A phase 1b/2 trial of lenvatinib plus pembrolizumab in patients with squamous cell carcinoma of the head and neck.

Authors

null

Matthew H. Taylor

Knight Cancer Institute, Oregon Health and Science University, Portland, OR

Matthew H. Taylor , Drew W. Rasco , Marcia S. Brose , Nicholas J. Vogelzang , Stephen Lane Richey , Allen Lee Cohn , Donald A. Richards , Daniel E. Stepan , Corina E. Dutcus , Matthew Guo , Robert Charles Shumaker , Emmett V. Schmidt , Lori J. Wirth

Organizations

Knight Cancer Institute, Oregon Health and Science University, Portland, OR, South Texas Accelerated Research Therapeutics, San Antonio, TX, Department of Otorhinolaryngology: Head and Neck Surgery, Abramson Cancer Center of the University of Pennsylvania, Philadelphia, PA, Comprehensive Cancer Centers of Nevada, Las Vegas, NV, Texas Oncology, The US Oncology Network, McKesson Specialty Health, Fort Worth, TX, Rocky Mountain Cancer Center, US Oncology, Denver, CO, US Oncology Research, Tyler, TX, Eisai Inc., Woodcliff Lake, NJ, Merck & Co., Inc., Kenilworth, NJ, Massachusetts General Hospital Cancer Center, Boston, MA

Research Funding

Pharmaceutical/Biotech Company

Background: Lenvatinib (LEN) is a multikinase inhibitor of vascular endothelial growth factor receptor 1−3, fibroblast growth factor receptor 1−4, platelet-derived growth factor receptor α, RET, and KIT. Pembrolizumab (PEM) is an anti-PD-1 antibody approved for the second-line treatment of recurrent or metastatic squamous cell carcinoma of the head and neck (SCCHN) based on durable responses and an objective response rate (ORR) of 16% (Bauml J et al, J Clin Oncol 2017). We report initial results of the SCCHN cohort from a phase 1b/2 trial of the LEN + PEM combination (NCT02501096). Methods: In this multicenter, open-label study, patients (pts) with measurable, confirmed metastatic SCCHN and ECOG performance status ≤1 received LEN (20 mg/day orally) + PEM (200 mg Q3W, IV). Pts were not preselected based on PD-L1 status. Tumor assessments were performed by study investigators using immune-related RECIST (irRECIST). The phase 2 primary endpoint was ORR at 24 weeks (ORRWK24). Secondary endpoints included ORR, progression-free survival (PFS), and duration of response (DOR), which is calculated for pts with complete or partial responses. Results: At data cutoff of August 1, 2017, 22 pts with SCCHN (regardless of PD-L1 status) were enrolled. 86% of pts had ≥1 prior anticancer therapy. Median follow-up for PFS was 7.6 months (95% confidence interval [CI], 4.2–12.6) per irRECIST. Efficacy outcomes are summarized in the table. Grade 3 or 4 AEs occurred in 91% of pts (grade 4 AEs in 14%). However, 4 (18%) discontinued study treatment due to AEs. The most common AEs were fatigue (55%), decreased appetite (41%), hypertension (41%), diarrhea (36%), and nausea (36%). Updated data will be presented. Conclusions: LEN + PEM demonstrated promising clinical activity and manageable toxicities, supporting further evaluation of the LEN + PEM combination in pts with SCCHN. Clinical trial information: NCT02501096

OutcomeirRECIST (N = 22)
ORRWK24, n (%)*8 (36.4)
95% CI17.2–59.3
ORR, n (%)8 (36.4)
95% CI17.2–59.3
Median DOR, months (95% CI)8.2 (2.2–not estimable)
Median PFS, months (95% CI)8.2 (4.3–not estimable)
PFS rate at 12 months, % (95% CI)37.2 (12.8–62.2)

*8 partial responses (PR). 7 PRs, 1 complete response. 4 of the 8 (50%) responders achieved a DOR of > 6 months.

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Abstract Details

Meeting

2018 ASCO Annual Meeting

Session Type

Poster Discussion Session

Session Title

Head and Neck Cancer

Track

Head and Neck Cancer

Sub Track

Advanced/Metastatic Disease

Clinical Trial Registration Number

NCT02501096

Citation

J Clin Oncol 36, 2018 (suppl; abstr 6016)

DOI

10.1200/JCO.2018.36.15_suppl.6016

Abstract #

6016

Poster Bd #

4

Abstract Disclosures