A randomized phase 2 trial of veliparib (V), radiotherapy (RT) and temozolomide (TMZ) in patients (pts) with unmethylated MGMT (uMGMT) glioblastoma (GBM): Feasibility and safety outcomes (the VERTU study).

Authors

Mustafa Khasraw

Mustafa Khasraw

Royal North Shore Hospital/ University of Sydney, St Leonards, Australia

Mustafa Khasraw , Kerrie Leanne McDonald , Mark Rosenthal , Zarnie Lwin , David M. Ashley , Helen Wheeler , Elizabeth Barnes , Eng-Siew Koh , Matthew C Foote , Michael Buckland , Lauren Fisher , Robyn Leonard , Merryn Hall , Sonia Yip , John Simes

Organizations

Royal North Shore Hospital/ University of Sydney, St Leonards, Australia, University of NSW, Kensington, Australia, The Royal Melbourne Hospital, Parkville, Australia, Department of Medical Oncology, Brisbane, Australia, Andrew Love Cancer Centre, Geelong, Australia, Royal North Shore Hospital, Department of Oncology, St Leonards, Australia, NHMRC Clinical Trials Centre, Sydney, Australia, Liverpool Hospital, Liverpool, Australia, Princess Alexandra Hospital and University of Queensland, Brisbane, Australia, Royal Prince Alfred Hospital, Camperdown, Sydney, Australia, COGNO Consumer Advisory Panel, Sydney, Australia, NHMRC Clinical Trials Centre, University of Sydney, Sydney, Australia, Sydney Catalyst Translational Cancer Research Centre, Sydney, Australia

Research Funding

Other Foundation

Background: TMZ offers minimal benefit in uMGMT GBM pts. V is synergistic with both RT and TMZ in preclinical models, safe when combined with either RT or TMZ clinically but the triplet (V+RT+TMZ) is poorly tolerated. This study examines a novel approach to patients with uMGMT GBM. Methods: VERTU is a randomized Phase 2 trial comparing Arm A (experimental arm) = RT (60gy/30 fractions) + V (200mg BID) followed by TMZ (150-200mg/m2D 1-5) + V (40mg bid, D 1-7) every 28 days for 6 cycles vs Arm B (Standard of care) = RT (60gy/30 fractions) + TMZ (75mg/m2 daily) followed by TMZ (150-200mg/m2D 1-5) every 28 days for 6 cycles in pts with newly diagnosed uMGMT GBM. The study aims to randomize 120 pts (2:1 to the experimental arm). The primary endpoint is 6 months Progression Free Survival (6PFS) with multiple secondary and tertiary endpoints. Evaluation of feasibility and safety was planned after completion of RT in the first 60 pts (Stage 1). Acceptable feasibility and safety criteria for study continuation was defined as ≥70% of pts on the experimental arm completing ≥70% of the planned treatment with ≤30% of pts having any ≥ Grade (G) 3 Adverse Events (AEs). (ANZCTR #ACTRN12615000407594) Results: 60 pts have been randomized in Stage 1 (Arm A = 39, Arm B = 21). Patient characteristics (age, gender, performance status, and extent of resection) were well matched. All 39 pts in the experimental arm completed at least 80% of the planned V treatment, receiving at least 70% of the full V dose and 80% of the planned RT dose. Eleven pts (28%) in the experimental arm experienced ≥ G3 AEs during concurrent treatment. The commonest severe AEs were seizures observed in 3pt in each arm, 7% in the experimental arm and 15% in the standard treatment arm followed by thrombocytopenia seen in 2 pts in each arm, 5% in the experimental arm and 10% in the standard arm. Conclusions: Stage 1 of VERTU satisfied the predefined feasibility and safety criteria and the study will continue until the accrual target (120pts) is reached (anticipated mid-2018). Efficacy endpoints will be analyzed and reported after completion of accrual. Clinical trial information: 12615000407594.

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Abstract Details

Meeting

2018 ASCO Annual Meeting

Session Type

Poster Session

Session Title

Central Nervous System Tumors

Track

Central Nervous System Tumors

Sub Track

Central Nervous System Tumors

Clinical Trial Registration Number

12615000407594

Citation

J Clin Oncol 36, 2018 (suppl; abstr 2045)

DOI

10.1200/JCO.2018.36.15_suppl.2045

Abstract #

2045

Poster Bd #

203

Abstract Disclosures