Publications by authors named "Patricia Marinello"

Previous analyses of the phase 2 KEYNOTE-087 (NCT02453594) trial of pembrolizumab monotherapy demonstrated effective antitumor activity with acceptable safety in patients with relapsed or refractory (R/R) classical Hodgkin lymphoma (cHL). However, long-term response durability and outcome of patients who receive a second course after treatment discontinuation after complete response (CR) remain of clinical interest. We present KEYNOTE-087 data after >5 years of median follow-up.

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Background: Pembrolizumab demonstrated durable clinical benefit and manageable safety in previously treated advanced or metastatic microsatellite instability-high (MSI-H)/mismatch repair deficient (dMMR) colorectal cancer (CRC) in the phase 2 KEYNOTE-164 study. Results from the final analysis are presented.

Methods: Eligible patients had unresectable or metastatic MSI-H/dMMR CRC and ≥2 prior systemic therapies (cohort A) or ≥1 prior systemic therapy (cohort B).

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  • * The final analysis presented a 41.5% overall response rate, with a median duration of response not reached, and 33% of patients remained progression-free after 4 years.
  • * Most patients experienced mild to moderate treatment-related side effects, such as neutropenia and hypothyroidism, with only a small percentage facing severe adverse events, highlighting pembrolizumab's long-term safety and effectiveness.
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The multicohort phase 1b KEYNOTE-013 study (NCT01953692) evaluated the safety and efficacy of pembrolizumab in patients with relapsed or refractory NHL who were ineligible for or failed hematopoietic cell transplantation (HCT). Patients received pembrolizumab (cohort 4) or pembrolizumab plus lenalidomide (cohort 5). Primary end points were safety and objective response rate (ORR) per IWG 2007 criteria.

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The phase 3 KEYNOTE-177 study evaluated pembrolizumab versus chemotherapy with or without bevacizumab or cetuximab in patients with newly diagnosed, microsatellite-instability-high (MSI-H)/mismatch-repair-deficient (dMMR) metastatic colorectal cancer (mCRC). Primary endpoints were progression-free survival (PFS) per RECIST v1.1 by blinded independent central review (BICR) and overall survival (OS).

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  • Pembrolizumab, a treatment for newly diagnosed microsatellite instability-high metastatic colorectal cancer, shows improved progression-free survival compared to traditional chemotherapy, but its impact on overall survival remained uncertain prior to this study.
  • The KEYNOTE-177 study was a phase 3, randomized trial conducted across 193 sites in 23 countries, enrolling patients with untreated metastatic colorectal cancer to compare pembrolizumab with standard chemotherapy regimens.
  • The trial aimed to evaluate overall survival and progression-free survival, contributing important data to the effectiveness of immunotherapy in this patient population.
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The phase 1b multicohort KEYNOTE-013 study assessed the safety and antitumor activity of pembrolizumab given at 10 mg/kg/day every 2 weeks for up to 2 years in hematologic malignancies, including myelodysplastic syndromes (MDS) refractory to a hypomethylating agent (HMA). Primary outcomes were safety and objective response rate per International Working Group 2006 criteria. By June 26, 2020, 28 patients were enrolled; median duration of follow-up was 5.

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  • Preclinical studies showed that combining an anti-PD-1 inhibitor with a CDK9 inhibitor can boost cancer-fighting effects while minimizing side effects, indicating a potential new treatment strategy.
  • The phase 1 KEYNOTE-155 trial tested this combination on patients with difficult-to-treat cancers like chronic lymphocytic leukemia, diffuse large B-cell lymphoma, and multiple myeloma, focusing on safety and effectiveness.
  • Out of 72 patients, the combination treatment was generally well tolerated, with observed response rates of 29.4% for chronic lymphocytic leukemia and 21.1% for diffuse large B-cell lymphoma, but no responses in multiple myeloma, highlighting a need for further research on this combination therapy
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  • The study analyzed the patterns of relapsed/refractory Hodgkin lymphoma (rrHL) in 409 patients, showing that about half experienced relapse within a year and over half were at advanced stages (III/IV) at the time of relapse.
  • A significant majority underwent high-dose chemotherapy and autologous stem-cell transplantation (ASCT), but many did not qualify due to low-risk disease or age-related factors, with 38 patients experiencing failed ASCT.
  • The overall 10-year progression-free survival (PFS) and overall survival (OS) rates after first relapse were 48.2% and 59.4%, respectively, revealing that patients with low-risk disease had much better survival outcomes, even without ASCT, while
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Aims: There is limited published evidence for the cost-effectiveness of treatments for unresectable or metastatic endometrial cancer (mEC). The objective of this analysis was to assess the cost-effectiveness of pembrolizumab versus chemotherapy for previously treated unresectable or mEC, in women whose tumors have deficient mismatch repair (dMMR) or high microsatellite instability (MSI-H). The analysis was carried out from a US healthcare payer perspective.

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The global, randomized, open-label KEYNOTE-183 phase 3 study was closed early after an interim analysis showed unfavorable risk-benefit when pembrolizumab was added to pomalidomide and dexamethasone in patients with relapsed or refractory multiple myeloma (MM). This subgroup analysis reported outcomes in 27 Japanese patients randomly assigned to receive pembrolizumab plus pomalidomide and dexamethasone (n = 15) or pomalidomide and dexamethasone alone (n = 12). Co-primary endpoints were progression-free survival (PFS) and overall survival (OS).

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Background: PD-1 blockade via pembrolizumab monotherapy has shown antitumour activity and toxicity in patients with relapsed or refractory classical Hodgkin lymphoma. Here, we present interim analyses from the KEYNOTE-204 study evaluating pembrolizumab versus brentuximab vedotin for relapsed or refractory classical Hodgkin lymphoma.

Methods: In this randomised, open-label, phase 3 study, patients aged 18 years or older with relapsed or refractory classical Hodgkin lymphoma with measurable disease and an Eastern Cooperative Oncology Group performance status of 0 or 1 who were ineligible for or had relapsed after autologous haematopoietic stem-cell transplantation (HSCT) were enrolled at 78 hospitals and cancer centres in 20 countries and territories.

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Background: Programmed death 1 (PD-1) blockade has clinical benefit in microsatellite-instability-high (MSI-H) or mismatch-repair-deficient (dMMR) tumors after previous therapy. The efficacy of PD-1 blockade as compared with chemotherapy as first-line therapy for MSI-H-dMMR advanced or metastatic colorectal cancer is unknown.

Methods: In this phase 3, open-label trial, 307 patients with metastatic MSI-H-dMMR colorectal cancer who had not previously received treatment were randomly assigned, in a 1:1 ratio, to receive pembrolizumab at a dose of 200 mg every 3 weeks or chemotherapy (5-fluorouracil-based therapy with or without bevacizumab or cetuximab) every 2 weeks.

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The phase III, randomized, active-controlled, multicenter, open-label KEYNOTE-183 study (NCT02576977) evaluating pomalidomide and low dose dexamethasone (standard-of-care [SOC]) with or without pembrolizumab in patients with refractory or relapsed and refractory multiple myeloma (rrMM) was placed on full clinical hold by the US FDA on July 03, 2017 due to an imbalance in the number of deaths between arms. Clinically-led subgroup analyses are typically used to shed light on clinical findings. However, this approach is not always successful.

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  • The KEYNOTE-185 study investigated the effects of adding pembrolizumab to a standard treatment for multiple myeloma in Japanese patients but was halted early due to safety concerns.
  • In a small group of 52 patients, the combination of pembrolizumab with lenalidomide and low-dose dexamethasone showed promising progression-free survival rates, with 6-month outcomes of 91.2% compared to 86.2% for the standard treatment.
  • However, the study's limitations include a short follow-up period of 7.2 months and a small sample size, raising questions about the applicability of the findings to the larger population.
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The KEYNOTE-013 study was conducted to evaluate pembrolizumab monotherapy in hematologic malignancies; classical Hodgkin lymphoma (cHL) was an independent expansion cohort. We present long-term results based on >4 years of median follow-up for the cHL cohort. The trial enrolled cHL patients who experienced relapse after, were ineligible for, or declined autologous stem cell transplantation and experienced progression with or did not respond to brentuximab vedotin.

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Purpose: KEYNOTE-164 (NCT02460198) evaluated the antitumor activity of pembrolizumab in previously treated, metastatic, microsatellite instability-high/mismatch repair-deficient (MSI-H/dMMR) colorectal cancer (CRC).

Methods: This phase II open-label study involved 128 centers worldwide. Eligible patients were age ≥ 18 years and had metastatic MSI-H/dMMR CRC treated with ≥ 2 prior lines of standard therapy, including fluoropyrimidine, oxaliplatin, and irinotecan with or without anti-vascular endothelial growth factor/epidermal growth factor receptor monoclonal antibody (cohort A) or ≥ 1 prior line of therapy (cohort B).

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  • The KEYNOTE-185 trial studied the addition of pembrolizumab to the standard treatment of lenalidomide and dexamethasone in newly diagnosed, transplant-ineligible multiple myeloma patients to evaluate potential increases in treatment efficacy.
  • This phase 3 trial involved 301 participants from 15 countries, and randomly assigned them to receive either the combination of the three drugs or just lenalidomide and dexamethasone.
  • An unplanned interim analysis was conducted to assess the combination's safety and effectiveness, particularly focusing on progression-free survival due to early termination of the trial as requested by the FDA.
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Background: Pomalidomide and dexamethasone is a standard of care for patients with multiple myeloma in whom bortezomib and lenalidomide treatment has failed. KEYNOTE-183 assessed efficacy and safety of pomalidomide and dexamethasone with or without pembrolizumab in patients with relapsed or refractory multiple myeloma. Here, we present the findings of an unplanned, ad-hoc interim analysis at the request of the US Food and Drug Administration (FDA).

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Increased levels of NeuGc-containing gangliosides have been described in human breast cancer. A controlled Phase II clinical trial was conducted in patients with metastatic breast cancer to evaluate immunogenicity, safety and to identify evidences of biological activity of a cancer vaccine composed by NeuGcGM3 in a proteoliposome of Neisseria meningitidis together with Montanide ISA 51 as adjuvant. After first line chemotherapy, 79 women were randomized 1:1 to receive the vaccine candidate or best supportive care.

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