Pembrolizumab for platinum- and cetuximab-refractory head and neck cancer: Results from a single-arm, phase II study

Joshua Bauml, Tanguy Y. Seiwert, David G. Pfister, Francis Worden, Stephen V. Liu, Jill Gilbert, Nabil F. Saba, Jared Weiss, Lori Wirth, Ammar Sukari, Hyunseok Kang, Michael K. Gibson, Erminia Massarelli, Steven Powell, Amy Meister, Xinxin Shu, Jonathan D. Cheng, Robert Haddad

Research output: Contribution to journalArticle

Abstract

Purpose: There are no approved treatments for recurrent/metastatic head and neck squamous cell carcinoma refractory to platinum and cetuximab. In the single-arm, phase II KEYNOTE-055 study, we evaluated pembrolizumab, an anti-programmed death 1 receptor antibody, in this platinum- and cetuximab-pretreated population with poor prognosis. Methods: Eligibility stipulated disease progression within 6 months of platinum and cetuximab treatment. Patients received pembrolizumab 200 mg every 3 weeks. Imaging was performed every 6 to 9 weeks. Primary end points: overall response rate (Response Evaluation Criteria in Solid Tumors v1.1, central review) and safety. Efficacy was assessed in all dosed patients and in subgroups on the basis of programmed death ligand 1 (PD-L1) expression and human papillomavirus (HPV) status. Results: Among 171 patients treated, 75% received two or more prior lines of therapy for metastatic disease, 82% were PD-L1 positive, and 22% were HPV positive. At the time of analysis, 109 patients (64%) experienced a treatment-related adverse event; 26 patients (15%) experienced a grade ≥ 3 event. Seven patients (4%) discontinued treatment, and one died of treatment-related adverse events. Overall response rate was 16% (95% CI, 11% to 23%), with a median duration of response of 8 months (range, 2+ to 12+ months); 75% of responses were ongoing at the time of analysis. Response rates were similar in all HPV and PD-L1 subgroups. Median progression-free survival was 2.1 months, and median overall survival was 8 months. Conclusion: Pembrolizumab exhibited clinically meaningful antitumor activity and an acceptable safety profile in recurrent/metastatic head and neck squamous cell carcinoma previously treated with platinum and cetuximab.

Original languageEnglish (US)
Pages (from-to)1542-1549
Number of pages8
JournalJournal of Clinical Oncology
Volume35
Issue number14
DOIs
StatePublished - May 10 2017

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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    Bauml, J., Seiwert, T. Y., Pfister, D. G., Worden, F., Liu, S. V., Gilbert, J., Saba, N. F., Weiss, J., Wirth, L., Sukari, A., Kang, H., Gibson, M. K., Massarelli, E., Powell, S., Meister, A., Shu, X., Cheng, J. D., & Haddad, R. (2017). Pembrolizumab for platinum- and cetuximab-refractory head and neck cancer: Results from a single-arm, phase II study. Journal of Clinical Oncology, 35(14), 1542-1549. https://doi.org/10.1200/JCO.2016.70.1524