Johns Hopkins Kimmel Cancer Center, 1800 Orleans Street, Baltimore, MD 21287, USA.
Melanoma Institute Australia, The University of Sydney, and Royal North Shore and Mater Hospitals, 40 Rocklands Road North Sydney, Sydney, NSW 2060, Australia.
Eur J Cancer. 2024 Mar;199:113530. doi: 10.1016/j.ejca.2024.113530. Epub 2024 Jan 11.
BACKGROUND: Pembrolizumab has a manageable safety profile as described in its label, which was primarily based on 2799 patients who participated in clinical trials for melanoma or non-small cell lung cancer. Here, we evaluated the safety of pembrolizumab in a broader population of patients from 31 advanced cancer clinical trials across 19 cancer types. METHODS: Safety was analyzed in patients who received at least one dose of pembrolizumab (200 mg every 3 weeks [Q3W], 10 mg/kg Q2W or Q3W, or 2 mg/kg Q3W). Adverse events (AEs) and immune-mediated AEs and infusion reactions were evaluated. RESULTS: Safety data from 8937 patients in 31 trials of pembrolizumab monotherapy were pooled (median, seven administrations; range, 1-59). Median duration on treatment was 4.1 months (range, 0.03-40.1). AEs occurred in 96.6% of patients. Grade 3-5 AEs occurred in 50.6% of patients. AEs led to pembrolizumab discontinuation in 12.7% of patients and death in 5.9%. Immune-mediated AEs and infusion reactions occurred in 23.7% of patients (4.6% experienced multiple immune-mediated AEs/infusion reactions) and led to pembrolizumab discontinuation in 3.6% and death in 0.2%. Grade 3-5 immune-mediated AEs occurred in 6.3% of patients. Serious immune-mediated AEs and infusion reactions occurred in 6.0% of patients. Median time to immune-mediated AE onset was 85 days (range, 13-163). Of 2657 immune-mediated AEs, 22.3% were initially treated with prednisone ≥ 40 mg/day or equivalent, and 8.3% were initially treated with lower steroid doses. CONCLUSIONS: This pooled analysis of 31 clinical trials showed that pembrolizumab has a consistent safety profile across indications.
背景:派姆单抗的安全性特征在其标签中已有描述,主要基于参与黑色素瘤或非小细胞肺癌临床试验的 2799 例患者数据。在此,我们评估了派姆单抗在来自 19 种癌症类型 31 项晚期癌症临床试验更广泛患者人群中的安全性。
方法:对至少接受过一次派姆单抗治疗(每 3 周 200mg[Q3W]、每 2 周 10mg/kg 或 Q3W、或每 3 周 2mg/kg)的患者进行安全性分析。评估不良事件(AE)、免疫介导的 AE 和输液反应。
结果:对来自 31 项派姆单抗单药治疗试验的 8937 例患者的安全性数据进行了汇总(中位治疗 7 次;范围 1-59)。中位治疗持续时间为 4.1 个月(范围 0.03-40.1)。96.6%的患者发生 AE。50.6%的患者发生 3-5 级 AE。12.7%的患者因 AE 而停用派姆单抗,5.9%的患者因 AE 而死亡。23.7%的患者发生免疫介导的 AE 和输液反应(4.6%的患者发生多次免疫介导的 AE/输液反应),3.6%的患者因 AE 而停用派姆单抗,0.2%的患者因 AE 而死亡。6.3%的患者发生 3-5 级免疫介导的 AE。6.0%的患者发生严重免疫介导的 AE 和输液反应。免疫介导的 AE 发生中位时间为 85 天(范围 13-163)。在 2657 例免疫介导的 AE 中,22.3%的患者初始接受泼尼松≥40mg/天或等效剂量治疗,8.3%的患者初始接受较低剂量的类固醇治疗。
结论:本汇总分析来自 31 项临床试验,表明派姆单抗在各适应证中的安全性特征一致。
Front Pharmacol. 2017-10-18