Journal
NEW ENGLAND JOURNAL OF MEDICINE
Volume 378, Issue 19, Pages 1789-1801Publisher
MASSACHUSETTS MEDICAL SOC
DOI: 10.1056/NEJMoa1802357
Keywords
-
Categories
Funding
- Merck
- Actelion
- Agenus
- Bayer
- Bristol-Myers Squibb (BMS)
- GlaxoSmithKline (GSK)
- ISA Pharmaceuticals
- HalioDX
- MedImmune
- Merck Serono
- Merck Sharpe and Dohme (MSD)
- Nektar
- Sanofi
- BMS
- Novartis
- GSK
- Lilly
- MSD
- Pfizer
- Roche
- Array
- Amgen
- Pierre Fabre
- Incyte
- Pierre-Fabre
- Eisai
- Kymab
- Roche-Genentech
- Larkin
- Secarna
- EUSA Pharma
- Isdin
- Genmab
- NewLink Genetics
- Syndax
- AstraZeneca
- Blueprint Medicines
- Boehringer Ingelheim
- MerckEMD
- Medicament
- Merck-Pfizer
- Sun Pharma
- Johnson Johnson
- Philiogen
Ask authors/readers for more resources
BACKGROUND The programmed death 1 (PD-1) inhibitor pembrolizumab has been found to prolong progression-free and overall survival among patients with advanced melanoma. We conducted a phase 3 double-blind trial to evaluate pembrolizumab as adjuvant therapy in patients with resected, high-risk stage III melanoma. METHODS Patients with completely resected stage III melanoma were randomly assigned (with stratification according to cancer stage and geographic region) to receive 200 mg of pembrolizumab (514 patients) or placebo (505 patients) intravenously every 3 weeks for a total of 18 doses (approximately 1 year) or until disease recurrence or unacceptable toxic effects occurred. Recurrence-free survival in the overall intention-to-treat population and in the subgroup of patients with cancer that was positive for the PD-1 ligand (PD-L1) were the primary end points. Safety was also evaluated. RESULTS At a median follow-up of 15 months, pembrolizumab was associated with significantly longer recurrence-free survival than placebo in the overall intention-to-treat population (1-year rate of recurrence-free survival, 75.4% [95% confidence interval {CI}, 71.3 to 78.9] vs. 61.0% [95% CI, 56.5 to 65.1]; hazard ratio for recurrence or death, 0.57; 98.4% CI, 0.43 to 0.74; P < 0.001) and in the subgroup of 853 patients with PD-L1-positive tumors (1-year rate of recurrence-free survival, 77.1% [95% CI, 72.7 to 80.9] in the pembrolizumab group and 62.6% [95% CI, 57.7 to 67.0] in the placebo group; hazard ratio, 0.54; 95% CI, 0.42 to 0.69; P < 0.001). Adverse events of grades 3 to 5 that were related to the trial regimen were reported in 14.7% of the patients in the pembrolizumab group and in 3.4% of patients in the placebo group. There was one treatment-related death due to myositis in the pembrolizumab group. CONCLUSIONS As adjuvant therapy for high-risk stage III melanoma, 200 mg of pembrolizumab administered every 3 weeks for up to 1 year resulted in significantly longer recurrence-free survival than placebo, with no new toxic effects identified.
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available