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Dr. Petrylak on the KEYNOTE-045 Trial for Urothelial Carcinoma

Daniel P. Petrylak, MD
Published: Friday, Jun 09, 2017



Daniel P. Petrylak, MD, professor of Medicine (Medical Oncology) and Urology, co-director, Signal Transduction Research Program, Yale Cancer Center, 2017 Giant of Cancer Care in Genitourinary Cancer, discusses the KEYNOTE-045 trial investigating pembrolizumab (Keytruda) versus physician’s choice of chemotherapy for patients with urothelial carcinoma.

KEYNOTE-045 is a randomized trial that compares pembrolizumab to a dealer's choice chemotherapy in patients with urothelial cancer that have been previously treated with platinum-based chemotherapy regimens that could be with carboplatin or cisplatin, explains Petrylak. This trial was the first to demonstrate a survival benefit in favor of the checkpoint inhibitor compared with chemotherapy.

The chemotherapy arm was about 7 months, whereas the checkpoint inhibition arm was about 10 months. That is a significant difference and is clinically meaningful. There is a proportion of patients, about 25%, who do extremely well. They have prolonged durable responses and that is what is really driving the survival benefit in the situation, states Petrylak.
 


Daniel P. Petrylak, MD, professor of Medicine (Medical Oncology) and Urology, co-director, Signal Transduction Research Program, Yale Cancer Center, 2017 Giant of Cancer Care in Genitourinary Cancer, discusses the KEYNOTE-045 trial investigating pembrolizumab (Keytruda) versus physician’s choice of chemotherapy for patients with urothelial carcinoma.

KEYNOTE-045 is a randomized trial that compares pembrolizumab to a dealer's choice chemotherapy in patients with urothelial cancer that have been previously treated with platinum-based chemotherapy regimens that could be with carboplatin or cisplatin, explains Petrylak. This trial was the first to demonstrate a survival benefit in favor of the checkpoint inhibitor compared with chemotherapy.

The chemotherapy arm was about 7 months, whereas the checkpoint inhibition arm was about 10 months. That is a significant difference and is clinically meaningful. There is a proportion of patients, about 25%, who do extremely well. They have prolonged durable responses and that is what is really driving the survival benefit in the situation, states Petrylak.
 



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