Dana-Farber Cancer Institute, Boston, MA
Nancy U. Lin , Alisha Stein , Alan Nicholas , Anita M. Fung , Priya Kumthekar , Nuhad K. Ibrahim , Mark D. Pegram
Background: There is currently no clear standard of care to address the management of recurring/multiple intracranial metastases post RT in HER2-positive MBC. The ongoing PATRICIA study (NCT02536339) is evaluating the safety and efficacy of P in combination with high-dose h for patients with HER2-positive MBC with CNS metastases who have CNS progression following RT. Reported herein are results from the protocol-specified interim analysis of PATRICIA. Methods: All eligible patients must have measurable (≥10 mm) CNS progression post RT, and stable non-CNS disease. Patients receive P (840-mg loading dose, then 420 mg every 3 weeks) and high-dose h (6 mg/kg weekly). The primary efficacy endpoint is objective response rate (ORR) in the CNS per Response Assessment in Neuro-Oncology Brain Metastases (RANO-BM) criteria. The interim analysis was planned after 15 patients were enrolled and had ≥2 left ventricular ejection fraction (LVEF) measurements, 2 cycles of study drugs, and 2 response measurements. The study would proceed to full enrollment (n=40) if objective response or stable disease in the CNS was observed in ≥1 of 15 patients and <2 of 15 patients develop congestive heart failure (CHF) related to P or H. Results: As of Sept 6, 2016, 15 patients had been enrolled across 9 sites. Median treatment duration was 4.4 (range 1.2−8.3) months. Six patients discontinued treatment (5 for disease progression; 1 for symptomatic deterioration). Range for duration of response was 1.4−3.3 months. There were no new safety signals for P combined with high-dose h treatment. No patients had CHF or a clinically significant drop in LVEF. Conclusions: Based on early evidence of clinical benefit (ORR 20%) and a lack of new safety signals, the safety and futility boundaries for PATRICIA have been passed and study enrollment continues. Clinical trial information: NCT02536339
Efficacy within CNS per RANO-BM criteria | n (%) |
---|---|
Complete response (CR) | 0 |
Partial response (PR) | 3 (20) |
Stable disease (SD) | 9 (60) |
Disease progression | 3 (20) |
ORRa | 3 (20) |
95% CI | 4.3−48.1 |
CR + PR + SD ≥4 months | 6 (40) |
95% CI | 16.3−67.7 |
aCR or PR.
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Abstract Disclosures
First Author: Nicholas Patrick McAndrew
2023 ASCO Annual Meeting
First Author: Ulrich Keilholz
2016 ASCO Annual Meeting
First Author: Nancy U. Lin
2024 ASCO Gastrointestinal Cancers Symposium
First Author: Zhi Peng