Phase 1 study of glutaminase (GLS) inhibitor CB-839 combined with either everolimus (E) or cabozantinib (Cabo) in patients (pts) with clear cell (cc) and papillary (pap) metastatic renal cell cancer (mRCC).

Authors

null

Nizar M. Tannir

UT MD Anderson Cancer Center, Houston, TX

Nizar M. Tannir , Alice C. Fan , Richard J. Lee , Bradley Curtis Carthon , Othon Iliopoulos , James Walter Mier , Manish R. Patel , Funda Meric-Bernstam , Angela DeMichele , Martin Henner Voss , James J. Harding , Ramaprasad Srinivasan , Geoffrey Shapiro , Melinda L. Telli , Pamela N. Munster , Richard D. Carvajal , Yonchu Jenkins , Samuel H. Whiting , Johanna C. Bendell , Todd Michael Bauer

Organizations

UT MD Anderson Cancer Center, Houston, TX, Stanford Cancer Institute, Stanford, CA, Massachusetts General Hospital Cancer Center, Boston, MA, Emory University Winship Cancer Institute, Atlanta, GA, Harvard Medcl School, Charlestown, MA, Dana-Farber/Harvard Cancer Center, Beth Israel Deaconess Medical Center, Boston, MA, Florida Cancer Specialists, Sarasota, FL, Penn Medicine Abramson Cancer Center, Philadelphia, PA, Memorial Sloan Kettering Cancer Center, New York, NY, Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York, NY, National Cancer Institute at the National Institutes of Health, Bethesda, MD, Dana-Farber Cancer Institute, Boston, MA, Stanford University Medical Center, Stanford, CA, University of California San Francisco, San Francisco, CA, Columbia University Medical Center, New York, NY, Calithera Biosciences, Inc., South San Francisco, CA, Calithera Biosciences, Inc, South San Francisco, CA, Tennessee Oncology, PLLC, Nashville, TN, Sarah Cannon Research Institute/ Tennessee Oncology, PLLC, Nashville, TN

Research Funding

Pharmaceutical/Biotech Company

Background: CB-839 is a first-in-class inhibitor of GLS that targets tumor glutamine utilization, a pathway upregulated in kidney cancer. CB-839 combines with E or Cabo in pre-clinical RCC models to inhibit metabolic pathways resulting in enhanced anti-tumor activity. The CX-839-001 study includes cohorts evaluating the safety, efficacy and recommended Phase 2 dose (RP2D) of CB-839 in combination with E (CBE) or Cabo (CB-Cabo) in pts with mRCC. Here we report results from the CBE and CB-Cabo cohorts. Methods: Eligibility criteria included mRCC with cc or pap histology, ECOG 0-1, RECIST measurable disease and, for cc pts, treatment with at least 1 prior anti-VEGF therapy. Pts received escalating doses of CB-839 (PO BID) in a 3+3 design, either 400-800 mg with E (10 mg PO QD) or 600-800 mg with Cabo (60 mg PO QD). Tumor response (RECIST 1.1) was assessed every 8 wks. Results: 27 pts (22 cc, 3 pap, 2 other) were enrolled in CB-E escalation (n = 17) and expansion (n = 10) cohorts (7 at 400 mg, 13 at 600 mg, 7 at 800 mg) and 11 pts (9 cc, 2 pap) in CB-Cabo escalation cohorts (6 at 600 mg, 5 at 800 mg). Median prior lines of therapy was 2 for CBE (including 64% of cc pts with ≥2 prior anti-VEGF therapies) and 3 for CB-Cabo (range 0-6). A maximum tolerated dose was not reached; 800 mg was selected as the RP2D for CB-839. The most common treatment-related Gr≥3 AEs were fatigue (11%), anemia, hyperglycemia, and neutropenia (7% each) for CBE (N = 27) and diarrhea (14%) and platelet count decreased (14% including 1 DLT at 600 mg) for CB-Cabo (N = 7). Of 24 evaluable CBE pts there was 1 PR and 21 SD for a disease control rate (DCR = CR + PR + SD) of 92% with a median PFS of 7.1 mo (95% CI 4 - 11). For 9 evaluable CB-Cabo pts the ORR and DCR were 44% (4 PR) and 100%, respectively. Conclusions: The tumor metabolism inhibitor CB-839 combines with full dose of RCC targeted therapies, E and Cabo, with good tolerability and encouraging clinical activity in heavily-pretreated mRCC pts. CB-Cabo ORR and DCR of 44% and 100% are promising, and CBE DCR of 92% and PFS of 7.1 mo compare favorably to historical E monotherapy. Randomized Phase 2 studies have been initiated (CBE) or are planned (CB-Cabo). Clinical trial information: NCT02071862

Disclaimer

This material on this page is ©2024 American Society of Clinical Oncology, all rights reserved. Licensing available upon request. For more information, please contact licensing@asco.org

Abstract Details

Meeting

2018 Genitourinary Cancers Symposium

Session Type

Poster Session

Session Title

Poster Session C: Renal Cell Cancer

Track

Renal Cell Cancer

Sub Track

Renal Cell Cancer

Clinical Trial Registration Number

NCT02071862

Citation

J Clin Oncol 36, 2018 (suppl 6S; abstr 603)

DOI

10.1200/JCO.2018.36.6_suppl.603

Abstract #

603

Poster Bd #

F18

Abstract Disclosures