus and Institute of Oncology (VHIO), Pg. de la Vall d'Hebron 119, Barcelona 08035, Spain. Electronic address: jtabernero@vhio.net.

Arndt Vogel (A)

Division of Gastroenterology and Hepatology, Toronto General Hospital, Toronto, Canada; Medical Oncology, Princess Margaret Cancer Centre, Toronto, Canada; Hannover Medical School, Hannover, Germany. Electronic address: vogel.arndt@mh-hannover.de.

Pier Luigi Zinzani (PL)

IRCCS Azienda Ospedaliero-Universitaria di Bologna Istituto di Ematologia "Seràgnoli", Dipartimento di Scienze Mediche e Chirurgiche, Università di Bologna, Bologna, Italy. Electronic address: pierluigi.zinzani@unibo.it.

Niusha Jafari (N)

Merck & Co., Inc., Rahway, NJ, USA. Electronic address: Niusha.Jafari@merck.com.

Steven Bird (S)

Merck & Co., Inc., Rahway, NJ, USA. Electronic address: Steven_Bird@merck.com.

Ellen Snyder (E)

Merck & Co., Inc., Rahway, NJ, USA. Electronic address: ellen_snyder@merck.com.

Christine Gause (C)

Merck & Co., Inc., Rahway, NJ, USA. Electronic address: christine_gause@merck.com.

Oswaldo L Bracco (OL)

Merck & Co., Inc., Rahway, NJ, USA. Electronic address: oswaldo.bracco@merck.com.

M Catherine Pietanza (MC)

Merck & Co., Inc., Rahway, NJ, USA. Electronic address: cathy.pietanza@merck.com.

Todd Gruber (T)

Merck & Co., Inc., Rahway, NJ, USA.

Antoni Ribas (A)

David Geffen School of Medicine at UCLA, 2825 Santa Monica Blvd., Suite 200, Santa Monica, CA 90404, USA. Electronic address: aribas@mednet.ucla.edu.

Classifications MeSH