Phase Ib/II Clinical Trial of Pembrolizumab With Bevacizumab for Metastatic Renal Cell Carcinoma: BTCRC-GU14-003.

Purpose: We hypothesized that bevacizumab will potentiate activity of pembrolizumab. We conducted a phase Ib/II, single-arm, multisite clinical trial of the combination in metastatic renal cell carcinoma (RCC).Patients and Methods: Patients with metastatic clear cell RCC who experienced progression...

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Published in:Journal of Clinical Oncology Vol. 38; no. 11; pp. 1138 - 1147
Main Authors: Dudek, Arkadiusz Z., Liu, Li C., Gupta, Shilpa, Logan, Theodore F., Singer, Eric A., Joshi, Monika, Zakharia, Yousef N., Lang, Joshua M., Schwarz, James K., Al-Janadi, Anas, Alva, Ajjai S.
Format: research Journal Article
Published: American Society of Clinical Oncology 4/10/2020
Online Access:View this record in EBSCOhost
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      dt: 4/10/2020
      vid: 38
      iid: 11
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      pub: American Society of Clinical Oncology
      place: Alexandria, Virginia
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        10.1200/JCO.19.02394
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        atl: Phase Ib/II Clinical Trial of Pembrolizumab With Bevacizumab for Metastatic Renal Cell Carcinoma: BTCRC-GU14-003.
      aug:
        au:
          Dudek, Arkadiusz Z.
          Liu, Li C.
          Gupta, Shilpa
          Logan, Theodore F.
          Singer, Eric A.
          Joshi, Monika
          Zakharia, Yousef N.
          Lang, Joshua M.
          Schwarz, James K.
          Al-Janadi, Anas
          Alva, Ajjai S.
        affil: Division of Hematology/Oncology, Department of Medicine, University of Illinois at Chicago, Chicago, IL
      sug:
        subj:
          Kidney Neoplasms Drug Therapy
          Carcinoma, Renal Cell Drug Therapy
          Antineoplastic Agents, Combined Therapeutic Use
          Carcinoma, Renal Cell Pathology
          Kidney Neoplasms Mortality
          Middle Age
          Neoplasm Metastasis
          Aged, 80 and Over
          Male
          Antibodies, Monoclonal Adverse Effects
          Female
          Aged
          Antibodies, Monoclonal Administration and Dosage
          Adult
          Kidney Neoplasms Pathology
          Carcinoma, Renal Cell Mortality
          Human
          Validation Studies
          Comparative Studies
          Evaluation Research
          Multicenter Studies
          Scales
          Middle Aged: 45-64 years
          Aged, 80 & over
          Aged: 65+ years
          Adult: 19-44 years
          Male
          Female
      ab: Purpose: We hypothesized that bevacizumab will potentiate activity of pembrolizumab. We conducted a phase Ib/II, single-arm, multisite clinical trial of the combination in metastatic renal cell carcinoma (RCC).Patients and Methods: Patients with metastatic clear cell RCC who experienced progression after at least one systemic therapy (phase Ib) or were treatment naïve (phase II) were enrolled. In phase Ib, pembrolizumab (200 mg) and bevacizumab (10 or 15 mg/kg) were given intravenously every 3 weeks. The primary end point for phase II was overall response rate (ORR). With an 80% statistical power and a type I error probability of 0.1, 48 patients were to be accrued to detect an ORR of 42%.Results: Thirteen patients (ages 33-68 years; median, 55 years) were enrolled in the phase Ib study. No dose-limiting toxicities were reported. Pembrolizumab 200 mg and bevacizumab 15 mg/kg were chosen for phase II. Forty-eight patients (ages 42-84 years; median age, 61 years; 33 males) were accrued for the phase II study. The primary end point was met, with the ORR reaching 60.9% (95% CI, 45.4% to 74.9%), consisting of 1 complete response (CR), 2 CRs in target lesions, 25 partial responses, 18 responses of stable disease, 2 unevaluable responses. Median progression-free survival was 20.7 months (95% CI, 11.3 to 27.4 months). Median overall survival was not reached at the median follow-up of 28.3 months. The most common treatment-related grade 3 toxicities were hypertension and proteinuria. There were two grade 4 toxicities: duodenal ulcer and hyponatremia. Presence of tumor-infiltrating T cells, but not programmed death-ligand 1 expression, in tumor tissue correlated with response.Conclusion: The combination of 200 mg of pembrolizumab and a 15 mg/kg dose of bevacizumab given every 3 weeks is safe and active in metastatic RCC.
      pubtype: Academic Journal
      doctype:
        research
        Journal Article
      ougenre: Article
    language: English
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