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Pembrolizumab vs Chemotherapy for Platinum-Treated, Recurrent or Metastatic Nasopharyngeal Cancer
According to a phase 3 trial, there was no difference in efficacy between pembrolizumab and chemotherapy for patients with advanced nasopharyngeal cancer who had previously been treated with platinum chemotherapy.
The international, open-label KEYNOTE-122 study enrolled 233 patients with recurrent or metastatic nasopharyngeal cancer who had prior treatment with platinum chemotherapy between May 5, 2016, and May 28, 2018. Patients were randomized on a 1-to-1 basis to receive either pembrolizumab (n = 117) or chemotherapy (n = 116). The chemotherapy used was capecitabine, gemcitabine, docetaxel by investigator choice. The primary end point was overall survival (OS).
At the data cut-off date of November 30, 2020, the median follow-up duration was 45.1 months. The OS of patients treated with pembrolizumab was 17.2 months (95% confidence interval [CI], 11.7 to 22.9), compared with 15.3 months (95% CI, 10.9 to 18.1) for those treated with chemotherapy (hazard ratio, 0.90; 95% CI, 0.67 to 1.19; P = .2262)
There were grade 3 to 5 treatment-related adverse events in 10.3% of pembrolizumab arm, compared with 43.8% of the chemotherapy arm. There were 3 treatment-related deaths: 1 in the pembrolizumab arm due to pneumonitis, and 2 in the chemotherapy arm, due to pneumonia and intracranial hemorrhage, respectively.
Study authors concluded, “pembrolizumab did not significantly improve OS compared with chemotherapy in participants with platinum-pretreated recurrent and/or metastatic [nasopharyngeal cancer] but did have manageable safety and a lower incidence of treatment-related adverse events.”
Source:
Chan ATC, Lee VHF, Hong R-L, et al. Pembrolizumab monotherapy versus chemotherapy in platinum-pretreated, recurrent or metastatic nasopharyngeal cancer (KEYNOTE-122): an open-label, randomized, phase III trial. Ann Oncol. Published online: December 16, 2022. doi:10.1016/j.annonc.2022.12.007
