Reference Detail

Ref Type

PMID

Authors

MA Burgess, V Bolejack, BA Van Tine, S Schuetze, J Hu, SP D'Angelo, S Attia, DA Priebat, SH Okuno, RF Riedel, LE Davis, S Movva, DR Reed, LH Butterfield, J Roszik, DK Reinke, LH Baker, RG Maki, S Patel, HA Tawbi

Title

Multicenter phase II study of pembrolizumab (P) in advanced soft tissue (STS) and bone sarcomas (BS): Final results of SARC028 and biomarker analyses.

Journal	Vol	Issue	Date	Pages	Journal Short Title
J Clin Oncol	35	no. 15_suppl

URL

http://meetinglibrary.asco.org/record/145286/abstract

Abstract Text

Background: SARC028 is the first multicenter Phase II study of P monotherapy in patients (pts) with STS and BS. Designed to detect clinical efficacy signals in multiple histologies, the study collected blood & tissue samples on all pts. We report extended clinical follow-up and in-depth biomarker correlates of response. Methods: The primary endpoint was objective response rate (ORR) by RECIST 1.1. Secondary endpoints were safety, 12 wk progression-free survival (PFS), and overall survival (OS). The STS arm had 10 pts in each of 4 cohorts: undifferentiated pleomorphic sarcoma (UPS), dedifferentiated liposarcoma (DDLPS), synovial sarcoma (SS) and leiomyosarcoma (LMS). The BS arm included 40 pts with osteosarcoma (OS), Ewing sarcoma (ES) or dedifferentiated chondrosarcoma (CS). Pre- and on-P biopsies were required as well as blood at multiple time points. Tumor was assessed for PD-L1 expression (clone 22C3) and immune infiltrates by multi-color IHC (Vectra). Ongoing analyses include circulating cytokine and checkpoint levels and exome (DNA), transcriptome (RNA), and T-cell receptor (TCR) sequencing. Results: 86 pts were enrolled, 80 were evaluable for response. For STS, median follow-up was 14.5 months. The ORR in the overall STS cohort was 18% and the 12-wk PFS 55% [95% CI, 42-71]). Clinical activity was variable by histologic subtype with 40% ORR in UPS (1 CR and 3PR out of 10 evaluable pts), 2 PR/10 were seen in DDLPS, 1PR/10 in SS and 0/10 in LMS. For BS, median follow-up was 12.3 months (ORR 5%; 12-wk PFS 28% [95% CI, 14-41]), with 1PR/22 OS, 1PR/5 CS and 0/13 ES. 70 pre-P tissues were analyzed (11 excluded for insufficiency), with PD-L1+ in 3/70 (4%); all 3 were UPS. Of the 2 evaluable pts, 1 had CR and 1 PR. 2 OS were PD-L1+ on multi-color IHC, 1 had PR. All PD-L1+ samples had CD8+ T-cell infiltration. There were no post-P PD-L1+ samples. Conclusions: P has clinical activity in UPS and LPS, and expansion cohorts in those subtypes are planned. Pre-treatment PD-L1 expression was infrequent, but correlated with T-cell infiltration and response in UPS & OS. Ongoing biomarker analyses that may guide combination strategies are ongoing and will be presented at the meeting. Clinical trial information: NCT02301039.

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Molecular Profile	Treatment Approach

Gene Name	Source	Synonyms	Protein Domains	Gene Description	Gene Role

Therapy Name	Drugs	Efficacy Evidence	Clinical Trials

Drug Name	Trade Name	Synonyms	Drug Classes	Drug Description

Gene	Variant	Impact	Protein Effect	Variant Description	Associated with drug Resistance

Molecular Profile	Indication/Tumor Type	Response Type	Therapy Name	Approval Status	Evidence Type	Efficacy Evidence	References
CD274 positive	osteosarcoma	sensitive	Pembrolizumab	Case Reports/Case Series	Actionable	In a Phase II trial, Keytruda (pembrolizumab) treatment resulted in 1 partial response in 2 patients with CD274 (PD-L1)-positive osteosarcoma (J Clin Oncol 35, no. 15_suppl (May 20, 2017) 11008; NCT02301039).	detail...
CD274 positive	fibrous histiocytoma	sensitive	Pembrolizumab	Case Reports/Case Series	Actionable	In a Phase II trial, Keytruda (pembrolizumab) treatment resulted in 1 complete response and 1 partial response in 3 patients with CD274 (PD-L1)-positive undifferentiated pleomorphic sarcoma (malignant fibrous histiocytoma) (J Clin Oncol 35, no. 15_suppl (May 20, 2017) 11008; NCT02301039).	detail...