John Kuruvilla, MD, Discusses Toxicities Observed in the Phase 3 KEYNOTE-204 Study

The expert in hematology highlighted the toxicities reported in this trial and explained the differences observed between the 2 drugs studied.

Findings from the randomized, open-label, phase III KEYNOTE-204 trial, presented at the 2020 American Society of Clinical Oncology (ASCO) Virtual Scientific Program, demonstrated that pembrolizumab (Keytruda) was superior to brentuximab vedotin (Adcetris) in patients with relapsed or refractory classic Hodgkin lymphoma.

In an interview with CancerNetwork®, John Kuruvilla, MD, of the Princess Margaret Cancer Centre, highlighted the toxicities reported in this trial and explained the differences observed between the 2 drugs studied. 


The other thing to highlight about KEYNOTE-204 relates to the toxicity that was seen on the clinical trial. Both of the drugs, there’s certainly lots of experience in routine clinical practice using them. So, we didn't see anything particularly new or surprising, but because the drugs work with different mechanisms, we saw differential toxicity. So, with brentuximab the common things that you see are things like peripheral neuropathy, largely improving or self-limited when the drug is held, or dose reduced. With pembrolizumab, we saw a lot of the immune-related adverse events that are fairly common for these types of drugs. They're generally fairly minor things like hypothyroidism, or those sorts of things that are fairly common grade 1 or 2 toxicities. The one that a lot of clinicians and patients need to know a little bit about is pneumonitis. And so, this was seen in about 10% of the patients that received pembrolizumab, it was grade 3 or 4 in a little over 5% of the patients that received the drug. Again, thankfully no patient related deaths were seen in patients with these types of toxicities. It could be successfully managed with steroids in the majority of the patients and so is an important toxicity the highlight but certainly did not limit the effectiveness of the drug.

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