Palbociclib (P) in patients (pts) with non-small cell lung cancer (NSCLC) with CDKN2A alterations: Results from the Targeted Agent and Profiling Utilization Registry (TAPUR) Study.

Authors

null

Eugene R Ahn

Cancer Treatment Centers of America, Zion, IL

Eugene R Ahn , Pam K. Mangat , Elizabeth Garrett-Mayer , Susan Halabi , Elie G. Dib , Daniel Ernest Haggstrom , Kathryn B. Alguire , Ricardo H. Alvarez , Carmen Julia Calfa , Timothy Lewis Cannon , Pamela A. Crilley , Anu G. Gaba , Alissa S. Marr , Ashish Sangal , Ramya Thota , Kaitlyn R. Antonelli , Samiha Islam , Andrew Lawrence Rygiel , Suanna S. Bruinooge , Richard L. Schilsky

Organizations

Cancer Treatment Centers of America, Zion, IL, American Society of Clinical Oncology, Alexandria, VA, Medical University of South Carolina, Charleston, SC, Duke University Medical Center, Durham, NC, Sanford Health, Sioux Falls, SD, Levine Cancer Institute, Charlotte, NC, Grand Rapids Oncology Program, Grand Rapids, MI, Cancer Treatment Centers of America, Newnan, GA, Memorial Cancer Institute, Hollywood, FL, Inova Schar Cancer Institute, Fairfax, VA, Cancer Treatment Centers of America, Boca Raton, FL, Roger Maris Cancer Ctr, Fargo, ND, University of Nebraska Medical Center, Omaha, NE, Cancer Treatment Centers of America, Goodyear, AZ, Intermountain Healthcare, Murray, UT

Research Funding

Pharmaceutical/Biotech Company

Background: TAPUR is a phase II basket study evaluating anti-tumor activity of commercially available targeted agents in pts with advanced cancers with genomic alterations. Results in a cohort of NSCLC pts with CDKN2A loss or mutation treated with P are reported. Methods: Eligible pts had advanced NSCLC, no standard treatment options, measurable disease, ECOG PS 0-2 and adequate organ function. Genomic testing was performed using commercially available tests. Pts matched to P had NSCLC with CDKN2A loss or mutation and no RB mutations. A Simon two-stage design was used to test a null rate of 15% vs. 35% (power = 0.85; α = 0.10). If ≥2 of 10 pts in stage 1 have disease control (DC) (objective response (OR) or stable disease at 16 weeks (wks) (SD16+)), an additional 18 pts are enrolled. If ≥7 of 28 pts have DC, the drug is considered worthy of further study. Secondary endpoints are progression-free survival (PFS), overall survival (OS) and safety. Results: Twenty-nine pts were enrolled from January 2017 to June 2018; 1 pt was unevaluable for response but is included in safety analyses. Pts received P at 125 mg orally once daily for 21 days, followed by 7 days off. Demographics and outcomes are summarized in Table (N = 28). One PR and 6 SD16+ were observed for a DC rate of 29% (90% CI, 15% to 37%). 10 pts had at least one grade 3 or 4 AE or SAE at least possibly related to P with the most common being cytopenias. Other grade 3-4 AEs or SAEs at least possibly related to P included fatigue, anorexia, febrile neutropenia, myocardial infarction, sepsis, vomiting, and hypophosphatemia. Conclusions: Monotherapy with P demonstrated evidence of anti-tumor activity in heavily pre-treated NSCLC pts with CDKN2A loss or mutation. Additional study is warranted to confirm the efficacy of P in pts with NSCLC with CDKN2A loss or mutation. Clinical trial information: NCT02693535

DC rate, % (OR or SD16+) (90% CI)29% (15%, 37%)
Median PFS, wks (95% CI)7.9 (7.0, 15.1)
Median OS, wks (95% CI)20.6 (14.0, 39.0)
Drug-related AEs, grades 3-4 (% of pts)34%
Drug-related SAEs (% of pts)17%
Median age, yrs (range)63 (41, 79)
Male, %54%
ECOG Performance Status, %
018%
164%
218%
Prior systemic regimens, %
04%
1-225%
≥371%

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Abstract Details

Meeting

2019 ASCO Annual Meeting

Session Type

Poster Session

Session Title

Lung Cancer—Non-Small Cell Metastatic

Track

Lung Cancer

Sub Track

Metastatic Non–Small Cell Lung Cancer

Clinical Trial Registration Number

NCT02693535

Citation

J Clin Oncol 37, 2019 (suppl; abstr 9041)

DOI

10.1200/JCO.2019.37.15_suppl.9041

Abstract #

9041

Poster Bd #

364

Abstract Disclosures