The purpose of this study is to assess the efficacy and safety of pembrolizumab in patient with locally advanced or metastatic squamous cell carcinoma of the skin
Agents blocking the Programmed Cell Death 1(PD1)/Programmed Cell Death 1-Ligand 1 (PD-L1) pathway have demonstrated objective, durable tumor regressions in patients with advanced solid malignancies and efficacy has been linked to PD-L1 expression. PD-L1 expression by tumour cells is the strongest single predictor of response to anti-PD1 therapy (J Taube, R Anders et al, Clin Cancer Res 2014). Pembrolizumab (MK-3475) is a high-affinity humanized monoclonal anti-PD1 antibody. It leads to dual PD1-ligand blockade of PD-L1 and PD-L2 that may reactivate the immune surveillance and elicit anti-tumour response. It has antitumor activity in melanoma and NSCLC (phase III trials). Pembrolizumab might be of interest in unresectable squamous cell carcinomas of the skin (SCCS). Approximately 20% to 30% of non-melanoma skin cancers are SCCS. Most patients with primary SCCS have an excellent prognosis, but SCCS can progress to advanced stages that are impossible to treat by surgical excision or radiotherapy. Few therapeutic options are available for these tumors. Conventional chemotherapy, such as cisplatin-based combinations, has some efficacy, but the toxic effects of these combinations often prohibit their use in elderly patients. Epidermal Growth Factor (EGFR) signaling antagonists have activity only in a subset of patients. New therapeutic options are needed for patients with advanced SCCS. No trial evaluating pembrolizumab in human SCCS is ongoing. Investigators hypothesize that: i) PD-L1 is expressed in SCCS as in HNSCC ii) pembrolizumab may be effective as a single agent in patients with unresectable SCCS iii) Efficacy of pembrolizumab is correlated to PD-L1 expression in SCCS. Investigators therefore intend to determine the efficacy and safety of single agent pembrolizumab in all patients and in patients with PD-L1-positive unresectable SCCS naïve of chemotherapy and of EGFR inhibitors.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
57
200 mg, administered as intravenous (IV) infusion every 3 weeks up to 24 months or until progression or unacceptable toxicity develops.
Hôpital Avicenne
Bobigny, France
Response rate (RR)
Response rate (RR) at 15 weeks (RECIST v.1.1) in the whole sample by CT or MRI Response Evaluation Criteria in Solid Tumors with central radiology review
Time frame: 15 weeks
Safety profile (NCI CTCAE v4.0)
Advers event and serious adverse event status
Time frame: up to 28 months
RR in PD-L1-positive patients
To assess in the whole sample and in PD-L1 positive patients
Time frame: 15 weeks
Disease Control Rate using RECIST and modified RECIST v.1.1
Controled by the radiological evaluation
Time frame: 15 weeks
RR using modified RECIST 1.1
Controled by the radiological evaluation
Time frame: 15 weeks
RR using RECIST and modified RECIST v.1.1
Controled by the radiological evaluation
Time frame: 24 weeks
Best RR using RECIST and modified RECIST v.1.1
The best response was collected after all radiological evaluation completion
Time frame: 24 months
Overall Survival (OS)
Survival status
Time frame: up to 24 months
Progression Free Survival by RECIST 1.1 and modified RECIST 1.1
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Controled by the radiological evaluation
Time frame: up to 24 months
Duration of response (DOR) by RECIST 1.1 and modified RECIST 1.1
Controled by the radiological evaluation
Time frame: up to 24 months
Duration of control by RECIST 1.1 and modified RECIST 1.1
Controled by the radiological evaluation
Time frame: up to 24 months
Time to disease progression by RECIST 1.1 and modified RECIST 1.1
Controled by the radiological evaluation
Time frame: up to 24 months