Efficacy analysis of ABT-414 with or without temozolomide (TMZ) in patients (pts) with EGFR-amplified, recurrent glioblastoma (rGBM) from a multicenter, international phase I clinical trial.

Authors

Andrew Lassman

Andrew B. Lassman

Columbia University Medical Center, New York, NY

Andrew B. Lassman , Martin J. Van Den Bent , Hui Kong Gan , David A. Reardon , Priya Kumthekar , Nicholas A. Butowski , Zarnie Lwin , Tom Mikkelsen , Louis B. Nabors , Kyriakos P. Papadopoulos , Marta Penas-Prado , John Simes , Helen Wheeler , Erica J. Gomez , Ho-Jin Lee , Lisa Roberts-Rapp , Hao Xiong , Earle E. Bain , David Maag , Ryan Thomas Merrell

Organizations

Columbia University Medical Center, New York, NY, Erasmus MC Cancer Institute, Rotterdam, Netherlands, Austin Health and Olivia Newton-John Cancer Research Institute, Melbourne, Australia, Dana-Farber Cancer Institute/Harvard Medical School, Boston, MA, Northwestern Memorial Hospital, Chicago, IL, University of California, San Francisco, San Francisco, CA, Cancer Care Services, Brisbane, Australia, Henry Ford Health System, Detroit, MI, University of Alabama at Birmingham, Birmingham, AL, START, San Antonio, TX, The University of Texas MD Anderson Cancer Center, Houston, TX, NHMRC Clinical Trials Centre, The University of Sydney, Sydney, Australia, Royal North Shore Hospital, Department of Oncology, St Leonards, Australia, AbbVie Inc., Chicago, IL, NorthShore University Health System, Evanston, IL

Research Funding

Pharmaceutical/Biotech Company

Background: GBM is the most common malignant primary brain tumor in adults. Pts with rGBM have a poor prognosis. EGFR is amplified (amp) in ~50% of GBMs and is a compelling therapeutic target. ABT-414 is an antibody-drug conjugate composed of an EGFR-directed antibody conjugated to a microtubule toxin, MMAF. ABT-414 binds a unique epitope exposed during EGFR activation, either through ligand stimulation or mutation such as EGFR variant III (EGFRvIII), releasing MMAF into the cancer cell. Here, we report a pooled safety and efficacy analysis of ABT-414 +/- TMZ in EGFR amp, rGBM. Methods: M12-356 is a Phase 1, open-label, multi-arm study. Results from the 2 arms accruing rGBM pts were pooled for analysis. Eligible adults had rGBM, centrally confirmed EGFR amp, and KPS ≥ 70. Pts received 0.5-1.25 mg/kg ABT-414 on days 1 and 15 +/- 150-200 mg/m2 TMZ on days 1-5 of 28-day cycles until progression (per RANO). Results: As of 11 January 2017, 126 pts were treated. The most common adverse events (AEs, ≥ 25% pts) were ocular (90%) and included blurred vision (64%) and photophobia (31%), which were mainly reversible. Common non-ocular AEs were fatigue (36%) and headache (30%). Grade 3/4 AEs (≥ 5% pts) included ocular toxicities (29%) and decreased platelets/thrombocytopenia (10%). Serious AEs included seizure and keratitis (2% each). Of 125 pts evaluable by RANO, 52% had improvement or stabilization as best response (2 CR, 9 PR, 54 SD), and the remaining 60 (48%) had PD. Of 115 pts with measurable disease at baseline, the objective response rate (ORR) was 10% (2 CR + 9 PR). For 5 pts, re-resection for radiographic PD revealed mostly necrotic tissue and pts were classified as SD, suggesting the ORR may be an underestimate. Of all 126 pts, the 6-month PFS rate (PFS6) was 26%; median OS was 8.5 months. Conclusions: In this Phase 1 trial of EGFR amp, rGBM, we observed encouraging disease control (52%, CR + PR + SD) and PFS6 (26%) rates. Toxicity was mainly ocular, and reversible. A global, randomized trial of ABT-414 vs. ABT-414 + TMZ vs. TMZ/lomustine in EGFR amp, rGBM has completed accrual with results expected later this year (NCT02343406). Clinical trial information: NCT01800695

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Abstract Details

Meeting

2017 ASCO Annual Meeting

Session Type

Oral Abstract Session

Session Title

Central Nervous System Tumors

Track

Central Nervous System Tumors

Sub Track

Central Nervous System Tumors

Clinical Trial Registration Number

NCT01800695

Citation

J Clin Oncol 35, 2017 (suppl; abstr 2003)

DOI

10.1200/JCO.2017.35.15_suppl.2003

Abstract #

2003

Abstract Disclosures