University of Pittsburgh Cancer Institute, Pittsburgh, PA
Shalu Pahuja , Jan Hendrik Beumer , Leonard Joseph Appleman , Hussein Abdul-Hassan Tawbi , Ronald G. Stoller , James J. Lee , Yan Lin , Brian Kiesel , Jing Yu , Antoinette R. Tan , Chandra Prakash Belani , Helen K. Chew , Agustin A. Garcia , Robert Morgan , Alice P. Chen , Vincent L. Giranda , Stacie Peacock Shepherd , Edward Chu , Shannon Puhalla
Background: Veliparib (V) (ABT-888) is an oral, potent inhibitor of PARP 1/2. PARP inhibitors have preclinical and clinical efficacy in BRCA+ malignancies. There are genotypic and phenotypic similarities between BRCA+ cancers, serous ovarian cancer and basal-like breast cancer and we postulated that these tumors types may be similarly sensitive to single-agent PARP inhibition. This study sought to establish the maximum tolerated dose (MTD), dose -limiting toxicities (DLT), pharmacokinetic and pharmocodynamic properties, and preliminary efficacy of chronically-dosed V in 2 cohorts of patients, BRCA+ and BRCA-wt (consisting of serous ovarian cancer and triple-negative breast cancer (TNBC). Methods: A 3+3 dose escalation phase I trial was performed. Nine dose levels (DL) were planned, and dose escalation started at 50 mg BID to a maximum of 500 mg BID to determine a maximum tolerated dose (MTD) and recommended phase II dose (RP2D). V was administered orally continuously on a 28 day cycle. BRCA+ and BRCA-wt patients were enrolled in 2 separate cohorts with 2 separate escalations. Results: 98 (70 BRCA+ and 28 BRCA-wt) pts have been enrolled. The maximum administered dose (MAD) was 500mg BID and the MTD/RP2D is 400mg BID for both cohorts. 59 BRCA+ pts and 24 BRCA-wt pts (21 TNBC and 3 ovary) were evaluable for response. ORR was defined as CR+PR and clinical benefit rate (CBR) as CR+PR+SD > 6 months. Results are summarized in the table. Conclusions: There is evidence of anti-tumor activity with V comparable to that of other PARP inhibitors in the BRCA+ population. There was indication of dose responsiveness with greater activity in this population at higher doses. There is less activity in the mostly TNBC, BRCA-wt population, although there was evidence of benefit in a small number of patients. Ongoing tissue correlative studies will help to identify potential mechanisms of sensitivity and resistance. Clinical trial information: NCT00892736.
Total ORR | RP2D/MAD ORR | Total CBR | RP2D/MAD CBR | |
---|---|---|---|---|
All tumor types: BRCA+ | 14/59 = 24% | 13/35 = 37% | 33/59 = 56% | 22/35 = 63% |
BRCA+ breast cancer | 4/14 = 29% | 3/5 = 60% | 8/14 = 57% | 4/5 = 80% |
All tumor types: BRCA-wt | 1/24 = 4% | 0/5 = 0% | 4/24 = 17% | 0/5 = 0% |
BRCA-wt breast cancer | 1/21 = 5% | 0/4 = 0% | 4/21 = 19% | 0/4 = 0% |
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Abstract Disclosures
2022 ASCO Annual Meeting
First Author: Huiping Li
2023 ASCO Annual Meeting
First Author: Helen Mackay
2012 ASCO Annual Meeting
First Author: Shannon Leigh Huggins-Puhalla
2024 ASCO Genitourinary Cancers Symposium
First Author: Daniel Triner