Phase 2 study of pembrolizumab in patients with recurrent and residual high-grade meningiomas.

Phase 2 study of pembrolizumab in patients with recurrent and residual high-grade meningiomas.
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pembrolizumab在复发和残留高度脑膜瘤患者中的2阶段研究。

DOI:
10.1038/s41467-022-29052-7
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发表时间:
2022-03-14
影响因子:
16.6
通讯作者:
Santagata S
Santagata S
中科院分区:
综合性期刊1区
文献类型:
--
作者:
Brastianos PK;Kim AE;Giobbie-Hurder A;Lee EQ;Wang N;Eichler AF;Chukwueke U;Forst DA;Arrillaga-Romany IC;Dietrich J;Corbin Z;Moliterno J;Baehring J;White M;Lou KW;Larson J;de Sauvage MA;Evancic K;Mora J;Nayyar N;Loeffler J;Oh K;Shih HA;Curry WT;Cahill DP;Barker FG;Gerstner ER;Santagata S

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高级别脑膜瘤与神经认知发病相关,且治疗方法有限。高级别脑膜瘤具有免疫抑制性肿瘤微环境 (TME),程序性死亡配体 1 (PD-L1) 表达可能导致其侵袭性表型。在此,我们介绍了一项单臂、开放标签 2 期试验 (NCT03279692) 的结果,该试验评估了 PD-1 抑制剂派姆单抗 (pembrolizumab) 在 25 名可评估的复发性和进展性 2 级和 3 级脑膜瘤患者中的疗效。主要终点是 6 个月时存活且无进展的患者比例 (PFS-6)。次要终点包括无进展生存期和总生存期、最佳颅内反应和毒性。我们的研究已达到主要终点,PFS-6 率为 0.48(90% 准确 CI:0.31-0.66),中位 PFS 为 7.6 个月(90% CI:3.4-12.9 个月)。 20% 的患者经历过一种(或多种)3 级或更高级别的治疗相关不良事件。这些结果表明派姆单抗对这些肿瘤的一部分具有良好的疗效。需要进一步的研究来确定脑膜瘤 TME 中可能驱动免疫疗法反应的生物学方面。高级别脑膜瘤预后较差,几乎没有有效的全身治疗方法。在此,作者报告了一项 2 期临床试验的结果,该试验证明了 PD-1 抑制剂派姆单抗 (pembrolizumab) 在复发性和残留性高级别脑膜瘤患者中的安全性和活性。
High-grade meningiomas are associated with neuro-cognitive morbidity and have limited treatments. High-grade meningiomas harbor an immunosuppressive tumor microenvironment (TME) and programmed death-ligand 1 (PD-L1) expression may contribute to their aggressive phenotype. Here, we present the results of a single-arm, open-label phase 2 trial (NCT03279692) evaluating the efficacy of pembrolizumab, a PD-1 inhibitor, in a cohort of 25 evaluable patients with recurrent and progressive grade 2 and 3 meningiomas. The primary endpoint is the proportion of patients alive and progression-free at 6 months (PFS-6). Secondary endpoints include progression-free and overall survival, best intracranial response, and toxicity. Our study has met its primary endpoint and achieved a PFS-6 rate of 0.48 (90% exact CI: 0.31–0.66) and a median PFS of 7.6 months (90% CI: 3.4–12.9 months). Twenty percent of patients have experienced one (or more) grade-3 or higher treatment-related adverse events. These results suggest that pembrolizumab exerts promising efficacy on a subset of these tumors. Further studies are needed to identify the biological facets within the meningioma TME that may drive response to immune-based therapies. High-grade meningiomas have a poor prognosis with virtually no effective systemic therapies. Here, the authors report results of a phase 2 clinical trial demonstrating safety and activity of pembrolizumab, a PD-1 inhibitor, in patients with recurrent and residual high-grade meningiomas.
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