The PEMDAC phase 2 study of pembrolizumab and entinostat in patients with metastatic uveal melanoma

Lars Ny, Henrik Jespersen, Joakim Karlsson, Samuel Alsén, Stefan Filges, Charlotta All-Eriksson, Bengt Andersson, Ana Carneiro, Hildur Helgadottir, Max Levin, Ingrid Ljuslinder, Roger Olofsson Bagge, Vasu R. Sah, Ulrika Stierner, Anders Ståhlberg, Gustav Ullenhag, Lisa M. Nilsson, Jonas A. Nilsson

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90 Citations (Scopus)

Abstract

Preclinical studies have suggested that epigenetic therapy could enhance immunogenicity of cancer cells. We report the results of the PEMDAC phase 2 clinical trial (n = 29; NCT02697630) where the HDAC inhibitor entinostat was combined with the PD-1 inhibitor pembrolizumab in patients with metastatic uveal melanoma (UM). The primary endpoint was objective response rate (ORR), and was met with an ORR of 14%. The clinical benefit rate at 18 weeks was 28%, median progression free survival was 2.1 months and the median overall survival was 13.4 months. Toxicities were manageable, and there were no treatment-related deaths. Objective responses and/or prolonged survival were seen in patients with BAP1 wildtype tumors, and in one patient with an iris melanoma that exhibited a UV signature. Longer survival also correlated with low baseline ctDNA levels or LDH. In conclusion, HDAC inhibition and anti-PD1 immunotherapy results in durable responses in a subset of patients with metastatic UM. Trial registration ClinicalTrials.gov registration number: NCT02697630 (registered 3 March 2016). EudraCT registration number: 2016–002114-50.

Original languageEnglish
Article number5155
JournalNature Communications
Volume12
Issue number1
DOIs
Publication statusPublished - 1 Dec 2021

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