At 10 years, more than one-third (34.0%) of patients with advanced melanoma were alive after treatment with KEYTRUDA, compared to 23.6% of patients treated with ipilimumab

RAHWAY, N.J.--(BUSINESS WIRE)-- Merck (NYSE: MRK), known as MSD outside of the United States and Canada, today announced long-term overall survival (OS) data from the pivotal Phase 3 KEYNOTE-006 trial, evaluating KEYTRUDA® (pembrolizumab), Merck’s anti-PD-1 therapy, in patients with advanced melanoma. Based on 10 years of follow-up, the data showed sustained improved survival outcomes for patients receiving KEYTRUDA as a single agent compared to ipilimumab in patients with advanced melanoma. These late-breaking data will be presented for the first time today during a mini oral session at the European Society for Medical Oncology (ESMO) Congress 2024 (presentation #LBA44) and published in the Annals of Oncology.

For patients with advanced melanoma, these long-term follow-up data showed the 10-year OS rate for KEYTRUDA was 34.0% versus 23.6% for ipilimumab. KEYTRUDA demonstrated a sustained OS benefit, reducing the risk of death by 29% (HR=0.71 [95% CI, 0.60-0.85]). At 10 years, KEYTRUDA more than doubled the median OS compared to ipilimumab (32.7 months versus 15.9 months).

“Ten years ago, KEYTRUDA became the first anti-PD-1/L1 therapy approved in the United States, setting the stage for transformative breakthroughs in the treatment of advanced melanoma and other types of cancer,” said Dr. Marjorie Green, senior vice president and head of oncology, global clinical development, Merck Research Laboratories. “KEYTRUDA has reshaped the treatment of certain types of cancers, extending its benefits to a broader range of tumor types and patients, and we look forward to the prospect of more innovation for patients over the next 10 years and beyond.”

“The prognosis for patients diagnosed with melanoma has been steadily improving, with a 30% reduction in mortality compared to a decade ago,” said Dr. Caroline Robert, head of dermatology at Gustave Roussy, Villejuif and Paris-Sud University Cancer Campus, Grand Paris. “These latest data from KEYNOTE-006 illustrate the progress we’ve made in patient care. It is remarkable to see that more than one-third of patients treated with KEYTRUDA are still alive today, 10 years after treatment.”

To date, KEYTRUDA has demonstrated sustained survival benefits of five years or more across multiple types of cancer, including certain types of melanoma (KEYNOTE-006, KEYNOTE-054), non-small cell lung cancer (KEYNOTE-189, KEYNOTE-407), head and neck cancer (KEYNOTE-048) and bladder cancer (KEYNOTE-045).

Based on the results from KEYNOTE-006 in December 2015, the U.S. Food and Drug Administration approved KEYTRUDA for the treatment of patients with unresectable or metastatic melanoma.

Ten-year follow-up of KEYNOTE-006 patients (Presentation #LBA44)

KEYNOTE-006 (ClinicalTrials.gov, NCT01866319) was an open-label, randomized Phase 3 study comparing the efficacy and safety of KEYTRUDA versus ipilimumab in participants with advanced melanoma. The primary endpoints for KEYNOTE-006 were progression-free survival (PFS) and OS. At the conclusion of the KEYNOTE-006 study, participants were eligible to transition to the KEYNOTE-587 (ClinicalTrials.gov, NCT03486873) extension study for long-term follow-up. The primary endpoint for KEYNOTE-587 is OS. Results being presented at ESMO include an analysis of the efficacy and safety outcomes for 211 former KEYNOTE-006 participants who transitioned to KEYNOTE-587 (KEYTRUDA, n=159; ipilimumab, n=52) after 10 years of follow-up and an analysis of additional antitumor activity in patients who received a second course of KEYTRUDA.

With a median follow-up of 123.7 months (range, 122.0-127.3) from the time of study entry in KEYNOTE-006 to data cutoff for KEYNOTE-587, KEYTRUDA continued to demonstrate improved OS and PFS. Findings from this long-term follow-up showed that the median OS was 32.7 months (95% CI, 24.5-41.6) for KEYTRUDA versus 15.9 months (95% CI, 13.3-22.0) for ipilimumab (HR=0.71 [95% CI, 0.60-0.85]). The 10-year OS rate was 34.0% for KEYTRUDA versus 23.6% for ipilimumab. Median modified PFS was 9.4 months (95% CI, 6.7-11.6) for KEYTRUDA and 3.8 months (95% CI, 2.9-4.3) for ipilimumab (HR=0.64 [95% CI, 0.54-0.75]).

At the final primary analysis with a median follow-up of 32 months, KEYNOTE-006 showed that with KEYTRUDA, 55.1% and 55.3% of patients were alive two years after starting treatment (every two weeks and three weeks, respectively), compared to 43.0% of patients receiving ipilimumab (HR=0.68 [95% CI, 0.53-0.87; p=0.0008] and HR=0.68 [95% CI, 0.53-0.86; p=0.0008], respectively).

Selected safety information from KEYNOTE-006 can be found below.

About melanoma

Melanoma, the most serious form of skin cancer, is characterized by the uncontrolled growth of pigment-producing cells. The rates of melanoma have been rising over the past few decades, with more than 331,650 new cases diagnosed worldwide in 2022. In the U.S., skin cancer is one of the most common types of cancer diagnosed, and melanoma accounts for a large majority of skin cancer deaths. It is estimated there will be more than 100,640 new cases of melanoma diagnosed and more than 8,290 deaths resulting from the disease in the U.S. in 2024. As of 2018, the estimated five-year survival rate for distant metastatic (Stage IV) melanoma is 22.5%.

About KEYTRUDA® (pembrolizumab) injection, 100 mg

KEYTRUDA is an anti-programmed death receptor-1 (PD-1) therapy that works by increasing the ability of the body’s immune system to help detect and fight tumor cells. KEYTRUDA is a humanized monoclonal antibody that blocks the interaction between PD-1 and its ligands, PD- L1 and PD-L2, thereby activating T lymphocytes which may affect both tumor cells and healthy cells.

Merck has the industry’s largest immuno-oncology clinical research program. There are currently more than 1,600 trials studying KEYTRUDA across a wide variety of cancers and treatment settings. The KEYTRUDA clinical program seeks to understand the role of KEYTRUDA across cancers and the factors that may predict a patient's likelihood of benefitting from treatment with KEYTRUDA, including exploring several different biomarkers.

Selected KEYTRUDA® (pembrolizumab) Indications in the U.S.

Melanoma

KEYTRUDA is indicated for the treatment of patients with unresectable or metastatic melanoma.

KEYTRUDA is indicated for the adjuvant treatment of adult and pediatric (12 years and older) patients with Stage IIB, IIC, or III melanoma following complete resection.

See additional selected KEYTRUDA indications in the U.S. after the Selected Important Safety Information.

Selected Important Safety Information for KEYTRUDA

Severe and Fatal Immune-Mediated Adverse Reactions

KEYTRUDA is a monoclonal antibody that belongs to a class of drugs that bind to either the programmed death receptor-1 (PD-1) or the programmed death ligand 1 (PD-L1), blocking the PD-1/PD-L1 pathway, thereby removing inhibition of the immune response, potentially breaking peripheral tolerance and inducing immune-mediated adverse reactions. Immune-mediated adverse reactions, which may be severe or fatal, can occur in any organ system or tissue, can affect more than one body system simultaneously, and can occur at any time after starting treatment or after discontinuation of treatment. Important immune-mediated adverse reactions listed here may not include all possible severe and fatal immune-mediated adverse reactions.

Monitor patients closely for symptoms and signs that may be clinical manifestations of underlying immune-mediated adverse reactions. Early identification and management are essential to ensure safe use of anti–PD-1/PD-L1 treatments. Evaluate liver enzymes, creatinine, and thyroid function at baseline and periodically during treatment. For patients with TNBC treated with KEYTRUDA in the neoadjuvant setting, monitor blood cortisol at baseline, prior to surgery, and as clinically indicated. In cases of suspected immune-mediated adverse reactions, initiate appropriate workup to exclude alternative etiologies, including infection. Institute medical management promptly, including specialty consultation as appropriate.

Withhold or permanently discontinue KEYTRUDA depending on severity of the immune-mediated adverse reaction. In general, if KEYTRUDA requires interruption or discontinuation, administer systemic corticosteroid therapy (1 to 2 mg/kg/day prednisone or equivalent) until improvement to Grade 1 or less. Upon improvement to Grade 1 or less, initiate corticosteroid taper and continue to taper over at least 1 month. Consider administration of other systemic immunosuppressants in patients whose adverse reactions are not controlled with corticosteroid therapy.

Immune-Mediated Pneumonitis

KEYTRUDA can cause immune-mediated pneumonitis. The incidence is higher in patients who have received prior thoracic radiation. Immune-mediated pneumonitis occurred in 3.4% (94/2799) of patients receiving KEYTRUDA, including fatal (0.1%), Grade 4 (0.3%), Grade 3 (0.9%), and Grade 2 (1.3%) reactions. Systemic corticosteroids were required in 67% (63/94) of patients. Pneumonitis led to permanent discontinuation of KEYTRUDA in 1.3% (36) and withholding in 0.9% (26) of patients. All patients who were withheld reinitiated KEYTRUDA after symptom improvement; of these, 23% had recurrence. Pneumonitis resolved in 59% of the 94 patients.

Pneumonitis occurred in 8% (31/389) of adult patients with cHL receiving KEYTRUDA as a single agent, including Grades 3-4 in 2.3% of patients. Patients received high-dose corticosteroids for a median duration of 10 days (range: 2 days to 53 months). Pneumonitis rates were similar in patients with and without prior thoracic radiation. Pneumonitis led to discontinuation of KEYTRUDA in 5.4% (21) of patients. Of the patients who developed pneumonitis, 42% interrupted KEYTRUDA, 68% discontinued KEYTRUDA, and 77% had resolution.

Pneumonitis occurred in 7% (41/580) of adult patients with resected NSCLC who received KEYTRUDA as a single agent for adjuvant treatment of NSCLC, including fatal (0.2%), Grade 4 (0.3%), and Grade 3 (1%) adverse reactions. Patients received high-dose corticosteroids for a median duration of 10 days (range: 1 day to 2.3 months). Pneumonitis led to discontinuation of KEYTRUDA in 26 (4.5%) of patients. Of the patients who developed pneumonitis, 54% interrupted KEYTRUDA, 63% discontinued KEYTRUDA, and 71% had resolution.

Immune-Mediated Colitis

KEYTRUDA can cause immune-mediated colitis, which may present with diarrhea. Cytomegalovirus infection/reactivation has been reported in patients with corticosteroid-refractory immune-mediated colitis. In cases of corticosteroid-refractory colitis, consider repeating infectious workup to exclude alternative etiologies. Immune-mediated colitis occurred in 1.7% (48/2799) of patients receiving KEYTRUDA, including Grade 4 (

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