Pembrolizumab in microsatellite instability high or mismatch repair deficient cancers: updated analysis from the phase II KEYNOTE-158 study.

BACKGROUND: Pembrolizumab demonstrated durable antitumor activity in 233 patients with previously treated advanced microsatellite instability high (MSI-H) or mismatch repair deficient (dMMR) advanced solid tumors in the phase II multicohort KEYNOTE-158 (NCT02628067) study. Herein, we report safety and efficacy outcomes with longer follow-up for more patients with previously treated advanced MSI-H/dMMR noncolorectal cancers who were included in cohort K of the KEYNOTE-158 (NCT02628067) study. PATIENTS AND METHODS: Eligible patients with previously treated advanced noncolorectal MSI-H/dMMR solid tumors, measurable disease as per RECIST v1.1, and Eastern Cooperative Oncology Group performance status of 0 or 1 received pembrolizumab 200 mg Q3W for 35 cycles or until disease progression or unacceptable toxicity. The primary endpoint was objective response rate (ORR) as per RECIST v1.1 by independent central radiologic review. RESULTS: Three hundred and fifty-one patients with various tumor types were enrolled in KEYNOTE-158 cohort K. The most common tumor types were endometrial (22.5%), gastric (14.5%), and small intestine (7.4%). Median time from first dose to database cut-off (5 October 2020) was 37.5 months (range, 0.2-55.6 months). ORR among 321 patients in the efficacy population (patients who received ≥1 dose of pembrolizumab enrolled ≥6 months before the data cut-off date) was 30.8% [95% confidence interval (CI) 25.8% to 36.2%]. Median duration of response was 47.5 months (range, 2.1+ to 51.1+ months; '+' indicates no progressive disease by the time of last disease assessment). Median progression-free survival was 3.5 months (95% CI 2.3-4.2 months) and median overall survival was 20.1 months (95% CI 14.1-27.1 months). Treatment-related adverse events (AEs) occurred in 227 patients (64.7%). Grade 3-4 treatment-related AEs occurred in 39 patients (11.1%); 3 (0.9%) had grade 5 treatment-related AEs (myocarditis, pneumonia, and Guillain-Barre syndrome, n = 1 each). CONCLUSIONS: Pembrolizumab demonstrated clinically meaningful and durable benefit, with a high ORR of 30.8%, long median duration of response of 47.5 months, and manageable safety across a range of heavily pretreated, advanced MSI-H/dMMR noncolorectal cancers, providing support for use of pembrolizumab in this setting.

[Eribulin in the treatment for metastatic breast cancer].

Eribulin is a novel antimicrotubule drug, which is approved in the second line treatment of advanced breast cancer in patients who received anthracyclines and taxanes. The article presents the results of two huge phase III clinical trials (301, 305) and their pooled analysis. Eribulin monotherapy demonstates staistically significant improved overall survival compared to standart treatments (15.2 mnths vs 12.8 mnths, p = 0.03 in pooled analysis). Certain subgroups of patients--Her2-negative and triple-negative have the most survival benefit. According to own experience with Eribulin inside the clinical trials, presented in the article, the drug is effective and well tolerated even by older patients.

[Analysis of the -238(G/A)TNF polymorphism in breast cancer patients].

TNF is an inflammatory cytokine that involved in pathogenesis of different malignancies. Promoter single nucleotide polymorphism -238(G/A)TNF (rs361525) is investigated for the detection of susceptibility to the infectious, autoimmune and oncological diseases. The goal of the study was to investigate the association of-238(G/A)TNF polymorphism (rs361525) with breast cancer (BC) prognosis. -238(G/A) TNF allelic variants were detected by PCR-RFLP. We failed to reveal the genotype distributions disparity among groups with different stages of the disease, ER, PR or Her2/neu positive versus negative status. The AG genotype frequency was about 10% and there were no BC patients with AA genotype in all separated groups. However the overall survival was significantly lower for AG then for GG carriers with II stage or ER-positive BC. Our data suggest that -238(G/A)TNF polymorphism perhaps is not involved in the initiation of malignancies but it is a substantial factor of BC prognosis.

Antitumor activity of specific immunotherapy with mucin containing CA 125 antigen in mice with CaO 1 ovarian carcinoma.

Experiments in CBA mice with transplanted CaO 1 ovarian carcinoma possessing common antigenic determinants with human ovarian carcinoma showed that specific immunotherapy with mucin containing CA 125 antigen inhibited tumor growth by 60% and prolonged animal lifespan by 40-60% in comparison with the control. The correlation coefficient between the tumor size and antibody titer after injection of mucin was -0.4 for IgM and -0.6 for IgG. Titration of IgG may be used for monitoring of the efficiency of specific immunotherapy.

Immunotoxicological characteristics of preparations based on carcinoembryonic antigen and mucin containing CA 125 antigen.

Experiments on male hybrid mice demonstrated that specific immunotherapy with preparations based on carcinoembryonal antigen and mucin containing CA 125 antigen was not associated with general toxicity, local irritating effect, and hepatorenal dysfunction. The absence of toxicity is apparently due to the fact that antigens injected intramuscularly or subcutaneously virtually do not enter the blood. Injections of preparations based on carcinoembryonal antigen and mucin containing CA 125 antigen to mice induced a standard immune response with predominance of class M immunoglobulins during the early terms and class G immunoglobulins at later terms.