A single arm phase II study of rucaparib maintenance in patients with advanced pancreatic adenocarcinoma and a known deleterious BRCA1, BRCA2 or PALB2 mutation who have achieved stability on platinum therapy.

Authors

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Kim Anna Reiss

University of Pennsylvania, Philadelphia, PA

Kim Anna Reiss , Kara Noelle Maxwell , Katharine Nathanson , Ursina R. Teitelbaum , Mark H. O'Hara , Peter J. O'Dwyer , Charles Schneider , Erica L. Carpenter , Rosemarie Mick , Susan M. Domchek

Organizations

University of Pennsylvania, Philadelphia, PA, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, University of Pennsylvania Hospital, Philadelphia, PA, University of Pennsylvania Abramson Cancer Center, Philadelphia, PA, Helen F. Graham Cancer Center, Christiana Care Health System, Newark, DE, University of Pennsylvania School of Medicine, Philadelphia, PA

Research Funding

Pharmaceutical/Biotech Company

Background: Pancreatic ductal adenocarcinoma (PDAC) is a highly lethal malignancy with a median overall survival of < 1 year. A subset of PDAC is characterized by a homologous recombination deficiency (HRD). The most well-defined patients within this group are those with deleterious mutations in BRCA1, BRCA2 and PALB2. This subset of tumors respond exceptionally well to treatment with platinum agents, leading to durable responses. However, cumulative toxicity can complicate or even prevent continued therapy, and there is an unmet need to establish maintenance strategies for such patients.Prior studies have shown that BRCA1 and BRCA2 associated PDACs respond to PARP inhibitors. Cross-resistance to platinum and PARP inhibitors exists, so initiating PARP inhibitor therapy after the development of platinum-resistance is an inferior approach. In this setting, we have designed a phase II trial of rucaparib as maintenance therapy for patients with deleterious BRCA1, BRCA2 or PALB2 who have sustained stability on platinum-based treatment. Methods: We have enrolled 2 of 42 planned patients on study NCT03140670. Eligibility criteria include inoperable PDAC, a known somatic or germline deleterious mutation in BRCA1, BRCA2 or PALB2 and stability on platinum-based chemotherapy for ≥16 weeks. Patients who have progressed on platinum-based treatment or who have received prior therapy with PARP inhibitors are excluded. Patients will receive oral rucaparib twice daily continuously in 28-day cycles. The primary endpoint is progression-free survival at 6 months. Secondary endpoints include response rate, duration of response and overall survival. A pre-treatment tumor biopsy and biopsy at progression will be obtained, as well as serial blood collections for circulating tumor material. Correlative assays will include tumor and circulating tumor DNA sequencing to identify genomic predictors of outcome and study resistance mechanisms. Clinical trial information: NCT03140670

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Abstract Details

Meeting

2018 Gastrointestinal Cancers Symposium

Session Type

Trials in Progress Poster Session

Session Title

Trials in Progress Poster Session B: Cancers of the Pancreas, Small Bowel, and Hepatobiliary Tract

Track

Cancers of the Pancreas, Small Bowel, and Hepatobiliary Tract

Sub Track

Translational Research

Clinical Trial Registration Number

NCT03140670

Citation

J Clin Oncol 36, 2018 (suppl 4S; abstr TPS531)

DOI

10.1200/JCO.2018.36.4_suppl.TPS531

Abstract #

TPS531

Poster Bd #

Q7

Abstract Disclosures