Efficacy and Safety of Pembrolizumab for Heavily Pretreated Patients With Advanced, Metastatic Adenocarcinoma or Squamous Cell Carcinoma of the Esophagus
Pembrolizumab provides modest but durable antitumor activity with a manageable safety profile in patients with heavily pretreated metastatic esophageal cancer.
This phase 2, open‑label, single‑arm KEYNOTE‑180 study evaluated the safety and efficacy of pembrolizumab in 121 heavily pretreated patients with advanced metastatic esophageal carcinoma (adenocarcinoma or squamous cell carcinoma) that progressed after ≥2 lines of systemic therapy. Pembrolizumab 200 mg IV every 3 weeks was administered until disease progression, unacceptable toxicity, or withdrawal. The primary endpoint was objective response rate (ORR) per RECIST 1.1. ORR was 9.9 % (12/121) overall; 14.3 % (9/63) for squamous cell carcinoma (ESCC) and 5.2 % (3/58) for adenocarcinoma. Median duration of response was not reached (range 1.9–14.4 mo). Treatment‑related grade 3‑5 adverse events occurred in 12.4 % of patients, with 4.1 % discontinuing due to toxicity and one treatment‑related death from pneumonitis.
Esophageal cancer has limited therapeutic options after second‑line therapy. Demonstrating that pembrolizumab can elicit objective responses and acceptable toxicity offers a new potential treatment strategy and supports further investigation in larger, randomized trials.
Evidence level: Állatkísérletes. Állatmodellben vizsgálták.
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