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Displaying One Session

Mini Oral session
Date
Fri, 17.09.2021
Time
17:30 - 18:30
Location
Channel 7
Mini Oral session

1759MO - Associations between sarcopenia and gut microbiota in patients (pts) with metastatic renal cell carcinoma (mRCC) and breast cancer (BC)

Presentation Number
1759MO
Speakers
  • Zeynep B. Zengin (Duarte, United States of America)
Lecture Time
17:30 - 17:35
Session Name
Location
Channel 7, Paris Expo Porte de Versailles, Paris, France
Date
Fri, 17.09.2021
Time
17:30 - 18:30

Abstract

Background

Sarcopenia, or the loss of skeletal muscle mass, is associated with poor outcomes in cancer patients (Shachar et al. Eur J Cancer, 2016). We aimed to explore the association between stool microbiome and sarcopenia status in pts with mRCC and BC.

Methods

Pts with mRCC and BC, who had stool microbiome analysis by shotgun metagenome sequencing as part of institutional research studies, were retrospectively identified. Muscle mass area (MMA) was calculated by using computed tomography 3rd lumbar vertebral axial segment images with sliceOmatic software (TomoVision, Canada). Skeletal muscle index (SMI) was determined as MMA/height2. Gender and body mass index (BMI) based SMI cut offs were used to determine sarcopenia: SMI <43 cm2/m2 (BMI <25 kg/m2), or <53 cm2/m2 (BMI ≥25 kg/m2) in males, and <41 cm2/m2 in females. LDA effect size analysis was performed to identify differentially abundant taxa between sarcopenic and nonsarcopenic patients.

Results

A total of 82 pts (45:37, M:F) were included. Median age was 68 (range 28-91); 62 (75.6%) pts and 20 (24.3%) pts had mRCC and BC, respectively. Twenty-seven (32.9%) pts in the mRCC cohort and 10 (12.2%) pts in the BC cohort were sarcopenic. Species that are differentially abundant with an LDA score above 3 were Alistipes putredinis and Dialister sp CAG 357 in pts with sarcopenia and Collinsella aerofaciens in pts without sarcopenia. In patients with mRCC, the most prominent species with an LDA score above 3 were Parabacteroides distasonis, Dialister sp CAG 357, and Campylobacter gracilis among sarcopenic pts, whereas Bacteroides vulgatus and Monoglobus pectinilyticus were more commonly seen in nonsarcopenic pts.

Conclusions

These are the first data to associate sarcopenia with composition of the gut microbiome in pts with cancer. Mechanistic studies are needed to determine if there is a causal interplay.

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

N. Dizman: Non-Financial Interests, Institutional, Advisory Role: Vivreon Bioscience. S.K. Pal: Non-Financial Interests, Institutional, Advisory Role: Genentech, Aveo, Eisai, Roche, Pfizer, Novartis, Exelixis, Ipsen, Bristol Myers Squibb, Astellas Pharma, GlaxoSmithKline; Non-Financial Interests, Institutional, Funding: Eisai, Pfizer, Bristol Myers Squibb, Aveo, Nektar Therapeutics, Exelixis, QED; Financial Interests, Institutional, Other: Novartis, Medivaton, Astellas Pharma. All other authors have declared no conflicts of interest.

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Mini Oral session

60MO - Gut microbiota and efficacy of immune-checkpoint inhibitors (ICIs) in patients (pts) with advanced solid tumor: SCRUM-Japan MONSTAR-SCREEN

Presentation Number
60MO
Speakers
  • Kentaro Sawada (Sapporo, Japan)
Lecture Time
17:35 - 17:40
Session Name
Location
Channel 7, Paris Expo Porte de Versailles, Paris, France
Date
Fri, 17.09.2021
Time
17:30 - 18:30

Abstract

Background

MONSTAR-SCREEN is the nationwide cancer genome screening project of prospectively assessing gut microbiota and circulating tumor DNA in 2,000 pts with advanced solid tumor at 31 Japanese institutions. Recently, several studies have showed that gut microbiota modulates efficacy of ICIs across cancer types. Here we report an initial analysis of association between alpha diversity index (ADI) of fecal microbiome and efficacy of ICIs between Sep 2019 and Sep 2020.

Methods

The 16S ribosomal RNA gene sequencing to V3-V4 region was conducted for assessing the ADI, which was represented as an operational taxonomic unit (OTU) score. Objective response rate (ORR) was assessed by RECIST version 1.1 and progression-free survival (PFS) on ICIs was estimated using the Kaplan-Meier method. Microsatellite instability (MSI) and blood tumor mutational burden (bTMB) status were measured by FoundationOneLiquid plus a 1.125Mb bTMB assay at the same time points as the feces collection. In addition, tissue TMB (tTMB) were measured by FoundationOneCDx using pretreatment tissue samples.

Results

A total of 167 pts were included. Most common cancer types were as follows; head and neck cancer (N=43), malignant melanoma (N=26) and gastric cancer (N=25). Of these, 136 (81%) pts received ICI alone, while 31 (19%) did ICI and chemotherapy combination. We determined the optimal cutoff value of 240 by combined sensitivity with specificity for the ORR. The ORR in high OTU (OTU-H > 240, N=52) was 35%, while that with low OTU (OTU-L < 240, N=115) was 17% (p=0.01). In addition, OTU-H pts had a significantly a longer PFS on ICIs than OTU-L (8.6 vs. 2.6 months; hazard ratio, 0.48; 95% CI, 0.30–0.78; p=0.002). Multivariate analyses for the ORR and PFS demonstrated the OTU was the only significant independent factor beyond MSI, bTMB, and tTMB status.

Conclusions

Diversity of gut microbiota by the OTU was significantly associated with higher ORR and longer PFS on ICIs in pts with advanced solid tumor. These results indicated the potential of the OTU as a putative tumor-agnostic biomarker for the efficacy of ICIs beyond MSI, bTMB and tTMB status. Further study with shotgun and single cell metagenome analyses are ongoing.

Legal entity responsible for the study

SCRUM-Japan.

Funding

SCRUM-Japan funding.

Disclosure

R. Yamashita: Financial Interests, Personal, Advisory Board: Takeda. Y. Nakamura: Financial Interests, Institutional, Research Grant: Genomedia; Financial Interests, Institutional, Research Grant: Guardant Health; Financial Interests, Institutional, Research Grant: Daiichi Sankyo; Financial Interests, Institutional, Research Grant: Taiho; Financial Interests, Institutional, Research Grant: Chugai. H. Taniguchi: Financial Interests, Personal, Speaker’s Bureau: Merck Biopharma; Financial Interests, Personal, Speaker’s Bureau: Takeda; Financial Interests, Personal, Speaker’s Bureau: Taiho; Financial Interests, Personal, Speaker’s Bureau: Chugai; Financial Interests, Institutional, Research Grant: Takeda; Financial Interests, Institutional, Research Grant: Taiho; Financial Interests, Institutional, Research Grant: Daiichi Sankyo; Financial Interests, Institutional, Research Grant: RDKK; Financial Interests, Institutional, Research Grant: Sysmexy; Financial Interests, Institutional, Research Grant: Chugai. S. Kadowaki: Financial Interests, Personal, Speaker’s Bureau: Lilly; Financial Interests, Personal, Speaker’s Bureau: Chugai Pharma; Financial Interests, Personal, Speaker’s Bureau: Bristol Myers Squibb; Financial Interests, Personal, Speaker’s Bureau: Eisai; Financial Interests, Personal, Speaker’s Bureau: Merck KGaA; Financial Interests, Personal, Speaker’s Bureau: Bayer; Financial Interests, Personal, Speaker’s Bureau: Daiichi Sankyo; Financial Interests, Personal, Speaker’s Bureau: Ono Pharmaceutical; Financial Interests, Personal, Advisory Role: Daiichi Sankyo; Financial Interests, Institutional, Research Grant: Lilly; Financial Interests, Institutional, Research Grant: Taiho Pharmaceutical; Financial Interests, Institutional, Research Grant: Ono Pharmaceutical; Financial Interests, Institutional, Research Grant: MSD; Financial Interests, Institutional, Research Grant: Chugai Pharma; Financial Interests, Institutional, Research Grant: Nobelpharma. M. Hosokawa: Financial Interests, Institutional, Member of the Board of Directors: bitBiome, Inc.. T. Kodama: Financial Interests, Personal, Full or part-time Employment: Chugai Pharmaceutical Co., Ltd.. K. Kato: Financial Interests, Institutional, Research Grant: Ono; Financial Interests, Institutional, Research Grant: MSD; Financial Interests, Institutional, Research Grant: BMS; Financial Interests, Institutional, Research Grant: Eisai; Financial Interests, Institutional, Research Grant: Takeda; Financial Interests, Institutional, Research Grant: Astellas; Financial Interests, Institutional, Research Grant: Bayer; Financial Interests, Personal, Advisory Board: Ono; Financial Interests, Personal, Advisory Board: BMS; Financial Interests, Personal, Advisory Board: Beigene; Financial Interests, Personal, Advisory Board: MSD; Financial Interests, Personal, Speaker’s Bureau: Eli lilly; Financial Interests, Personal, Speaker’s Bureau: Ono; Financial Interests, Personal, Speaker’s Bureau: BMS; Financial Interests, Personal, Advisory Role: Daiichi Sankyo; Financial Interests, Personal, Advisory Role: Ono. T. Satoh: Financial Interests, Personal and Institutional, Research Grant: Ono Pharmaceutical; Financial Interests, Personal and Institutional, Research Grant: Chugai Pharmaceutical; Financial Interests, Personal and Institutional, Research Grant: Yakult Honsha; Financial Interests, Institutional, Research Grant: Giliad; Financial Interests, Institutional, Research Grant: Bristol-Myers; Financial Interests, Institutional, Research Grant: MSD; Financial Interests, Institutional, Research Grant: Daiichi Sankyo; Financial Interests, Personal and Institutional, Research Grant: Eli Lilly; Financial Interests, Personal, Invited Speaker: Ono pharmaceutical; Financial Interests, Personal, Invited Speaker: Chugai Pharmaceutical; Financial Interests, Personal, Invited Speaker: Yakult Honsha; Financial Interests, Personal, Invited Speaker: Bristol-Myers; Financial Interests, Personal, Invited Speaker: Daiichi Sankyo; Financial Interests, Personal, Invited Speaker: Eli Lilly; Financial Interests, Institutional, Research Grant: BeiGene. Y. Komatsu: Financial Interests, Personal, Research Grant: Ono Pharmaceutical Co., Ltd; Financial Interests, Personal, Research Grant: Taiho Pharmaceutical Co., Ltd.; Financial Interests, Personal, Research Grant: Chugai Pharmaceutical Co., Ltd; Financial Interests, Personal, Research Grant: Eli Lilly and Company; Financial Interests, Personal, Research Grant: Mediscience Planning Inc.; Financial Interests, Personal, Research Grant: NanoCarrier Co.,Ltd.; Financial Interests, Personal, Research Grant: Yakult; Financial Interests, Personal, Research Grant: Daiichi Sankyo Company, Limited; Financial Interests, Personal, Research Grant: IQVIA Services Japan K.K; Financial Interests, Personal, Research Grant: Japanese Foundation for Multidisciplinary Treatment of Cancer; Financial Interests, Personal, Research Grant: Nationel Cancer Center Japan; Financial Interests, Personal, Speaker’s Bureau: Chugai Pharmaceutical Co., Ltd; Financial Interests, Personal, Speaker’s Bureau: Bayer Yakuhin, Ltd.; Financial Interests, Personal, Speaker’s Bureau: Eli Lilly and Company; Financial Interests, Personal, Speaker’s Bureau: Ono Pharmaceutical Co., Ltd.; Financial Interests, Personal, Speaker’s Bureau: Taiho Pharmaceutical Co., Ltd. M. Shiota: Financial Interests, Personal, Speaker’s Bureau: Janssen Pharmaceutical K.K.; Financial Interests, Personal, Speaker’s Bureau: Astellas Pharma Inc.; Financial Interests, Personal, Speaker’s Bureau: AstraZeneca; Financial Interests, Institutional, Research Grant: Daiichi Sankyo. H. Yasui: Financial Interests, Institutional, Research Grant: MSD; Financial Interests, Institutional, Research Grant: Ono Pharmaceutical; Financial Interests, Institutional, Research Grant: Daiichi Sankyo; Financial Interests, Institutional, Research Grant: Astellas Pharma; Financial Interests, Institutional, Research Grant: BeiGene; Financial Interests, Personal, Invited Speaker: Daiichi Sankyo; Financial Interests, Personal, Invited Speaker: Ono Pharmaceutical; Financial Interests, Personal, Invited Speaker: Taiho Pharmaceutical; Financial Interests, Personal, Invited Speaker: Chugai Pharma; Financial Interests, Personal, Invited Speaker: Bristol Myers Squibb Japan; Financial Interests, Personal, Invited Speaker: Terumo; Financial Interests, Personal, Invited Speaker: Eli Lilly Japan; Financial Interests, Personal, Invited Speaker: Merk Biopharma; Financial Interests, Personal, Invited Speaker: Yakult Honsha; Financial Interests, Personal, Invited Speaker: Bayer Yakuhin; Financial Interests, Personal, Invited Speaker: Takeda Pharmaceutical. K. Yamazaki: Financial Interests, Personal, Speaker’s Bureau: Chugai Pharma; Financial Interests, Personal, Speaker’s Bureau: Daiichi Sankyo; Financial Interests, Personal, Speaker’s Bureau: Yakult Honsha; Financial Interests, Personal, Speaker’s Bureau: Takeda; Financial Interests, Personal, Speaker’s Bureau: Bayer; Financial Interests, Personal, Speaker’s Bureau: Merck Serono; Financial Interests, Personal, Speaker’s Bureau: Taiho Pharmaceutical; Financial Interests, Personal, Speaker’s Bureau: Lilly; Financial Interests, Personal, Speaker’s Bureau: Sanofi; Financial Interests, Personal, Speaker’s Bureau: Ono Pharmaceutical; Financial Interests, Personal, Speaker’s Bureau: MSD; Financial Interests, Personal, Speaker’s Bureau: Bristol Myers Squibb. T. Yoshino: Financial Interests, Personal, Speaker’s Bureau: Taiho; Financial Interests, Personal, Speaker’s Bureau: Chugai; Financial Interests, Personal, Speaker’s Bureau: Eli Lilly; Financial Interests, Personal, Speaker’s Bureau: Merck Biopharma; Financial Interests, Personal, Speaker’s Bureau: Bayer; Financial Interests, Personal, Speaker’s Bureau: Ono; Financial Interests, Institutional, Research Grant: Taiho; Financial Interests, Institutional, Research Grant: Sumitomo Dainippon; Financial Interests, Institutional, Research Grant: Ono; Financial Interests, Institutional, Research Grant: Chugai; Financial Interests, Institutional, Research Grant: Amgen; Financial Interests, Institutional, Research Grant: Parexel International; Financial Interests, Institutional, Research Grant: MSD; Financial Interests, Institutional, Research Grant: Daiichi Sankyo; Financial Interests, Institutional, Research Grant: Sanofi. All other authors have declared no conflicts of interest.

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Mini Oral session

Discussion 1759MO and 60MO

Speakers
  • Katsuya Tsuchihara (Chuo-ku, Japan)
Lecture Time
17:40 - 17:50
Session Name
Location
Channel 7, Paris Expo Porte de Versailles, Paris, France
Date
Fri, 17.09.2021
Time
17:30 - 18:30
Mini Oral session

LBA68 - Clinical value of pre-treatment T-cell receptors (TCR) repertoire in non-small cell lung cancer (NSCLC) patients treated with single agent immunotherapy

Presentation Number
LBA68
Speakers
  • Afaf Abed (Perth, Australia)
Lecture Time
17:50 - 17:55
Session Name
Location
Channel 7, Paris Expo Porte de Versailles, Paris, France
Date
Fri, 17.09.2021
Time
17:30 - 18:30

Abstract

Background

Reduced Shannon diversity, increased clonality and increased convergence of TCRs have been suggested to reflect clonal expansion of antigen-specific T-cells in the tumour microenvironment and correlated with improved response rate (RR), progression free survival (PFS) and overall survival (OS). Moreover, increased clonality has been linked with increased risk of developing immune related toxicity. We aim to correlate TCR repertoire features with overall response rate RR, PFS, OS and adverse events in peripheral blood of NSCLC patients (with PDL1≥50%) treated with first line single agent pembrolizumab.

Methods

We prospectively collected baseline blood from 50 NSCLC patients treated with pembrolizumab. High quality DNA was extracted and TCR sequencing was performed. TCR repertoir variables were correlated with RR, PFS, OS and immune related toxicity.

Results

Our data matured for 29 patients with a follow-up of at least 18 months. We found that reduced number of unique clones and reduced Shannon diversity was associated with improved RR to pembrolizumab (P = 0.038, 0.021 respectively). 3 TCR families (TRBV6-4, TRBV10-2 and TRBV10-3) were observed to occur more frequently among non-responders comparing to responders (P=0.018, 0.046 and 0.018 respectively). Moreover, there was a significantly longer PFS in patients with reduced number of unique clones (HR = 0.40, P = 0.040), reduced Shannon diversity (HR = 0.44, P = 0.044), reduced Evenness (HR = 0.31, P = 0.033) and elevated clonality (HR = 2.45, P = 0.044). None of these parameters were statically significant in relation to OS. On the other hand, reduced evenness was associated with increased risk of immune related toxicity (P=0.017).

Conclusions

Increased pre-treatment TCR clonality and reduced diversity are associated with improved RR and PFS, but not OS in NSCLC patients with high PD-L1 treated with pembrolizumab monotherapy. Reduced eveness and increased clonality was correlated with increased risk of immune related adverse events. Further maturation of this cohort will demonstrate whether the circulating pre-treatment TCR repertoire is a prognostic factor for immune checkpoint inhibition.

Legal entity responsible for the study

The authors.

Funding

The Australasian Lung Cancer Trials Group.

Disclosure

All authors have declared no conflicts of interest.

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Mini Oral session

1760MO - Impact of immune checkpoint blockade therapy according to CD274 copy number alterations: A retrospective study in the ProfiLER cohort

Presentation Number
1760MO
Speakers
  • Khalil Hodroj (Lyon, Cedex 08, France)
Lecture Time
17:55 - 18:00
Session Name
Location
Channel 7, Paris Expo Porte de Versailles, Paris, France
Date
Fri, 17.09.2021
Time
17:30 - 18:30

Abstract

Background

Immune checkpoint therapy has led to important clinical advances in cancer treatment. Effectiveness of blocking the PD-L1/PD-1 signaling pathway was first correlated to PD-L1 expression with a predictive power that varies substantially between studies. Exploratory analyses of the SAFIR02-Breast study identified CD274 (PD-L1 gene) gain/amplification as a potential predictive biomarker for immune checkpoint blockade drugs (ICBDs) response in triple negative breast cancer patients. In order to determine if CD274 gain/amplification could be an agnostic predictive biomarker, we collected CD274 copy number alterations (CNA) and ICBDs treatment status in the ProfiLER cohort.

Methods

Among the 2962 patients included in the ProfiLER cohort, we selected (i) the subgroup of 285 patients whose tumour had CD274 amplification/gain and (ii) the subgroup of 144 who received ICBD and for which we had the CD274 copy number alteration (CNA) status. Then we assessed in the first group tumour evolution as a function of exposition to ICBD, and, in the second group, we compared clinical response to ICBD according to CD274 CNA.

Results

In the 285 patients with CD274 gain/amplification, median overall survival (OS) from metastatic relapse was 36.7 months in those who received ICBDs and 28 months in those who did not; hazard ratio (HR) 1.52, 95 % confidence interval (CI) [1.05-2.18], p=0.024. Among the 144 patients who did receive ICBD and for which we had the somatic CD274 CNA status, median OS was 15.2 months in the CD274 gain/amplification group compared with 9.7 months in the CD274 normal/loss group; HR 0.63, 95% CI [0.42-0.95], p=0.026. In the most prevalent cohort; head and neck carcinoma (n = 90); median OS was 28.6 months in the CD274 gain/amplification subgroup as compared with 9.1 months in the CD274 normal/loss subgroup; HR 0.40, 95% CI [0.21-0.76], p=0.004.

Conclusions

In this retrospective study, CD274 CNA gain/amplification is associated with OS improvement when patients are treated with ICBD. Further prospective studies are needed to confirm CD274 gain/amplification as a predictive biomarker for ICBDs response.

Legal entity responsible for the study

Centre Léon Berard.

Funding

Has not received any funding.

Disclosure

P. Heudel: Non-Financial Interests, Other: Pfizer; Financial Interests, Research Grant: Novartis; Financial Interests, Research Grant: Roche; Non-Financial Interests, Other: Novartis; Financial Interests, Other: Mylan; Financial Interests, Other: Pierre Fabre; Financial Interests, Other: Seagen; Financial Interests, Other: Amgen; Non-Financial Interests, Other: AstraZeneca. O. Tredan: Financial Interests, Other, personal fees: Roche; Financial Interests, Other, personal fees: MSD-Merck; Financial Interests, Other, personal fees: AstraZeneca; Financial Interests, Other, personal fees: Pfizer; Financial Interests, Other, personal fees: Lilly; Financial Interests, Other, personal fees: Seagen; Financial Interests, Other, personal fees: Daiichi Sankyo; Financial Interests, Other, personal fees: Eisai; Financial Interests, Other, personal fees: Pierre Fabre; Financial Interests, Research Grant: Roche; Financial Interests, Research Grant: MSD-Merck; Financial Interests, Research Grant: BMS. T. Filleron: Non-Financial Interests, Other, Consulting: Cellectics. F. André: Financial Interests, Invited Speaker, and research funding: Roche; Financial Interests, Invited Speaker, and research funding: AstraZeneca; Financial Interests, Invited Speaker, and research funding: Daiichi; Financial Interests, Invited Speaker, and research funding: Pfizer; Financial Interests, Invited Speaker, and research funding: Novartis; Financial Interests, Invited Speaker, and research funding: Lilly. T. Bachelot: Financial Interests, Invited Speaker, and research funding: Roche; Financial Interests, Invited Speaker, and research funding: Novartis; Financial Interests, Invited Speaker, and research funding: Pfizer; Financial Interests, Invited Speaker, and research funding: Seattle Genetic; Financial Interests, Invited Speaker, and research funding: Lilly; Financial Interests, Invited Speaker, and research funding: AstraZeneca. All other authors have declared no conflicts of interest.

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Mini Oral session

1761MO - Defining subset-wise myeloid responses to immune checkpoint blockade in melanoma

Presentation Number
1761MO
Speakers
  • Rosalin Cooper (Oxford, United Kingdom)
Lecture Time
18:00 - 18:05
Session Name
Location
Channel 7, Paris Expo Porte de Versailles, Paris, France
Date
Fri, 17.09.2021
Time
17:30 - 18:30

Abstract

Background

Immune checkpoint blockade (ICB) is associated with improved survival in patients with metastatic melanoma (MM). Despite this, many patients have limited clinical benefit, and there is ongoing attrition amongst responders. Moreover, ICB is associated with auto-immune toxicity. Peripheral biomarkers can help early identification of non-responders, as well as assist in treatment stratification. Recent evidence suggests that myeloid populations may play a role in modulating ICB response, but this has yet to be full defined at the transcriptomic level.

Methods

We performed bulk RNA-seq of peripheral CD14+ cells across 114 pre-treatment, 96 post-treatment MM patient samples and 45 healthy donors. Single-cell RNA-sequencing (scRNA-seq) across a total of 24,457 peripheral CD14+ cells from eight paired MM patient samples and three healthy donors was performed.

Results

Bulk RNA-seq data demonstrates distinct cancer-associated transcriptional profiles in monocytes. ICB is associated with induction of pathways including IFNγ signalling and antigen presentation, with more pronounced responses with combination ICB (cICB: anti-PD1 and anti-CTLA-4). Transcriptional CD14+ profiles are correlated with clinical outcome. At the single cell level, ICB leads to maturation within the classical monocyte compartment, and acquisition of a non-classical monocyte phenotype. Subset-wise monocyte signatures at baseline and following ICB are associated with clinical outcome. In particular, a myeloid-derived suppressor cell (MDSC) signature is negatively associated with the development of auto-immune adverse effects, and is modulated by cICB.

Conclusions

This work confirms ICB-dependent modulation of circulating monocytes, with novel observations regarding subset-wise myeloid responses. This demonstrates the potential clinical utility of circulating immune populations as diagnostic, predictive and prognostic markers in patients with MM.

Legal entity responsible for the study

The authors.

Funding

Cancer Research UK, Wellcome Trust, University of Oxford.

Disclosure

All authors have declared no conflicts of interest.

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Mini Oral session

61MO - Biomarker analysis of men with enzalutamide (enza)-resistant metastatic castration-resistant prostate cancer (mCRPC) treated with pembrolizumab (pembro) + enza in KEYNOTE-199

Presentation Number
61MO
Speakers
  • Julie N. Graff (Portland, United States of America)
Lecture Time
18:05 - 18:10
Session Name
Location
Channel 7, Paris Expo Porte de Versailles, Paris, France
Date
Fri, 17.09.2021
Time
17:30 - 18:30

Abstract

Background

In KEYNOTE-199 (NCT02787005), pembro + enza had durable antitumor activity in enza-refractory mCRPC. We evaluated the association between prespecified biomarkers and clinical outcomes.

Methods

Cohorts 4 (C4; RECIST-measurable disease) and 5 (C5; nonmeasurable, bone-predominant disease) enrolled men with chemotherapy-naive mCRPC, irrespective of PD-L1 status, that progressed after initial response to enza. We evaluated TMB by whole exome sequencing (n = 64), PD-L1 combined positive score (CPS) by IHC (n = 124), and 18-gene T-cell–inflamed gene expression profile (TcellinfGEP) by NanoString (n = 51). Outcomes were DCR, PFS, PSA response, PSA progression, OS, and ORR per blinded independent review (C4 only). Significance of continuous biomarkers (CPS, TMB, GEP) was prespecified at 0.05 for 1-sided P values from logistic (ORR, DCR, PSA response) and Cox proportional hazard (PFS, OS, PSA progression) regression adjusted for ECOG PS.

Results

In C4, ORR was 10% (5/48) in pts with evaluable TMB data and 12% (10/81) in pts with CPS data. In C4 and C5, 16% (10/64) and 14% (17/124) of pts with TMB and CPS data, respectively, achieved a PSA response. TMB was significantly associated with DCR (P = 0.03) and trended toward an association with PSA response (P = 0.08). TMB (AUROC [95% CI]: 0.68 [0.51-0.86]), but not CPS (0.54 [0.41-0.67]) or TcellinfGEP (0.55 [0.37-0.74]), enriched for PSA response. TMB (P = 0.04), but not CPS (P = 0.57) or TcellinfGEP (P = 0.32), was significantly associated with PSA progression. There was 1 MSI-H pt (per Promega PCR assay); this pt achieved an objective and PSA response and had PFS >6 months. TMB, CPS, and TcellinfGEP were not associated with PFS or OS. There was a low prevalence of TMB ≥175 mut/exome (11%) and TcellinfGEP-high (≥−0.318; 16%).

Conclusions

In this biomarker analysis of KEYNOTE-199 C4-C5, PD-L1 CPS and TcellinfGEP were not significantly associated with clinical outcome. Despite the low prevalence of TMB ≥175 mut/exome, TMB was positively associated with outcomes of pembro + enza in pts with mCRPC. The sample sizes for the exploratory analyses were small, and results should be interpreted with caution.

Clinical trial identification

NCT02787005.

Editorial acknowledgement

Medical writing and/or editorial assistance was provided by Dana Francis, PhD, of the ApotheCom pembrolizumab team (Yardley, PA, USA). This assistance was funded by Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc., Kenilworth, NJ, USA.

Legal entity responsible for the study

Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc., Kenilworth, NJ, USA.

Funding

Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc., Kenilworth, NJ, USA.

Disclosure

J.N. Graff: Financial Interests, Personal, Other, Travel expenses: Merck, Sanofi; Financial Interests, Institutional, Research Grant: Merck, Astellas/Pfizer, Sanofi, Janssen; Non-Financial Interests, Personal, Advisory Role: Merck, Astellas, Janssen. S. Tagawa: Financial Interests, Personal, Other, Honoraria: Sanofi, Medivation/Astellas, Dendreon, Janssen, Genentech, Bayer, Endocyte, Eisai, Immunomedics, Karyopharm, AbbVie, Tolmar, Seattle Genetics, Amgen, Clovis, QED, Pfizer, AAA/Novartis, Clarity, Genomic Health, POINT Biopharma, Blue Earth Diagnostics, AIki; Financial Interests, Institutional, Research Grant: Sanofi, Medivation, Astellas, Janssen, Amgen, Progenics, Dendreon, Lilly, Genentech, Newlink, BMS, Inovio, AstraZeneca, Immunomedics, Aveo, Rexahn, Atlab, Boehringer Ingelheim, Millennium, Bayer, Merck, AbbVie, Karyopharm, Endocyte, Clovis, Seattle Gene. C. Hoimes: Financial Interests, Personal, Advisory Role, Advisory/consultancy: Merck, Seagen, BMS, Genentech, Bayer; Financial Interests, Personal, Speaker’s Bureau, Speaker Bureau/Expert Testimony: Seagen, BMS, Genentech, Eisai. W. Gerritsen: Financial Interests, Institutional, Advisory Role, Advisory/consultancy: BMS, IqVia, Bayer, MSD, Sanofi, Janssen-Cilag; Financial Interests, Institutional, Speaker’s Bureau, Speaker Bureau/Expert Testimony: MSD; Financial Interests, Institutional, Research Grant: Astellas, Bayer, Janssen-Cilag, Sanofi. U.N. Vaishampayan: Financial Interests, Personal, Other, Honoraria: AAA, Alkermes, Bayer, Pfizer, BMS, Exelixis; Financial Interests, Personal, Advisory Role, Advisory/Consultancy: Merck, BMS, Exelixis; Financial Interests, Personal, Research Grant: Merck, BMS. C. Hwang: Financial Interests, Personal, Stocks/Shares: Johnson & Johnson; Financial Interests, Personal, Research Grant: Merck, Exelixis, Bayer, AstraZeneca, Genentech, Dendreon and Bausch; Financial Interests, Personal, Other: Sanofi/Genzyme, Bristol Myers Squibb, Astellas, Medivation, Bayer, and Janssen Scientific. A.G. Omlin: Financial Interests, Institutional, Other, Honoraria: AstraZeneca, Astellas, Bayer, BMS, Janssen, Molecular Partners, MSD, Pfizer, Roche, Sanofi Aventis; Financial Interests, Institutional, Research Grant: TEVA, Janssen; Financial Interests, Personal, Other, Travel/Accommodations/Expenses: Astellas, Bayer, Janssen, Sanofi Aventis. R.S. McDermott: Financial Interests, Personal, Advisory Role, Advisory/consultancy: Amgen, Bayer, BMS, Clovis, Janssen, Pfizer; Financial Interests, Personal, Speaker’s Bureau, Speaker Bureau/Expert Testimony: Astellas, Ipsen, MSD; Financial Interests, Institutional, Research Grant: Astellas, Bayer, BMS, Clovis, Regeneron, MSD. R. De Wit: Financial Interests, Personal, Other, Honoraria: Merck, Sanofi, Bayer, Astellas; Financial Interests, Personal, Advisory Role, Advisory/Consultancy: Merck, Sanofi, Bayer, Astellas; Financial Interests, Institutional, Research Grant: Bayer. C. Poehlein: Financial Interests, Personal, Full or part-time Employment: Merck & Co.; Financial Interests, Personal, Stocks/Shares: Merck & Co.. J. Kim: Financial Interests, Personal, Stocks/Shares: Merck & Co., Inc.; Financial Interests, Personal, Full or part-time Employment: Merck & Co., Inc.. L. Suttner: Financial Interests, Personal, Full or part-time Employment: Merck. R. Cristescu: Financial Interests, Personal, Stocks/Shares: Merck & Co., Inc.; Financial Interests, Personal, Full or part-time Employment: Merck & Co., Inc.; Financial Interests, Personal, Other: Pending patent: Patent WO 2020/167619. M.J. Marton: Financial Interests, Personal, Stocks/Shares: Merck; Financial Interests, Personal, Full or part-time Employment: MSD. C. Schloss: Financial Interests, Personal, Full or part-time Employment: Merck & Co., Inc.. J.S. de Bono: Financial Interests, Personal, Other, Honoraria: Amgen, Astellas, AstraZeneca, Bayer, Bioxcel Therapeutics, Boehringer Ingelheim, Cellcentric, Daiichi, Eisai, Genentech Roche, Genmab, GlaxoSmithKline, Harpoon, Janssen, Menarini Silicon Biosystems, Merck Serono, Merck Sharp & Dohme, Orion Pharma, Pfizer; Financial Interests, Personal, Advisory Role, Advisory/Consultancy: Amgen, Astellas, AstraZeneca, Bayer, Bioxcel Therapeutics, Boehringer Ingelheim, Cellcentric, Daiichi, Eisai, Genentech Roche, Genmab, GlaxoSmithKline, Harpoon, Janssen, Menarini Silicon Biosystems, Merck Serono, Merck Sharp & Dohme, Orion Pharma, Pfizer; Financial Interests, Personal, Other, Travel/Accommodations/Expenses: Amgen, Astellas, AstraZeneca, Bayer, Bioxcel Therapeutics, Boehringer Ingelheim, Cellcentric, Daiichi, Eisai, Genentech Roche, Genmab, GlaxoSmithKline, Harpoon, Janssen, Menarini Silicon Biosystems, Merck Serono, Merck Sharp & Dohme, Orion Pharma, Pfizer; Financial Interests, Institutional, Research Grant: Astellas, AstraZeneca, Bayer, Cellcentric, Daiichi, Genentech Roche, Genmab, GlaxoSmithKline, Harpoon, Janssen, Merck Serono, Merck Sharp & Dohme, Orion Pharma, Pfizer, Sanofi Aventis, Sierra Oncology, Taiho, Vertex Pharmaceuticals; Financial Interests, Personal, Other: Patent no. WO 2005 053662; Financial Interests, Personal, Other: Patent no. US5604213. E.S. Antonarakis: Financial Interests, Personal, Advisory Role, Advisory/consultancy: Amgen, Astellas, AstraZeneca, Bayer, Clovis Oncology, Dendreon, Eli Lilly, ESSA, GlaxoSmithKline, Janssen, Medivation, Merck, Sanofi; Financial Interests, Personal, Research Grant: AstraZeneca, Bristol Myers-Squibb, Celgene, Clovis Oncology, Dendreon, Genentech, Janssen, Johnson & Johnson, Merck, Novartis, Sanofi, Tokai; Financial Interests, Personal, Licensing Fees, Licensing/royalties: Qiagen. All other authors have declared no conflicts of interest.

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Mini Oral session

Discussion LBA68, 1760MO, 1761MO and 61MO

Speakers
  • Bertrand Routy (Montreal, Canada)
Lecture Time
18:10 - 18:30
Session Name
Location
Channel 7, Paris Expo Porte de Versailles, Paris, France
Date
Fri, 17.09.2021
Time
17:30 - 18:30