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Real-World Experience with Pembrolizumab Treatment in Patients with Heavily Treated Recurrent Gynecologic Malignancies

Yonsei Medical Journal 2020년 61권 10호 p.844 ~ 850
최민철, 문용화, 정상근, 박현, 주원덕, 송승훈, 이찬, 김광일, 김경아,
소속 상세정보
최민철 ( Choi Min-Chul ) - CHA University CHA Bundang Medical Center Comprehensive Gynecologic Cancer Center
문용화 ( Moon Yong-Wha ) - CHA University CHA Bundang Medical Center Hematology and Oncology
정상근 ( Jung Sang-Geun ) - CHA University CHA Bundang Medical Center Comprehensive Gynecologic Cancer Center
박현 ( Park Hyun ) - CHA University CHA Bundang Medical Center Comprehensive Gynecologic Cancer Center
주원덕 ( Joo Won-Duk ) - CHA University CHA Bundang Medical Center Comprehensive Gynecologic Cancer Center
송승훈 ( Song Seung-Hun ) - CHA University CHA Bundang Medical Center Comprehensive Gynecologic Cancer Center
이찬 ( Lee Chan ) - CHA University CHA Bundang Medical Center Comprehensive Gynecologic Cancer Center
김광일 ( Kim Gwang-Il ) - CHA University CHA Bundang Medical Center Department of Pathology
김경아 ( Kim Kyoung-Ah ) - CHA University CHA Bundang Medical Center Department of Radiology

Abstract


Purpose: We evaluated the efficacy and safety of pembrolizumab in patients with recurrent gynecologic cancers in real-world practice.

Materials and Methods: We conducted a retrospective, single-institution study of patients with recurrent gynecologic malignancies treated with pembrolizumab. The primary endpoints were the objective response rate (ORR) and safety.

Results: Thirty-one patients treated with pembrolizumab were included. The primary disease sites were the uterine cervix (n=18), ovaries (n=8), and uterine corpus (n=5). Fifteen of the 31 patients (48%) had an Eastern Cooperative Oncology Group performance status of ≥2. The median number of prior chemotherapy lines was 2 (range, 1?6), and 14 of 31 patients (45%) had received ≥ 3 prior lines of chemotherapy. The overall ORR was 22.6%: specifically, 22.3% (4 of 18 patients), 12.5% (1 of 8 patients), and 40% (2 of 5 patients) for cervical, ovarian, and endometrial cancers, respectively. During a median follow-up of 4.7 months (range, 0.2?35.3), the median time to response was 1.9 months (range, 1.4?5.7). The median duration of response was not reached (range, 8.8-not reached). The median progression-free survival was 2.5 months (95% confidence interval, 1.7-not reached). Adverse events occurred in 20 patients (64.5%), and only 3 (9.7%) were grade ≥3. There was one case of suspicious treatment-related mortality, apart from which most adverse events were manageable.

Conclusion: In real-world practice, pembrolizumab was feasible and effective in heavily treated recurrent gynecologic cancer patients with poor performance status who may not be eligible for enrollment in clinical trials.

키워드

Gynecologic neoplasms; pembrolizumab; recurrence

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