Dr. Bellmunt Discusses Follow-Up Data for Pembrolizumab vs Chemotherapy in Bladder Cancer

Joaquim Bellmunt, MD, PhD, associate professor of medicine, Harvard Medical School, director, Bladder Cancer Center, Dana-Farber Cancer Institute, discusses 2-year follow-up results from the phase III KEYNOTE-045 trial of pembrolizumab (Keytruda) versus chemotherapy in recurrent, advanced urothelial carcinoma during the 2018 Genitourinary Cancers Symposium.

The most important observation of these follow-up data is that 27% of patients that received pembrolizumab are still alive, compared with 14% of patients in the group assigned to receive chemotherapy.

At the 2-year follow-up, the hazard ratio has improved over the initial results, increasing from 0.73 to 0.70, showing that there is a 30% reduction in the risk of death in patients receiving pembrolizumab, Bellmunt says.

The initial results of the trial showed pembrolizumab had a superior response rate over chemotherapy, at 21% versus 11%. Investigators have now seen additional responses with subsequent follow-up, and the responses are durable. In the pembrolizumab arm, the median duration of response has not yet been reached, but is close to 50%. In the chemotherapy arm, the median duration of response is 4.5 months.

Bellmunt adds that investigators observed that additional duration of response may be even better in patients who are PD-L1 positive.