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KEYNOTE-017 showed that pembrolizumab given as the first treatment shrinks more than half of advanced Merkel cell carcinomas, whether or not the tumour carries the Merkel cell polyomavirus.
KEYNOTE-017 was a single-arm phase 2 trial of first-line pembrolizumab in advanced Merkel cell carcinoma run by the Cancer Immunotherapy Trials Network. It tested PD-1 blockade before chemotherapy, on the reasoning that chemotherapy responses in this disease are short and immunosuppressive.
The objective response rate was 56 percent in the first 26 patients (NEJM 2016) and remained 56 percent in the full cohort of 50 (JCO 2019), with responses in both virus-positive and virus-negative tumours and most responses lasting beyond two years. Grade 3 or worse treatment-related events occurred in a minority and were manageable.
Pembrolizumab was approved for Merkel cell carcinoma in December 2018. Together with JAVELIN Merkel 200 it moved immunotherapy to the first line and made chemotherapy a fallback for the minority who do not respond.
Numbers are from the trial as recorded here; see the source links in the table below. This is orientation, not medical advice: ask your team how closely the trial population matches you.
A second publication from the KEYNOTE-017 trial, later than the first and described in its title as an update or longer-term analysis. Read it with the primary publication linked from the trial page; the record was linked automatically and its figures have not been checked by hand.
This is the paper Europe PMC returns for registry id NCT02267603 with the most citations, so it is the natural first reading for anyone following the KEYNOTE-017 trial. Read the abstract above alongside the trial page and the registry entry; the record was linked automatically and its figures have not been checked by hand.
Shares ADMEC-O (adjuvant nivolumab in completely resected Merkel cell carcinoma), POD1UM-201 (retifanlimab in advanced Merkel cell carcinoma), Merkel cell carcinoma, Skin cancer (all types).
Shares ADMEC-O (adjuvant nivolumab in completely resected Merkel cell carcinoma), POD1UM-201 (retifanlimab in advanced Merkel cell carcinoma), Oncogenic viruses, Merkel cell carcinoma.
Shares ADMEC-O (adjuvant nivolumab in completely resected Merkel cell carcinoma), POD1UM-201 (retifanlimab in advanced Merkel cell carcinoma), Merkel cell carcinoma, Pembrolizumab.
Shares Merkel cell carcinoma, Merck & Co. (MSD), Pembrolizumab, Immune checkpoint inhibitors.
Shares PD-1 Blockade with Pembrolizumab in Advanced Merkel-Cell Carcinoma, Merkel cell carcinoma, Skin cancer (all types).
Shares Merkel cell carcinoma, Pembrolizumab, Immune checkpoint inhibitors.
Shares POD1UM-201 (retifanlimab in advanced Merkel cell carcinoma), Oncogenic viruses, Merkel cell carcinoma, Skin cancer (all types).
Shares Immune-related adverse events (irAEs), Pembrolizumab, Immune checkpoint inhibitors.