A phase II study of palbociclib (P) for previously treated cell cycle gene alteration positive patients (pts) with stage IV squamous cell lung cancer (SCC): Lung-MAP sub-study SWOG S1400C.

Authors

Martin Edelman

Martin J. Edelman

Fox Chase Cancer Center, Philadelphia, PA

Martin J. Edelman , Mary Weber Redman , Kathy S. Albain , Eric C. McGary , Norman Rafique , Daniel P. Petro , Saiama Naheed Waqar , Jieling Miao , Katie Griffin , Vassiliki Papadimitrakopoulou , Karen Kelly , David R. Gandara , Roy S. Herbst

Organizations

Fox Chase Cancer Center, Philadelphia, PA, Fred Hutchinson Cancer Research Center, Seattle, WA, Loyola University Chicago Stritch School of Medicine, Cardinal Bernardin Cancer Center, Maywood, IL, Kaiser Permanente, Cadillac, CA, Mercy Medical Center Tri-County Hematology/Oncology Associates, Massilon, OH, University of Pittsburgh Cancer Institute, Pittsburgh, PA, Division of Oncology, Department of Medicine, Washington University School of Medicine, St. Louis, MO, SWOG Statistical Center, Fred Hutchinson Cancer Research Center, Seattle, WA, The University of Texas MD Anderson Cancer Center, Houston, TX, University of California Davis Comprehensive Cancer Center, Sacramento, CA, University of California, Davis, Sacramento, CA, Yale School of Medicine, New Haven, CT

Research Funding

Other

Background: S1400 is a master platform trial designed to assess targeted therapies in SCC. Study C evaluated the response rate (RR) to P, a CDK 4/6 inhibitor, in pts with cell cycle gene abnormalities. Methods: Pts with SCC, PS 0-2, normal organ function, who had progressed after at least one prior platinum-based chemotherapy for any NSCLC indication were eligible. Tumor specimens were required and evaluated for gene alterations (Foundation Medicine, Foundation One NGS assay). Pts with CDK 4 or CCND1/2/ 3 amplifications were eligible. The study was originally designed as a phase II/III trial comparing P to docetaxel (D), but was modified to a 2-stage phase II trial with primary endpoint of response rate. If > 3 responses (R) of the first 20 pts were seen the study would continue to 40 pts, with 10 R for the 40 pts considered a positive study. Results: 89 pts (14% of pts screened) were assigned to S1400C, 53 pts enrolled (including 17 to D). One pt assigned to D re-registered to P. Frequency of cell cycle gene alterations for the enrolled pts: CCND1 amplification (n = 44, 83%); CCND2 amplification (n = 7, 13%); CCND3 amplification (n = 5, 9%); and CDK4 amplification (n = 3, 6%). (Note: some pts with multiple alterations.) Of the 37pts enrolled to P: 5 were ineligible (4 inadequate baseline labs, 1 did not progress on prior therapy). 1 not determinable for response. For the 32 eligible pts the median age was 67 (53-81), 21M/11F. Response: 2 PR (6% RR, 95% CI: 2%, 20%), 12 SD (38%, 95% CI: 21%, 54%) for a disease control rate (DCR) of 44% (95% CI: 27%, 61%). Median PFS was 1.7 mo (95% CI 1.6-2.9 mo). Of the 2 PR, one has progressed (duration of response, DOR, 7.7 mo), one still responding (DOR, 4 mo). Both responders had CCND1 amplification. 32 pts have been assessed for adverse events (AE). 4 experienced Grade 4 AE including lymphopenia (3), and thrombocytopenia (1). 13 others experienced Grade 3 treatment-related AE. Conclusions: 1. P failed to demonstrate the pre-specified RR to justify advancement to phase III. 2. P was well tolerated in this population. 3. Further analysis of those who derived benefit (e.g. response or prolonged SD) is underway. Clinical trial information: NCT02785939

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Abstract Details

Meeting

2017 ASCO Annual Meeting

Session Type

Poster Session

Session Title

Lung Cancer—Non-Small Cell Metastatic

Track

Lung Cancer

Sub Track

Metastatic Non–Small Cell Lung Cancer

Clinical Trial Registration Number

NCT02785939

Citation

J Clin Oncol 35, 2017 (suppl; abstr 9056)

DOI

10.1200/JCO.2017.35.15_suppl.9056

Abstract #

9056

Poster Bd #

382

Abstract Disclosures