Phase 2
Completed N=254
Study of Pembrolizumab (MK-3475) Monotherapy for Metastatic Triple-Negative Breast Cancer (MK-3475-086/KEYNOTE-086)
Source: ClinicalTrials.gov NCT02447003 ↗Enrolled (actual)
254
Serious AEs
25.9%
Results posted
Dec 2020
Primary outcomePrimary: Objective Response Rate (ORR) Per Response Evaluation Criteria in Solid Tumors Version 1.1 (RECIST 1.1) by Central Imaging Vendor (CIV) in All Cohort A Participants — 5.3 Percentage of participants
Summary
This is a two-part study of pembrolizumab monotherapy in participants with metastatic triple-negative breast cancer (mTNBC). Part 1 of the study will examine the efficacy and safety of pembrolizumab monotherapy as first line or above treatment in participants who have received either no prior systemic treatment or at least one prior systemic treatment for metastatic breast cancer. Part 2 of the study, if done, will expand the investigation of pembrolizumab treatment in a subgroup of participants from Part 1 and will only start after enrollment in Part 1 has been completed. There will be no hypothesis testing in this study.
Outcome Measures
| Outcome | Result | p-value |
|---|---|---|
| PRIMARY Objective Response Rate (ORR) Per Response Evaluation Criteria in Solid Tumors Version 1.1 (RECIST 1.1) by Central Imaging Vendor (CIV) in All Cohort A Participants |
5.3 | — |
| PRIMARY ORR Per RECIST 1.1 by CIV in Subgroup of Cohort A Participants With Programmed Cell Death- Ligand 1 (PD-L1) Positive Tumor Expression |
5.7 | — |
| PRIMARY Number of Participants Who Experienced at Least One Adverse Event (AE) |
161; 83 | — |
| PRIMARY Number of Participants Who Discontinued Study Drug Due to an AE |
8; 3 | — |
| SECONDARY ORR Per RECIST 1.1 by CIV in All Cohort B Participants |
21.4 | — |
| SECONDARY Duration of Response (DOR) Per RECIST 1.1 by CIV in All Cohort A and Cohort B Participants |
NA; 10.4 | — |
| SECONDARY DOR Per RECIST 1.1 by CIV in Subgroup of Cohort A Participants With PD-L1 Positive Tumor Expression |
NA | — |
| SECONDARY Disease Control Rate (DCR) Per RECIST 1.1 by CIV in All Cohort A and Cohort B Participants |
7.6; 23.8 | — |
| SECONDARY DCR Per RECIST 1.1 by CIV in Subgroup of Cohort A Participants With PD-L1 Positive Tumor Expression |
9.5 | — |
| SECONDARY Progression Free Survival (PFS) Per RECIST 1.1 by CIV in All Cohort A and Cohort B Participants |
2.0; 2.1 | — |
| SECONDARY PFS Per RECIST 1.1 by CIV in Subgroup of Cohort A Participants With PD-L1 Positive Tumor Expression |
2.0 | — |
| SECONDARY Overall Survival (OS) in All Cohort A and Cohort B Participants |
9.0; 18.0 | — |
| SECONDARY OS in Subgroup of Cohort A Participants With PD-L1 Positive Tumor Expression |
8.8 | — |
| SECONDARY Odds Ratio of Association Between PD-L1 Tumor Expression and Objective Response (OR) Per RECIST 1.1 by CIV in Cohort A Participants |
1.017 | — |
Eligibility Criteria
Inclusion Criteria
For the purposes of this study, neoadjuvant and/or adjuvant chemotherapy regimens do not count as a prior line of therapy.
For second line plus monotherapy (Parts 1 and 2):
- Has received at least one systemic treatment for metastatic breast cancer
- Has documented disease progression on or after the most recent therapy
- Prior treatment must include an anthracycline and a taxane in the neoadjuvant, adjuvant, or metastatic setting
For first line monotherapy (Part 1):
- Has received no prior systemic treatment for metastatic breast cancer
- Has PD-L1-positive mTNBC.
For second line plus monotherapy (Part 2):
- Has PD-L1 strong positive mTNBC
For all parts:
- Has mTNBC confirmed by a central laboratory
- For biomarker analysis, adequate newly obtained core or excisional biopsy of a not-previously-irradiated metastatic tumor lesion (mandatory)
- Has measurable metastatic disease
- Has Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1
- Female participants of childbearing potential should be willing to use 2 methods of birth control or be surgically sterile, or abstain from heterosexual activity for the course of the study through 120 days after the last dose of study treatment
- Male participants should agree to use an adequate method of contraception starting with the first dose of study treatment through 120 days after the last dose of study treatment
- Has adequate organ function
Exclusion Criteria
- Is currently participating and receiving study treatment, or has participated in a study of an investigational agent and received study therapy or used an investigational device within 4 weeks prior to study Day 1
- Has received prior anti-cancer monoclonal antibody (mAb) therapy for direct anti-neoplastic treatment within 4 weeks prior to study Day 1
- Has received prior chemotherapy, targeted small molecule therapy, or radiation therapy within at least 2 weeks prior to study Day 1
- Has not recovered (i.e., ≤ Grade 1 or at baseline) from adverse events due to agents administered within at least 2 weeks prior to study Day 1
- Has an active autoimmune disease requiring systemic treatment in past 2 years
- Has a diagnosis of immunodeficiency or receiving systemic steroid therapy or any other form of immunosuppressive therapy within 7 days prior to the first dose of study treatment
- Has known additional malignancy that progressed or required active treatment within the last 5 years. Exceptions include basal cell carcinoma of the skin, squamous cell carcinoma of the skin that has undergone potentially curative therapy, or in situ cervical cancer
- Has radiographically-detectable central nervous system (CNS) metastases and/or carcinomatous meningitis
- Has a history of (non-infectious) pneumonitis that required steroids or current pneumonitis or a history of interstitial lung disease
- Has an active infection requiring systemic therapy
- Has known psychiatric or substance abuse disorders that would interfere with cooperation with the requirements of the study
- Is pregnant, breastfeeding, or expecting to conceive or father children within the projected duration of the study, starting with the screening visit through 120 days after the last dose of study treatment
- Has received prior therapy with an anti-programmed cell death protein-1 (anti-PD-1), anti-PD-L1, anti-PD-L2 agent or with an agent directed to another co-inhibitory T-cell receptor (e.g. cytotoxic T-lymphocyte-associated protein-4 [CTLA-4], OX-40, CD137) or has participated in Merck MK-3475 (pembrolizumab) study
- Has a known history of human immunodeficiency virus (HIV)
- Has known active Hepatitis B or C
- Has received a live vaccine within 30 days of planned start of study treatment
Data sourced from ClinicalTrials.gov (NCT02447003). Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication. Informational only — not medical advice.