A phase II trial of durvalumab with or without tremelimumab in patients with persistent or recurrent endometrial carcinoma and endometrial carcinosarcoma.

Authors

null

Maria M Rubinstein

Memorial Sloan Kettering Cancer Center, New York, NY

Maria M Rubinstein , Imogen Caird , Qin Zhou , Alexia Iasonos , Claire Frances Friedman , Karen Anne Cadoo , Jason A. Konner , Roisin Eilish O'Cearbhaill , William P. Tew , Dmitriy Zamarin , Rachel N. Grisham , Chrisann Kyi , Krysten Soldan , Stuart M. Lichtman , Louise Ligresti , Sarah J. Schweber , Jasmeet Chadha Singh , Tiffany A. Troso-Sandoval , Carol Aghajanian , Vicky Makker

Organizations

Memorial Sloan Kettering Cancer Center, New York, NY, Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York, NY, Memorial Sloan-Kettering Cancer Center, New York, NY

Research Funding

Pharmaceutical/Biotech Company
U.S. National Institutes of Health

Background: Monoclonal antibodies Durvalumab (D) and Tremelimumab (T) inhibit binding of programmed cell death ligand 1 (PDL1) to PD1 and inhibit activation of cytotoxic T-lymphocyte-associated protein 4 (CTLA4), respectively, resulting in improved tumor immunosurveillance. There is rationale to study D and DT based on recent genomic and tumor microenvironment evaluation of endometrial cancer (EC). Methods: Eligible patients (pts) were randomized to D or DT. Pts received D 1500 mg intravenously (IV) every 4 weeks (wks). DT therapy pts received D 1500 mg IV every 4 wks and T 75 mg IV every 4 wks for 4 cycles, followed by D 1500 mg IV every 4 wks until progression or unacceptable toxicities. Pts were stratified by histology with 10 carcinosarcoma or MSI-H EC pts per arm. Efficacy assessments were every 8 wks and treatment related adverse events (TRAEs) were assessed per CTCAE v.4.03. The primary endpoint was overall response rate (ORR) by RECIST v1.1. Descriptive statistics and 90% one sided CI are reported. Progression free survival (PFS) rate at 24 wks (PFS24wks) was estimated by Kaplan Meier method. Results: At planned interim analysis, 56 pts were enrolled (28 per arm). 15 pts: carcinosarcoma, 15 pts: endometrioid (3: Gr1), 14 pts: serous, and 12 pts: other histology. 5(9%) pts: MSI-H, 48(86%) pts: microsatellite stable (MSS), 3(5%): unknown. 2 pts were excluded due to early death. 27 pts per arm were evaluable for efficacy. In the D arm: 1 pt had complete response (CR)(MSS) and 3 pts had a partial response (PR) (2:MSS, 1:MSI-H) with an ORR of 14.8% (CI: 6.6-100%). The median PFS was 7.6 wks and PFS24wks was 13.3% (CI 6.1-100%). Median duration of response (DOR) was 16 wks in the D arm. In the DT arm, 2 pts achieved CR (1:MSI-H, 1:MSS) and 1 had PR (MSS). The ORR was 11.1% (CI: 4.2-100%). Median PFS was 8.1 wks, PFS24wks was 18.5% (CI 10.1-100%) and DOR was 8 wks. Grade 3 TRAEs occurred in 2 (7%) pts in D and 9 (32%) pts in DT. Grade 4 TRAEs occurred 1 (4%) pt in D and 3 (11%) pts in DT. 2 pts discontinued due to a TRAE. Most common TRAEs in total were fatigue (23%), diarrhea (20%), nausea (14%), vomiting (13%) and pruritis (11%). Conclusions: D and DT show modest activity in EC. No new safety signals were identified. Second stage accrual is ongoing. Clinical trial information: NCT03015129

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Abstract Details

Meeting

2019 ASCO Annual Meeting

Session Type

Poster Session

Session Title

Gynecologic Cancer

Track

Gynecologic Cancer

Sub Track

Uterine Cancer

Clinical Trial Registration Number

NCT03015129

Citation

J Clin Oncol 37, 2019 (suppl; abstr 5582)

DOI

10.1200/JCO.2019.37.15_suppl.5582

Abstract #

5582

Poster Bd #

405

Abstract Disclosures