This study evaluates the effect of pembrolizumab on the duration of remission in acute myeloid leukemia. Pembrolizumab is given after complete remission is obtained in those with AML at least 60 years old who are not candidates for allogeneic stem cell transplant. The primary purpose of this study is determine if the time to relapse can be extended. Additionally, the safety and tolerability of pembrolizumab will be closely monitored.
Patients \>60 years old with AML often have a dismal prognosis. Even though many of these patients are able to obtain a Complete Response to treatment, relapse occurs in the vast majority of patients. Transplants may reduce relapse rates in this population, but is only feasible in a minority of patients. AML's immunosuppressive microenvironment in general and PD-1/PD-L1 upregulation in particular appears to increase the risk of relapse. Importantly, PD-1 and its ligands are particularly increased after therapy compared to initial diagnosis. As such, PD-1 inhibition with pembrolizumab offers to limit leukemic cell immune escape, thereby allowing the patient's immune system to eradicate the submicroscopic residual disease and reducing relapse rates. Treatment for this study is 200 mg Q3W as an appropriate dose for the switch to fixed dosing is based on simulations performed using the population PK model of Pembrolizumab showing that the fixed dose of 200 mg every 3 weeks will provide exposures that 1) are optimally consistent with those obtained with the 2 mg/kg dose every 3 weeks, 2) will maintain individual patient exposures in the exposure range established in melanoma as associated with maximal efficacy response and 3) will maintain individual patients exposure in the exposure range established in melanoma that are well tolerated and safe.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
12
200 mg IV given every three weeks
Hillman Cancer Center
Pittsburgh, Pennsylvania, United States
Time to Relapse (TTR)
Time to recurrence of AML, including only deaths related to recurrence. Relapse of AML is defined as patients reaching remission (bone marrow contains \<5% blast cells, blood cell counts return to within normal limits, no signs disease) followed by a return of leukemia cells in the marrow and a decrease in normal blood cells.
Time frame: Up to 24 months
Worst Grade of Adverse Events Experienced (Unrelated to Relatedness to Study Therapy)
Worst Grade of AE experienced, regardless of relatedness to study therapy, per CTCAE v5.0.
Time frame: Up to 24 months
Worst Grade of Adverse Events Experienced (at Least Probably Related to Treatment)
Worst Grade of AE experienced, at least probably related to treatment, per CTCAE v5.0.
Time frame: Up to 24 months
Overall Survival (OS)
The length of time from date of start of treatment that patients are still alive.
Time frame: Up to 48 months
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.