Activity of ramucirumab (R) with pembrolizumab (P) by PD-L1 expression in advanced solid tumors: Phase 1a/b study in later lines of therapy.

Authors

null

Roy S. Herbst

Yale University School of Medicine, New Haven, CT

Roy S. Herbst , Ian Chau , Daniel Peter Petrylak , Hendrik-Tobias Arkenau , Johanna C. Bendell , Rafael Santana-Davila , Emiliano Calvo , Nicolas Penel , Juan Martin-Liberal , Andres O. Soriano , Philippe Alexandre Cassier , Matthew Krebs , Nicolas Isambert Sr., Ryan Widau , Gu Mi , Jin Jin , David Raymond Ferry , Charles S. Fuchs , Luis G. Paz-Ares

Organizations

Yale University School of Medicine, New Haven, CT, Royal Marsden Hospital, London & Sutton, United Kingdom, Yale School of Medicine, New Haven, CT, Sarah Cannon Research Institute, London, United Kingdom, Sarah Cannon Research Institute/Tennessee Oncology, Nashville, TN, University of Washington, Seattle, WA, START Madrid, Madrid, Spain, Oscar Lambret Cancer Center, Lille, France, Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain and Catalan Institute of Oncology (ICO) Hospitalet, Barcelona, Spain, Florida Cancer Specialists, Miami, FL, Centre Léon-Bérard, Lyon, France, The Christie NHS Foundation Trust and The University of Manchester, Manchester Academic Health Sciences Centre, Manchester, United Kingdom, Service d'oncologie médicale CLCC Georges-François Leclerc, Dijon, France, Eli Lilly and Company, Indianapolis, IN, Eli Lilly and Company, New York, NY, Smilow Cancer Hospital, Yale New Haven Health, New Haven, CT, University Hospital 12 de October, Madrid, Spain

Research Funding

Pharmaceutical/Biotech Company

Background: R (anti-VEGFR2) and P (anti-PD-1) are active in patients (pts) with previously-treated non-small cell lung carcinoma (NSCLC), gastric or gastroesophageal adenocarcinoma (G/GEJ) and urothelial carcinoma (UC). Because PD-L1 expression may be a predictive biomarker, we examined the effect of R + P in relation to PD-L1. Methods: Eligible pts had progressive advanced or metastatic G/GEJ, NSCLC and UC, ECOG PS 0-1, and baseline tumor tissue. PD-L1 was assessed using the PD-L1 IHC 22C3 pharmDx assay, where the number of stained tumor cells (tumor proportion score; TPS) or tumor and immune cells (combined positive score; CPS) is relative to total tumor cells. PD-L1 positivity was defined by CPS ≥1% in G/GEJ and UC, and defined by TPS ≥1% in NSCLC. Primary objective was safety and tolerability of R + P. Results: As of 31-July-2017, 92 pts received P 200 mg on Day 1 q3W with R at 10 mg/kg on Day 1 (G/GEJ, n = 17; NSCLC, n = 27; and UC, n = 24) or R at 8 mg/kg, Day 1 and 8 q3W (G/GEJ, n = 24). Baseline demographics and characteristics were as expected for an advanced, previously treated population. Median follow-up duration for G/GEJ, NSCLC, and UC, was 17.9 months (mo), 20.1 mo, and 17.5 mo, respectively. The safety profile was consistent with that of each individual drug, with no additive toxicities. 84 (91%) of 92 pts were evaluable for PD-L1. Objective response rate (ORR), progression-free survival (PFS), and overall survival (OS) by PD-L1 are shown in the table. 13 pts remained on study treatment (G/GEJ, n = 4; NSCLC, n = 8; and UC, n = 1). Clinical trial information: NCT02443324 NR = not reached Conclusions: In previously treated G/GEJ, NSCLC, and UC, R + P appears to provide more benefit in PD-L1 positive compared to PD-L1 negative pts. Randomized trials are warranted. Updated safety and efficacy results will be presented at the meeting.

PD-L1 statusG/GEJ (2nd-3rd line)
NSCLC (2nd-4th line)
UC (2nd-4th line)
< 1%
n = 17
≥1%
n = 22
< 1%
n = 11
≥1%
n = 11
< 1%
n = 11
≥1%
n = 12
ORR, n (%)1 (6)2 (9)2 (18)5 (45)03 (25)
PFS, mo (95% CI)1.9 (1.3-4.0)4.6 (2.3-8.5)9.7 (2.1-13.9)6.9 (2.8-NR)1.3 (0.4-1.9)2.5 (1.2-7.4)
OS, mo (95% CI)5.2 (1.7-9.7)14.9 (4.6-NR)17.0 (10.5-NR)NR (4.0-NR)4.8 (0.6-13.9)6.4 (2.5-NR)

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Abstract Details

Meeting

2018 ASCO Annual Meeting

Session Type

Poster Session

Session Title

Developmental Therapeutics—Immunotherapy

Track

Developmental Therapeutics and Translational Research

Sub Track

Immune Checkpoint Inhibitors

Clinical Trial Registration Number

NCT02443324

Citation

J Clin Oncol 36, 2018 (suppl; abstr 3059)

DOI

10.1200/JCO.2018.36.15_suppl.3059

Abstract #

3059

Poster Bd #

273

Abstract Disclosures

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