Atezolizumab (A) + cobimetinib (C) + vemurafenib (V) in BRAFV600-mutant metastatic melanoma (mel): Updated safety and clinical activity.

Authors

null

Ryan J. Sullivan

Massachusetts General Hospital Cancer Center, Boston, MA

Ryan J. Sullivan , Rene Gonzalez , Karl D. Lewis , Omid Hamid , Jeffrey R. Infante , Manish R. Patel , F. Stephen Hodi , Jeffrey Wallin , Bethany Pitcher , Edward Cha , Louise Roberts , Marcus Ballinger , Patrick Hwu

Organizations

Massachusetts General Hospital Cancer Center, Boston, MA, University of Colorado Comprehensive Cancer Center, Aurora, CO, The Angeles Clinic and Research Institute, Los Angeles, CA, Sarah Cannon Research Institute and Tennessee Oncology, PLLC, Nashville, TN, Florida Cancer Specialists and Research Institute/Sarah Cannon Research Institute, Sarasota, FL, Dana-Farber Cancer Institute, Boston, MA, Genentech, Inc., San Francisco, CA, F. Hoffmann-La Roche Ltd., Mississauga, ON, Canada, The University of Texas MD Anderson Cancer Center, Houston, TX

Research Funding

Pharmaceutical/Biotech Company

Background: Targeted inhibition of MEK with C and BRAF with V in BRAFV600-mutant mel can lead to both anticancer immune activation and direct tumor cell death. A, an anti–PD-L1 monoclonal antibody, inhibits PD-L1/PD-1 signaling. Combining C + V with A may enhance antitumor activity, potentially leading to improved clinical responses and durability. Preliminary data from this phase Ib study (NCT01656642) showed that A + C + V had a manageable safety profile and promising antitumor activity in patients (pts) with untreated BRAFV600-mutant unresectable/metastatic mel, with increases in CD8-positive T-cell infiltration observed after C + V (Sullivan et al SMR 2016). We present updated safety and efficacy data. Methods: Pts received A + C + V after a 28-day run-in with C + V. A was given at 800 mg q2w, C at 60 mg qd for the first 21 days of each 28-day cycle, and V at 960 mg bid during day 1–21 of run-in and 720 mg thereafter. Safety was evaluated in pts who had ≥1 dose of A; efficacy, in pts who had ≥1 dose of A by the data cutoff date and received ≥1 dose of A, C, or V by the dosed-by date. Results: Thirty-four patients were treated and evaluated for both safety and efficacy. Median survival follow-up was 7.1 months (range 2.5–19.9). Elevated AST/ALT, diarrhea, arthralgia, fatigue, photosensitivity, pyrexia, nausea, flu-like symptoms, maculopapular rash, and pruritus were reported as A- and/or C- and/or V-related in > 20% of pts at any grade (G). A/C/V-related G3–4 adverse events (AEs) were seen in 15 pts (44.1%) with the triple combination (none G5). Three serious AEs were A-related. All AEs were manageable and reversible. Elevated ALT/AST (three pts each) and rash (one pt) led to discontinuation of any drug. Unconfirmed RECIST V1.1 responses were observed in 29 pts (85.3%; six complete, 23 partial). Three pts with confirmed partial responses had resolution of target lesions. Twenty of the 29 responding patients continue to respond at the time of the data cutoff. Conclusions: Updated results confirm preliminary findings that A + C + V has a manageable safety profile and promising antitumor activity in pts with BRAFV600-mutant metastatic mel. Continued exploration of A + C + V is warranted. Clinical trial information: NCT01656642

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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

NCT01656642

Citation

J Clin Oncol 35, 2017 (suppl; abstr 3063)

DOI

10.1200/JCO.2017.35.15_suppl.3063

Abstract #

3063

Poster Bd #

158

Abstract Disclosures