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01-09-2016 | Clinical Study

Pembrolizumab: first experience with recurrent primary central nervous system (CNS) tumors

Authors: Deborah T. Blumenthal, Michal Yalon, Gilad W. Vainer, Alexander Lossos, Shlomit Yust, Lior Tzach, Emanuela Cagnano, Dror Limon, Felix Bokstein

Published in: Journal of Neuro-Oncology | Issue 3/2016

Abstract

Patients with progressive primary brain tumors (PBT) are attracted to promising new treatments, even prior to convincing data. Anti-PD1 immunotherapies have been in the spotlight since publication of groundbreaking results for metastatic melanoma with pembrolizumab (PBL). Our objective was to report on the response and toxicity of PBL in patients with advanced PBT. We retrospectively reviewed the charts of 22 patients (17 adults and 5 children) with recurrent central nervous system tumors treated with PBL. We analyzed prior antineoplastic therapies, steroid usage, and outcomes. Patients received a median of two neoplastic therapies prior to PBL, and a median of three infusions of PBL in adults and four in children. Twelve patients (9 adults and 3 children) started PBL on steroids (median dose in adults 4 mg; range 2–8, and in children 1.5 mg, range 0.5–4) and five patients received steroids later during PBL treatment. Twelve patients (10 adults and 2 children) received concomitant bevacizumab with PBL. Side effects were minimal. All patients showed progressive tumor growth during therapy. Median OS from the start of PBL was 2.6 months in adults and 3.2 months in children. Two GB patients underwent tumor resection following treatment with PBL. Tumor-lymphocytic response in these cases was unremarkable, and PD-L1 immuno-staining was negative. In this series of 22 patients with recurrent primary brain tumors, PBL showed no clinical or histologic efficacy. We do not recommend further use of PBL for recurrent PBT unless convincing prospective clinical trial data are published.

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Title: Pembrolizumab: first experience with recurrent primary central nervous system (CNS) tumors
Authors: Deborah T. Blumenthal
Michal Yalon
Gilad W. Vainer
Alexander Lossos
Shlomit Yust
Lior Tzach
Emanuela Cagnano
Dror Limon
Felix Bokstein
Publication date: 01-09-2016
Publisher: Springer US
Published in: Journal of Neuro-Oncology / Issue 3/2016
Print ISSN: 0167-594X
Electronic ISSN: 1573-7373
DOI: https://doi.org/10.1007/s11060-016-2190-1

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Pembrolizumab: first experience with recurrent primary central nervous system (CNS) tumors

Abstract

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