Head and Neck Cancer - oncologynursingbrazil.com.br · Head and Neck Cancer Author: William...
Transcript of Head and Neck Cancer - oncologynursingbrazil.com.br · Head and Neck Cancer Author: William...
![Page 1: Head and Neck Cancer - oncologynursingbrazil.com.br · Head and Neck Cancer Author: William Jr,William Nassib Created Date: 10/10/2017 10:48:37 AM ...](https://reader036.fdocuments.in/reader036/viewer/2022071213/603e8829b815b04ad41556a8/html5/thumbnails/1.jpg)
Immune Checkpoint Inhibitors for Head and Neck CancersWilliam N. William Jr.
Diretor de Onco-Hematologia
Hospital BP, A Beneficência Portuguesa
![Page 2: Head and Neck Cancer - oncologynursingbrazil.com.br · Head and Neck Cancer Author: William Jr,William Nassib Created Date: 10/10/2017 10:48:37 AM ...](https://reader036.fdocuments.in/reader036/viewer/2022071213/603e8829b815b04ad41556a8/html5/thumbnails/2.jpg)
Outline
• Immunotherapy for recurrent / metastatic HNSCC
• Keynote-012 clinical data (pembrolizumab)
• Keynote-055 (pembrolizumab)
• Keynote-012 biomarker data (pembrolizumab)
• Keynote-040
• Checkmate 141 (nivolumab)
• Immunotherapy for recurrent / metastatic NPC
• Pembrolizumab and nivolumab
![Page 3: Head and Neck Cancer - oncologynursingbrazil.com.br · Head and Neck Cancer Author: William Jr,William Nassib Created Date: 10/10/2017 10:48:37 AM ...](https://reader036.fdocuments.in/reader036/viewer/2022071213/603e8829b815b04ad41556a8/html5/thumbnails/3.jpg)
Outline
• Immunotherapy for recurrent / metastatic HNSCC
• Keynote-012 clinical data (pembrolizumab)
• Keynote-055 (pembrolizumab)
• Keynote-012 biomarker data (pembrolizumab)
• Keynote-040
• Checkmate 141 (nivolumab)
• Immunotherapy for recurrent / metastatic NPC
• Pembrolizumab and nivolumab
![Page 4: Head and Neck Cancer - oncologynursingbrazil.com.br · Head and Neck Cancer Author: William Jr,William Nassib Created Date: 10/10/2017 10:48:37 AM ...](https://reader036.fdocuments.in/reader036/viewer/2022071213/603e8829b815b04ad41556a8/html5/thumbnails/4.jpg)
HNSCC Cohorts of Nonrandomized, Phase 1b, Multi-cohort KEYNOTE-012 Trial†
Presented By Ranee Mehra at 2016 ASCO Annual Meeting
![Page 5: Head and Neck Cancer - oncologynursingbrazil.com.br · Head and Neck Cancer Author: William Jr,William Nassib Created Date: 10/10/2017 10:48:37 AM ...](https://reader036.fdocuments.in/reader036/viewer/2022071213/603e8829b815b04ad41556a8/html5/thumbnails/5.jpg)
Baseline Characteristics All HNSCC Patients
Presented By Ranee Mehra at 2016 ASCO Annual Meeting
![Page 6: Head and Neck Cancer - oncologynursingbrazil.com.br · Head and Neck Cancer Author: William Jr,William Nassib Created Date: 10/10/2017 10:48:37 AM ...](https://reader036.fdocuments.in/reader036/viewer/2022071213/603e8829b815b04ad41556a8/html5/thumbnails/6.jpg)
Overall Response Rate
Presented By Ranee Mehra at 2016 ASCO Annual Meeting
![Page 7: Head and Neck Cancer - oncologynursingbrazil.com.br · Head and Neck Cancer Author: William Jr,William Nassib Created Date: 10/10/2017 10:48:37 AM ...](https://reader036.fdocuments.in/reader036/viewer/2022071213/603e8829b815b04ad41556a8/html5/thumbnails/7.jpg)
Overall Response Rate by Prior Treatment
Presented By Ranee Mehra at 2016 ASCO Annual Meeting
![Page 8: Head and Neck Cancer - oncologynursingbrazil.com.br · Head and Neck Cancer Author: William Jr,William Nassib Created Date: 10/10/2017 10:48:37 AM ...](https://reader036.fdocuments.in/reader036/viewer/2022071213/603e8829b815b04ad41556a8/html5/thumbnails/8.jpg)
Duration of Response in Responders
Presented By Ranee Mehra at 2016 ASCO Annual Meeting
• 85% responses lasted ≥6 months• 71% responses lasted ≥12 months
![Page 9: Head and Neck Cancer - oncologynursingbrazil.com.br · Head and Neck Cancer Author: William Jr,William Nassib Created Date: 10/10/2017 10:48:37 AM ...](https://reader036.fdocuments.in/reader036/viewer/2022071213/603e8829b815b04ad41556a8/html5/thumbnails/9.jpg)
Progression-Free Survival† and Overall Survival
Presented By Ranee Mehra at 2016 ASCO Annual Meeting
![Page 10: Head and Neck Cancer - oncologynursingbrazil.com.br · Head and Neck Cancer Author: William Jr,William Nassib Created Date: 10/10/2017 10:48:37 AM ...](https://reader036.fdocuments.in/reader036/viewer/2022071213/603e8829b815b04ad41556a8/html5/thumbnails/10.jpg)
Outline
• Immunotherapy for recurrent / metastatic HNSCC
• Keynote-012 clinical data (pembrolizumab)
• Keynote-055 (pembrolizumab)
• Keynote-012 biomarker data (pembrolizumab)
• Keynote-040
• Checkmate 141 (nivolumab)
• Immunotherapy for recurrent / metastatic NPC
• Pembrolizumab and nivolumab
![Page 11: Head and Neck Cancer - oncologynursingbrazil.com.br · Head and Neck Cancer Author: William Jr,William Nassib Created Date: 10/10/2017 10:48:37 AM ...](https://reader036.fdocuments.in/reader036/viewer/2022071213/603e8829b815b04ad41556a8/html5/thumbnails/11.jpg)
KEYNOTE-055: Single Arm, Phase 2 Trial in R/M HNSCC After Progression on Platinum/Cetuximab
Presented By Joshua Bauml at 2016 ASCO Annual Meeting
![Page 12: Head and Neck Cancer - oncologynursingbrazil.com.br · Head and Neck Cancer Author: William Jr,William Nassib Created Date: 10/10/2017 10:48:37 AM ...](https://reader036.fdocuments.in/reader036/viewer/2022071213/603e8829b815b04ad41556a8/html5/thumbnails/12.jpg)
Baseline Characteristics
Presented By Joshua Bauml at 2016 ASCO Annual Meeting
![Page 13: Head and Neck Cancer - oncologynursingbrazil.com.br · Head and Neck Cancer Author: William Jr,William Nassib Created Date: 10/10/2017 10:48:37 AM ...](https://reader036.fdocuments.in/reader036/viewer/2022071213/603e8829b815b04ad41556a8/html5/thumbnails/13.jpg)
Keynote-055 Response Rates
Bauml et al., ASCO 2016; JCO 2017
![Page 14: Head and Neck Cancer - oncologynursingbrazil.com.br · Head and Neck Cancer Author: William Jr,William Nassib Created Date: 10/10/2017 10:48:37 AM ...](https://reader036.fdocuments.in/reader036/viewer/2022071213/603e8829b815b04ad41556a8/html5/thumbnails/14.jpg)
Keynote-055 PFS and OS
Median PFS: 2.1 months Median OS: 8 months
Bauml et al., ASCO 2016; JCO 2017
![Page 15: Head and Neck Cancer - oncologynursingbrazil.com.br · Head and Neck Cancer Author: William Jr,William Nassib Created Date: 10/10/2017 10:48:37 AM ...](https://reader036.fdocuments.in/reader036/viewer/2022071213/603e8829b815b04ad41556a8/html5/thumbnails/15.jpg)
Keynote-055 Efficacy According to PD-L1
Bauml et al., ASCO 2016; JCO 2017
![Page 16: Head and Neck Cancer - oncologynursingbrazil.com.br · Head and Neck Cancer Author: William Jr,William Nassib Created Date: 10/10/2017 10:48:37 AM ...](https://reader036.fdocuments.in/reader036/viewer/2022071213/603e8829b815b04ad41556a8/html5/thumbnails/16.jpg)
Outline
• Immunotherapy for recurrent / metastatic HNSCC
• Keynote-012 clinical data (pembrolizumab)
• Keynote-055 (pembrolizumab)
• Keynote-012 biomarker data (pembrolizumab)
• Keynote-040
• Checkmate 141 (nivolumab)
• Immunotherapy for recurrent / metastatic NPC
• Pembrolizumab and nivolumab
![Page 17: Head and Neck Cancer - oncologynursingbrazil.com.br · Head and Neck Cancer Author: William Jr,William Nassib Created Date: 10/10/2017 10:48:37 AM ...](https://reader036.fdocuments.in/reader036/viewer/2022071213/603e8829b815b04ad41556a8/html5/thumbnails/17.jpg)
PD-L1 and PD-L2 Analyses in Pre-treatment Samples
Presented By Laura Chow at 2016 ASCO Annual Meeting
![Page 18: Head and Neck Cancer - oncologynursingbrazil.com.br · Head and Neck Cancer Author: William Jr,William Nassib Created Date: 10/10/2017 10:48:37 AM ...](https://reader036.fdocuments.in/reader036/viewer/2022071213/603e8829b815b04ad41556a8/html5/thumbnails/18.jpg)
Overall Response by PD-L1 Status
Presented By Laura Chow at 2016 ASCO Annual Meeting
![Page 19: Head and Neck Cancer - oncologynursingbrazil.com.br · Head and Neck Cancer Author: William Jr,William Nassib Created Date: 10/10/2017 10:48:37 AM ...](https://reader036.fdocuments.in/reader036/viewer/2022071213/603e8829b815b04ad41556a8/html5/thumbnails/19.jpg)
Progression-Free Survival by PD-L1 Status
Presented By Laura Chow at 2016 ASCO Annual Meeting
![Page 20: Head and Neck Cancer - oncologynursingbrazil.com.br · Head and Neck Cancer Author: William Jr,William Nassib Created Date: 10/10/2017 10:48:37 AM ...](https://reader036.fdocuments.in/reader036/viewer/2022071213/603e8829b815b04ad41556a8/html5/thumbnails/20.jpg)
Overall Survival by PD-L1 Status
Presented By Laura Chow at 2016 ASCO Annual Meeting
![Page 21: Head and Neck Cancer - oncologynursingbrazil.com.br · Head and Neck Cancer Author: William Jr,William Nassib Created Date: 10/10/2017 10:48:37 AM ...](https://reader036.fdocuments.in/reader036/viewer/2022071213/603e8829b815b04ad41556a8/html5/thumbnails/21.jpg)
Overall Response Rate by PD-L2 Status
Presented By Laura Chow at 2016 ASCO Annual Meeting
![Page 22: Head and Neck Cancer - oncologynursingbrazil.com.br · Head and Neck Cancer Author: William Jr,William Nassib Created Date: 10/10/2017 10:48:37 AM ...](https://reader036.fdocuments.in/reader036/viewer/2022071213/603e8829b815b04ad41556a8/html5/thumbnails/22.jpg)
Outline
• Immunotherapy for recurrent / metastatic HNSCC
• Keynote-012 clinical data (pembrolizumab)
• Keynote-055 (pembrolizumab)
• Keynote-012 biomarker data (pembrolizumab)
• Keynote-040
• Checkmate 141 (nivolumab)
• Immunotherapy for recurrent / metastatic NPC
• Pembrolizumab and nivolumab
![Page 23: Head and Neck Cancer - oncologynursingbrazil.com.br · Head and Neck Cancer Author: William Jr,William Nassib Created Date: 10/10/2017 10:48:37 AM ...](https://reader036.fdocuments.in/reader036/viewer/2022071213/603e8829b815b04ad41556a8/html5/thumbnails/23.jpg)
![Page 24: Head and Neck Cancer - oncologynursingbrazil.com.br · Head and Neck Cancer Author: William Jr,William Nassib Created Date: 10/10/2017 10:48:37 AM ...](https://reader036.fdocuments.in/reader036/viewer/2022071213/603e8829b815b04ad41556a8/html5/thumbnails/24.jpg)
![Page 25: Head and Neck Cancer - oncologynursingbrazil.com.br · Head and Neck Cancer Author: William Jr,William Nassib Created Date: 10/10/2017 10:48:37 AM ...](https://reader036.fdocuments.in/reader036/viewer/2022071213/603e8829b815b04ad41556a8/html5/thumbnails/25.jpg)
![Page 26: Head and Neck Cancer - oncologynursingbrazil.com.br · Head and Neck Cancer Author: William Jr,William Nassib Created Date: 10/10/2017 10:48:37 AM ...](https://reader036.fdocuments.in/reader036/viewer/2022071213/603e8829b815b04ad41556a8/html5/thumbnails/26.jpg)
![Page 27: Head and Neck Cancer - oncologynursingbrazil.com.br · Head and Neck Cancer Author: William Jr,William Nassib Created Date: 10/10/2017 10:48:37 AM ...](https://reader036.fdocuments.in/reader036/viewer/2022071213/603e8829b815b04ad41556a8/html5/thumbnails/27.jpg)
![Page 28: Head and Neck Cancer - oncologynursingbrazil.com.br · Head and Neck Cancer Author: William Jr,William Nassib Created Date: 10/10/2017 10:48:37 AM ...](https://reader036.fdocuments.in/reader036/viewer/2022071213/603e8829b815b04ad41556a8/html5/thumbnails/28.jpg)
![Page 29: Head and Neck Cancer - oncologynursingbrazil.com.br · Head and Neck Cancer Author: William Jr,William Nassib Created Date: 10/10/2017 10:48:37 AM ...](https://reader036.fdocuments.in/reader036/viewer/2022071213/603e8829b815b04ad41556a8/html5/thumbnails/29.jpg)
![Page 30: Head and Neck Cancer - oncologynursingbrazil.com.br · Head and Neck Cancer Author: William Jr,William Nassib Created Date: 10/10/2017 10:48:37 AM ...](https://reader036.fdocuments.in/reader036/viewer/2022071213/603e8829b815b04ad41556a8/html5/thumbnails/30.jpg)
Outline
• Immunotherapy for recurrent / metastatic HNSCC
• Keynote-012 clinical data (pembrolizumab)
• Keynote-055 (pembrolizumab)
• Keynote-012 biomarker data (pembrolizumab)
• Keynote-040
• Checkmate 141 (nivolumab)
• Immunotherapy for recurrent / metastatic NPC
• Pembrolizumab and nivolumab
![Page 31: Head and Neck Cancer - oncologynursingbrazil.com.br · Head and Neck Cancer Author: William Jr,William Nassib Created Date: 10/10/2017 10:48:37 AM ...](https://reader036.fdocuments.in/reader036/viewer/2022071213/603e8829b815b04ad41556a8/html5/thumbnails/31.jpg)
Phase 3 CheckMate 141 Study Design<br />Nivolumab in R/M SCCHN After Platinum Therapy
Presented By Robert Ferris at 2016 ASCO Annual Meeting
![Page 32: Head and Neck Cancer - oncologynursingbrazil.com.br · Head and Neck Cancer Author: William Jr,William Nassib Created Date: 10/10/2017 10:48:37 AM ...](https://reader036.fdocuments.in/reader036/viewer/2022071213/603e8829b815b04ad41556a8/html5/thumbnails/32.jpg)
Demographics<br />Nivolumab in R/M SCCHN After Platinum Therapy
Presented By Robert Ferris at 2016 ASCO Annual Meeting
![Page 33: Head and Neck Cancer - oncologynursingbrazil.com.br · Head and Neck Cancer Author: William Jr,William Nassib Created Date: 10/10/2017 10:48:37 AM ...](https://reader036.fdocuments.in/reader036/viewer/2022071213/603e8829b815b04ad41556a8/html5/thumbnails/33.jpg)
<br />Treatment Administration and Patient Disposition<br />Nivolumab in R/M SCCHN After Platinum Therapy
Presented By Robert Ferris at 2016 ASCO Annual Meeting
![Page 34: Head and Neck Cancer - oncologynursingbrazil.com.br · Head and Neck Cancer Author: William Jr,William Nassib Created Date: 10/10/2017 10:48:37 AM ...](https://reader036.fdocuments.in/reader036/viewer/2022071213/603e8829b815b04ad41556a8/html5/thumbnails/34.jpg)
Overall Survival<br />Nivolumab in R/M SCCHN After Platinum Therapy
Presented By Robert Ferris at 2016 ASCO Annual Meeting
![Page 35: Head and Neck Cancer - oncologynursingbrazil.com.br · Head and Neck Cancer Author: William Jr,William Nassib Created Date: 10/10/2017 10:48:37 AM ...](https://reader036.fdocuments.in/reader036/viewer/2022071213/603e8829b815b04ad41556a8/html5/thumbnails/35.jpg)
Progression-Free Survival <br />Nivolumab in R/M SCCHN After Platinum Therapy
Presented By Robert Ferris at 2016 ASCO Annual Meeting
![Page 36: Head and Neck Cancer - oncologynursingbrazil.com.br · Head and Neck Cancer Author: William Jr,William Nassib Created Date: 10/10/2017 10:48:37 AM ...](https://reader036.fdocuments.in/reader036/viewer/2022071213/603e8829b815b04ad41556a8/html5/thumbnails/36.jpg)
Objective Response Rate<br />Nivolumab in R/M SCCHN After Platinum Therapy
Presented By Robert Ferris at 2016 ASCO Annual Meeting
![Page 37: Head and Neck Cancer - oncologynursingbrazil.com.br · Head and Neck Cancer Author: William Jr,William Nassib Created Date: 10/10/2017 10:48:37 AM ...](https://reader036.fdocuments.in/reader036/viewer/2022071213/603e8829b815b04ad41556a8/html5/thumbnails/37.jpg)
Overall Survival by p16 Status<br />Nivolumab in R/M SCCHN After Platinum Therapy
Presented By Robert Ferris at 2016 ASCO Annual Meeting
![Page 38: Head and Neck Cancer - oncologynursingbrazil.com.br · Head and Neck Cancer Author: William Jr,William Nassib Created Date: 10/10/2017 10:48:37 AM ...](https://reader036.fdocuments.in/reader036/viewer/2022071213/603e8829b815b04ad41556a8/html5/thumbnails/38.jpg)
Overall Survival by Tumor PD-L1 Expression at 1%<br />Nivolumab in R/M SCCHN After Platinum Therapy
Presented By Robert Ferris at 2016 ASCO Annual Meeting
![Page 39: Head and Neck Cancer - oncologynursingbrazil.com.br · Head and Neck Cancer Author: William Jr,William Nassib Created Date: 10/10/2017 10:48:37 AM ...](https://reader036.fdocuments.in/reader036/viewer/2022071213/603e8829b815b04ad41556a8/html5/thumbnails/39.jpg)
<br />Overall Survival by Tumor PD-L1 Expression Level<br />Nivolumab in R/M SCCHN After Platinum Therapy
Presented By Robert Ferris at 2016 ASCO Annual Meeting
![Page 40: Head and Neck Cancer - oncologynursingbrazil.com.br · Head and Neck Cancer Author: William Jr,William Nassib Created Date: 10/10/2017 10:48:37 AM ...](https://reader036.fdocuments.in/reader036/viewer/2022071213/603e8829b815b04ad41556a8/html5/thumbnails/40.jpg)
Objective Response Rate by PD-L1 Expression<br />Nivolumab in R/M SCCHN After Platinum Therapy
Presented By Robert Ferris at 2016 ASCO Annual Meeting
![Page 41: Head and Neck Cancer - oncologynursingbrazil.com.br · Head and Neck Cancer Author: William Jr,William Nassib Created Date: 10/10/2017 10:48:37 AM ...](https://reader036.fdocuments.in/reader036/viewer/2022071213/603e8829b815b04ad41556a8/html5/thumbnails/41.jpg)
Treatment-Related Adverse Events<br />Nivolumab in R/M SCCHN After Platinum Therapy
Presented By Robert Ferris at 2016 ASCO Annual Meeting
![Page 42: Head and Neck Cancer - oncologynursingbrazil.com.br · Head and Neck Cancer Author: William Jr,William Nassib Created Date: 10/10/2017 10:48:37 AM ...](https://reader036.fdocuments.in/reader036/viewer/2022071213/603e8829b815b04ad41556a8/html5/thumbnails/42.jpg)
Quality of Life and Symptom Burden<br />Nivolumab in R/M SCCHN After Platinum Therapy
Presented By Robert Ferris at 2016 ASCO Annual Meeting
![Page 43: Head and Neck Cancer - oncologynursingbrazil.com.br · Head and Neck Cancer Author: William Jr,William Nassib Created Date: 10/10/2017 10:48:37 AM ...](https://reader036.fdocuments.in/reader036/viewer/2022071213/603e8829b815b04ad41556a8/html5/thumbnails/43.jpg)
Presented By Robert Ferris at 2017 ASCO Annual Meeting
![Page 44: Head and Neck Cancer - oncologynursingbrazil.com.br · Head and Neck Cancer Author: William Jr,William Nassib Created Date: 10/10/2017 10:48:37 AM ...](https://reader036.fdocuments.in/reader036/viewer/2022071213/603e8829b815b04ad41556a8/html5/thumbnails/44.jpg)
Outline
• Immunotherapy for recurrent / metastatic HNSCC
• Keynote-012 clinical data (pembrolizumab)
• Keynote-055 (pembrolizumab)
• Keynote-012 biomarker data (pembrolizumab)
• Checkmate 141 (nivolumab)
• Immunotherapy for recurrent / metastatic NPC
• Pembrolizumab
![Page 45: Head and Neck Cancer - oncologynursingbrazil.com.br · Head and Neck Cancer Author: William Jr,William Nassib Created Date: 10/10/2017 10:48:37 AM ...](https://reader036.fdocuments.in/reader036/viewer/2022071213/603e8829b815b04ad41556a8/html5/thumbnails/45.jpg)
Pembrolizumab in NPC – Keynote 028
• Phase Ib, multicenter, open-label study
• Previously treated NPC - PD-L1 positive by IHC (CPS ≥1%)
• Pembrolizumab 10 mg/kg IV every 2 weeks
• 27 patients – 63% Asian
– 22% keratinizing carcinomas
Hsu et al. JCO 2017
• Efficacy:– 26% response rate
– Median duration of response 17 months
![Page 46: Head and Neck Cancer - oncologynursingbrazil.com.br · Head and Neck Cancer Author: William Jr,William Nassib Created Date: 10/10/2017 10:48:37 AM ...](https://reader036.fdocuments.in/reader036/viewer/2022071213/603e8829b815b04ad41556a8/html5/thumbnails/46.jpg)
Checkmate-358Nivolumab in Non-Keratinizing NPC
Delord et al. ASCO 2017
![Page 47: Head and Neck Cancer - oncologynursingbrazil.com.br · Head and Neck Cancer Author: William Jr,William Nassib Created Date: 10/10/2017 10:48:37 AM ...](https://reader036.fdocuments.in/reader036/viewer/2022071213/603e8829b815b04ad41556a8/html5/thumbnails/47.jpg)
Summary• Pembrolizumab with 14-18% response rate in heavily pre-treated patient
population, and clinically meanigful (but not statistically different) improvementsin overall survival compared to stadard therapy
• Nivolumab with 13% response rate in heavily pre-treated patient population and significant improvent in overall survival and quality of life compared to standard therapy
• Efficacy of PD-1 inhibitors may be slightly higher in HPV-positive patients, but thisis up for debate
• PD-L1 expression predicts for better outcomes, in general
• Pembrolizumab and nivolumab active in recurrent/metastatic NPC