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dewophile

10/22/18 1:48 PM

#221550 RE: DewDiligence #221548

Keytruda monotherapy bests chemo in OS for PD-L1+ subgroup even though ORR and PFS were worse than chemo arm in that subgroup!



not the first time w PD-1s

DewDiligence

05/31/19 9:30 AM

#225120 RE: DewDiligence #221548

MRK—Final-OS/PFS data from KEYNOTE-048 in H&N cancer:

https://www.businesswire.com/news/home/20190531005104/en

The new findings presented today from the final analysis showed that KEYTRUDA in combination with chemotherapy (carboplatin or cisplatin plus 5-FU) reduced the risk of death by 40% in patients whose tumors expressed PD-L1 with CPS≥20, demonstrating significantly longer [median] OS (14.7 months [95% CI, 10.3-19.3]) compared with the EXTREME regimen (cetuximab with carboplatin or cisplatin plus 5-fluorouracil [5-FU]), the current standard of care (11.0 months [95% CI, 9.2-13.0]) (HR=0.60 [95% CI, 0.45-0.82]; p=0.0004).

For the dual primary endpoint of progression-free survival (PFS), statistical significance was not achieved for KEYTRUDA in combination with chemotherapy in the CPS≥20 population compared with the EXTREME regimen (HR=0.73 [95% CI, 0.55-.97]; p=0.0162).

New findings for the CPS ≥1 population showed KEYTRUDA in combination with chemotherapy reduced the risk of death by 35% in these patients, with significantly longer [median] OS (13.6 months [95% CI, 10.7-15.5]) compared with the EXTREME regimen (10.4 months [95% CI, 9.1-11.7]) (HR=0.65 [95% CI, 0.53-0.80]; p<0.0001). Per the sequential testing strategy, superiority for PFS was not tested in this population (HR=0.82 [95% CI, 0.67-1.00]).

Results for OS with KEYTRUDA monotherapy in the total population were consistent with the previously presented interim analysis, where non-inferiority was demonstrated (HR=0.83 [95% CI, 0.70-0.99]; p=0.0199), with a median OS of 11.5 months (95% CI, 10.3-13.4) for KEYTRUDA monotherapy in the total population compared with 10.7 months (95% CI, 9.3-11.7) for the EXTREME regimen. There was no difference in PFS between KEYTRUDA monotherapy in the total population and the EXTREME regimen (HR=1.34 [95% CI, 1.13-1.59]).

The PDUFA date for the sBLA based on these data is 6/10/19.