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Pembrolizumab Plus Olaparib for Patients With Previously Treated and Biomarker-Unselected Metastatic Castration-Resistant Prostate Cancer: The Randomized, Open-Label, Phase III KEYLYNK-010 Trial.


ABSTRACT:

Purpose

There is an unmet need for therapeutic options that prolong survival for patients with heavily pretreated, metastatic castration-resistant prostate cancer (mCRPC). The phase III, open-label KEYLYNK-010 study evaluated pembrolizumab plus olaparib versus a next-generation hormonal agent (NHA) for biomarker-unselected, previously treated mCRPC.

Methods

Eligible participants had mCRPC that progressed on or after abiraterone or enzalutamide (but not both) and docetaxel. Participants were randomly assigned (2:1) to pembrolizumab plus olaparib or NHA (abiraterone or enzalutamide). The dual primary end points were radiographic progression-free survival (rPFS) by blinded independent central review per Prostate Cancer Working Group-modified RECIST 1.1 and overall survival (OS). Time to first subsequent therapy (TFST) was a key secondary end point. Safety and objective response rate (ORR) were secondary end points.

Results

Between May 30, 2019, and July 16, 2021, 529 participants were randomly assigned to pembrolizumab plus olaparib and 264 to NHA. At final rPFS analysis, median rPFS was 4.4 months (95% CI, 4.2 to 6.0) with pembrolizumab plus olaparib and 4.2 months (95% CI, 4.0 to 6.1) with NHA (hazard ratio [HR], 1.02 [95% CI, 0.82 to 1.25]; P = .55). At final OS analysis, median OS was 15.8 months (95% CI, 14.6 to 17.0) and 14.6 months (95% CI, 12.6 to 17.3), respectively (HR, 0.94 [95% CI, 0.77 to 1.14]; P = .26). At final TFST analysis, median TFST was 7.2 months (95% CI, 6.7 to 8.1) versus 5.7 months (95% CI, 5.0 to 7.1), respectively (HR, 0.86 [95% CI, 0.71 to 1.03]). ORR was higher with pembrolizumab plus olaparib versus NHA (16.8% v 5.9%). Grade ≥3 treatment-related adverse events occurred in 34.6% and 9.0% of participants, respectively.

Conclusion

Pembrolizumab plus olaparib did not significantly improve rPFS or OS versus NHA in participants with biomarker-unselected, heavily pretreated mCRPC. The study was stopped for futility. No new safety signals occurred.

SUBMITTER: Antonarakis ES 

PROVIDER: S-EPMC10419579 | biostudies-literature | 2023 Aug

REPOSITORIES: biostudies-literature

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Publications

Pembrolizumab Plus Olaparib for Patients With Previously Treated and Biomarker-Unselected Metastatic Castration-Resistant Prostate Cancer: The Randomized, Open-Label, Phase III KEYLYNK-010 Trial.

Antonarakis Emmanuel S ES   Park Se Hoon SH   Goh Jeffrey C JC   Shin Sang Joon SJ   Lee Jae Lyun JL   Mehra Niven N   McDermott Ray R   Sala-Gonzalez Núria N   Fong Peter C PC   Greil Richard R   Retz Margitta M   Sade Juan Pablo JP   Yanez Patricio P   Huang Yi-Hsiu YH   Begbie Stephen D SD   Gafanov Rustem Airatovich RA   De Santis Maria M   Rosenbaum Eli E   Kolinsky Michael P MP   Rey Felipe F   Chiu Kun-Yuan KY   Roubaud Guilhem G   Kramer Gero G   Sumitomo Makoto M   Massari Francesco F   Suzuki Hiroyoshi H   Qiu Ping P   Zhang Jinchun J   Kim Jeri J   Poehlein Christian H CH   Yu Evan Y EY  

Journal of clinical oncology : official journal of the American Society of Clinical Oncology 20230608 22


<h4>Purpose</h4>There is an unmet need for therapeutic options that prolong survival for patients with heavily pretreated, metastatic castration-resistant prostate cancer (mCRPC). The phase III, open-label KEYLYNK-010 study evaluated pembrolizumab plus olaparib versus a next-generation hormonal agent (NHA) for biomarker-unselected, previously treated mCRPC.<h4>Methods</h4>Eligible participants had mCRPC that progressed on or after abiraterone or enzalutamide (but not both) and docetaxel. Partici  ...[more]

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