Pembrolizumab Appears Effective on Brain Metastases in Melanoma, NSCLC

Share this content:
Pembrolizumab demonstrated an acceptable safety profile and effectiveness upon brain metastases in melanoma or non-small cell lung cancer.
Pembrolizumab demonstrated an acceptable safety profile and effectiveness upon brain metastases in melanoma or non-small cell lung cancer.

Pembrolizumab demonstrated an acceptable safety profile and effectiveness upon brain metastases in patients with melanoma or non-small cell lung cancer (NSCLC), a study published in the journal The Lancet Oncology has shown.1

Immunotherapy targeting the PD-1 axis has activity in several tumor types, including melanoma, NSCLC, head and neck cancer, and endometrial cancer. Researchers explored the activity and safety of the PD-1 inhibitor pembrolizumab in patients with untreated brain metastases from melanoma or NSCLC.

For the open-label, phase 2 trial, investigators enrolled 18 patients with melanoma and 18 with NSCLC with untreated brain metastases, each of whom were receiving care at Yale Cancer Center in New Haven, Connecticut. Patients had at least 1 untreated or progressive brain metastasis between 5 and 20 mm in diameter without associated neurological symptoms or the need for corticosteroids.

Only patients with NSCLC had tumor tissue positive for PD-L1 expression. All patients received pembrolizumab 10 mg/kg IV every 2 weeks until disease progression.

Results showed that a brain metastasis response was achieved in 22% (95% CI, 7-48) of patients with melanoma and 33% (95% CI, 14-59) of patients with NSCLC. Researchers found that responses were durable, with only one NSCLC patient exhibiting an ongoing response at the time of data cut-off.

The most common treatment-related serious and grade 3 to 4 adverse events in the NSCLC cohort were grade 3 colitis, grade pneumonitis, grade 3 fatigue, grade 4 hyperkalemia, and grade 2 acute kidney injury. The only adverse event in the melanoma cohort was 1 case of grade 3 elevated aminotransferases.

RELATED: Pipeline Series: Non-small Cell Lung Cancer Treatment

Three patients with melanoma experienced clinically-significant neurologic adverse events, including transient grade 3 cognitive dysfunction and grade 1 to 2 seizures.

The findings suggest there might be a role for systemic immunotherapy in patients with untreated or progressive brain metastases.                        

Reference

  1. Goldberg SB, Gettinger SN, Mahajan A, Chiang AC, Herbst RS, Sznol M, et al. Pembrolizumab for patients with melanoma or non-small-cell lung cancer and untreated brain metastases: early analysis of a non-randomised, open-label, phase 2 trial [published online ahead of print June 3, 2016]. Lancet Oncol. doi: 10.1016/S1470-2045(16)30053-5.

Related Resources

You must be a registered member of Cancer Therapy Advisor to post a comment.

Regimen and Drug Listings

GET FULL LISTINGS OF TREATMENT Regimens and Drug INFORMATION

Bone Cancer Regimens Drugs
Brain Cancer Regimens Drugs
Breast Cancer Regimens Drugs
Endocrine Cancer Regimens Drugs
Gastrointestinal Cancer Regimens Drugs
Gynecologic Cancer Regimens Drugs
Head and Neck Cancer Regimens Drugs
Hematologic Cancer Regimens Drugs
Lung Cancer Regimens Drugs
Other Cancers Regimens
Prostate Cancer Regimens Drugs
Rare Cancers Regimens
Renal Cell Carcinoma Regimens Drugs
Skin Cancer Regimens Drugs
Urologic Cancers Regimens Drugs

Sign Up for Free e-newsletters