Phase I/II study of durvalumab and tremelimumab in patients with unresectable hepatocellular carcinoma (HCC): Phase I safety and efficacy analyses.

Authors

null

Robin Kate Kelley

University of California, San Francisco, San Francisco, CA

Robin Kate Kelley , Ghassan K. Abou-Alfa , Johanna C. Bendell , Tae-You Kim , Mitesh J. Borad , Wei-Peng Yong , Michael Morse , Yoon-Koo Kang , Marlon Rebelatto , Mallory Makowsky , Feng Xiao , Shannon R. Morris , Bruno Sangro

Organizations

University of California, San Francisco, San Francisco, CA, Memorial Sloan Kettering Cancer Center, New York, NY, Sarah Cannon Research Institute and Tennessee Oncology, PLLC, Nashville, TN, Seoul National University Hospital, Seoul, South Korea, Mayo Clinic, Scottsdale, AZ, National University Hospital, Singapore, Singapore, Duke University Medical Center, Durham, NC, Asan Medical Center, University of Ulsan College of Medcine, Seoul, South Korea, MedImmune, Gaithersburg, MD, Clinica Universidad de Navarra and Biomedical Research Network in Hepatic and Digestive Diseases (CIBEREHD), Pamplona, Spain

Research Funding

Pharmaceutical/Biotech Company

Background: Durvalumab and tremelimumab, investigational monoclonal antibodies against PD-L1 and CTLA-4 immune checkpoints, respectively, have shown efficacy in monotherapy and offer promise in combination for patients (pts) with HCC. This is a phase I/II, open-label, randomized study of durvalumab combined with tremelimumab in unresectable HCC. Methods: Phase I part of this study is a safety run-in cohort treated at the recommended phase II doses of the durvalumab/tremelimumab combination (20 and 1 mg/kg IV Q4W respectively for 4 doses followed by 20 mg/kg Q4W durvalumab alone) in pts with unresectable HCC with or without concomitant HBV or HCV infection who progress on, are intolerant to, or have refused sorafenib therapy. Secondary objectives include evaluation of antitumor activity. Here we present results of a preplanned analysis from the completed phase I part of the study. Results: As of 10 January 2017, 40 pts have been enrolled (11 HBV+, 9 HCV+, 20 uninfected). 30% had no prior systemic therapy; 93% were Child Pugh Class A. 24 (60%) had ≥1 treatment-related AE; 20% had ≥1 grade ≥3 related AE. Most common (≥15%) treatment-related AEs: fatigue (20%), increased ALT (18%), pruritus (18%), and increased AST (15%). Most common grade ≥3 related AE was asymptomatic increased AST (10%). 24 pts have discontinued treatment: 3 due to treatment-related AEs (grade 3 pneumonitis, grade 3 colitis/diarrhea, asymptomatic grade 4 elevated AST and ALT), 16 due to progressive disease, 4 due to death unrelated to treatment (cardiac arrest, variceal bleed, progressive disease, probable HCC rupture), and 1 other (pt entered hospice care). 40 pts were evaluable for response at ≥16 weeks follow-up. Conclusions: No unexpected safety signals with durvalumab and tremelimumab were seen in this unresectable HCC population. Clinical activity observed predominantly in uninfected pts though interpretation limited by small subsets. Enrollment to the phase II portion of the study is ongoing. Clinical trial information: NCT02519348

n (%)HBV+
(N = 11)
HCV+
(N = 9)
Uninfected
(N = 20)
All
(N = 40)
Confirmed ORR (all PR)006 (30)6 (15)
CR + PR (confirmed + unconfirmed)1 (9.1)07 (35)8 (20)
CR + PR + SD ≥16 wk (DCR16)5 (45.5)4 (44.4)14 (70)23 (57.5)

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Abstract Details

Meeting

2017 ASCO Annual Meeting

Session Type

Poster Session

Session Title

Gastrointestinal (Noncolorectal) Cancer

Track

Gastrointestinal Cancer—Gastroesophageal, Pancreatic, and Hepatobiliary

Sub Track

Hepatobiliary Cancer

Clinical Trial Registration Number

NCT02519348

Citation

J Clin Oncol 35, 2017 (suppl; abstr 4073)

DOI

10.1200/JCO.2017.35.15_suppl.4073

Abstract #

4073

Poster Bd #

65

Abstract Disclosures