Atezolizumab (A) + cobimetinib (C) in metastatic melanoma (mel): Updated safety and clinical activity.

Authors

null

Wilson H. Miller Jr.

Segal Cancer Centre, Jewish General Hospital, McGill University, Montreal, QC, Canada

Wilson H. Miller Jr., Tae Min Kim , Carrie B. Lee , Keith T. Flaherty , Sunil Reddy , Rahima Jamal , Laura Q. Chow , Isabelle Anne Rooney , Bethany Pitcher , Edward Cha , Jeffrey R. Infante

Organizations

Segal Cancer Centre, Jewish General Hospital, McGill University, Montreal, QC, Canada, Seoul National University Hospital, Seoul, Republic of Korea, University of North Carolina Lineberger Comprehensive Cancer Center, Chapel Hill, NC, Massachusetts General Hospital, Boston, MA, Stanford Cancer Center, Stanford, CA, Notre-Dame Hospital, CHUM, University of Montreal, CHUM Research Centre (CRCHUM), Montreal, QC, Canada, University of Washington, Seattle, WA, Genentech, Inc., San Francisco, CA, F. Hoffmann-La Roche Ltd., Mississauga, ON, Canada, Sarah Cannon Research Institute and Tennessee Oncology, PLLC, Nashville, TN

Research Funding

Pharmaceutical/Biotech Company

Background: A, an anti–programmed death-ligand 1 (PD-L1) monoclonal antibody, inhibits PD-L1/programmed death-1 (PD-1) and PD-L1/B7.1 binding and shows promising clinical activity in patients (pts) with cutaneous mel (objective response rate [ORR] 33%; median progression-free survival [mPFS] 5.5 months; Hodi et al SMR 2014). C promotes intratumoral T-cell infiltration, major histocompatibility complex 1 upregulation, and PD-L1 expression via targeted MEK inhibition in preclinical models (Ebert et al Immunity 2016) and tumor biopsy specimens (Bendell et al ASCO 2016). Therefore, clinical benefits may be enhanced by combining A + C vs A. This Phase Ib dose-escalation and -expansion study (NCT01988896) suggested higher ORR/disease control rate (DCR, ORR + stable disease) and longer PFS may be achieved with A + C vs A or C alone in mel. We present updated safety and efficacy data. Methods: Oral C, escalated 20 mg→40 mg→60 mg, was given qd for 21 days followed by 7 days off. Intravenous (IV) A was given at 800 mg q2w. Tumor-specific expansion cohorts were enrolled at maximum tolerated doses (C 60 mg/d 21/7; A 800 mg IV q2w). No prior anti–PD-L1 or –PD-1 therapy was allowed. Results: Data cut-off was Oct 12, 2016; 22 patients were safety-evaluable (two ocular, 20 non-ocular [ten each BRAF-mutant and -wild-type]). Median safety follow-up was 14.4 months (range 2.1–23.2). Adverse events (AEs) were experienced in all pts (diarrhea [20 pts, 90.9%] and rash [15 pts, 68.2%] were most common); related grade (G)3–4 AEs in 54.5% (diarrhea [three pts, 13.6%] and dermatitis acneiform [two pts, 9.1%] were most common; no related G5 AEs); related serious AEs in 13.6%. All were manageable. One pt discontinued A + C due to an AE. RECIST v1.1-confirmed ORR was 45.0% in pts with non-ocular mel (median duration of response was not reached); DCR was 75.0%; mPFS was 12.0 months (95% CI 2.8–not evaluable). ORR was similar for pts with BRAF-mutant and wild-type mel. Conclusions: Updated results confirm previous findings that suggest higher ORR/DCR and longer PFS may be achieved with A + C vs A or C monotherapy for mel. Together with biomarker data from other cohorts, our data suggest that the immune contexture may be altered by C, enhancing A activity. Clinical trial information: NCT01988896

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Abstract Details

Meeting

2017 ASCO Annual Meeting

Session Type

Poster Session

Session Title

Developmental Therapeutics—Immunotherapy

Track

Developmental Therapeutics and Translational Research,Immunotherapy

Sub Track

Immune Checkpoint Inhibitors

Clinical Trial Registration Number

NCT01988896

Citation

J Clin Oncol 35, 2017 (suppl; abstr 3057)

DOI

10.1200/JCO.2017.35.15_suppl.3057

Abstract #

3057

Poster Bd #

152

Abstract Disclosures

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