Exploratory analysis of the effect of maintenance rucaparib on postprogression outcomes in patients (pts) with platinum-sensitive recurrent ovarian carcinoma (OC) and updated safety data from the phase 3 study ARIEL3.

Authors

Robert Coleman

Robert L. Coleman

The University of Texas MD Anderson Cancer Center, Houston, TX

Robert L. Coleman , Amit M. Oza , Domenica Lorusso , Carol Aghajanian , Ana Oaknin , Andrew Peter Dean , Nicoletta Colombo , Johanne I Weberpals , Andrew R. Clamp , Giovanni Scambia , Alexandra Leary , Robert W. Holloway , Margarita Amenedo , Peter C.C. Fong , Jeffrey C. Goh , David M. O'Malley , Teresa Cameron , Lara Maloney , Sandra Goble , Jonathan A. Ledermann

Organizations

The University of Texas MD Anderson Cancer Center, Houston, TX, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada, Fondazione Policlinico Universitario A. Gemelli IRCCS and MITO, Rome, Italy, Memorial Sloan Kettering Cancer Center, New York, NY, Vall d’Hebron University Hospital, Vall d’Hebron Institute of Oncology (VHIO), Barcelona, Spain, Saint John of God Subiaco Hospital, Subiaco, Australia, European Institute of Oncology and University of Milan-Bicocca, Milan, Italy, Ottawa Hospital Research Institute, Ottawa, ON, Canada, The Christie NHS Foundation Trust and University of Manchester, Manchester, United Kingdom, Gustave Roussy Cancer Center, INSERM U981, and Groupe D'Investigateurs Nationaux pour l'Etude des Cancers Ovariens (GINECO), Villejuif, France, Florida Hospital Cancer Institute, Orlando, FL, Oncology Center of Galicia, La Coruña, Spain, Auckland City Hospital, Auckland, New Zealand, Royal Brisbane and Women’s Hospital, Herston, and University of Queensland, St Lucia, Brisbane, Australia, The Ohio State University, James Cancer Center, Columbus, OH, Clovis Oncology, Inc., Boulder, CO, UCL Cancer Institute and UCL Hospitals, London, United Kingdom

Research Funding

Pharmaceutical/Biotech Company

Background: In ARIEL3, rucaparib maintenance treatment significantly improved progression-free survival (PFS) vs placebo in all predefined, nested cohorts: BRCA mutation; BRCA mutation + wild-type BRCA/high loss of heterozygosity (LOH); and intent-to-treat (ITT) population. Methods: Pts were randomized 2:1 to receive oral rucaparib 600 mg BID or placebo. Exploratory endpoints of time to first subsequent therapy (TFST), time to investigator-assessed PFS on the subsequent line of treatment or death (PFS2), and time to second subsequent therapy (TSST) were assessed in the predefined cohorts. Results: Exploratory efficacy endpoint data are given in the Table. As of Dec 31, 2017, the most common treatment-emergent adverse events (TEAEs) of any grade (rucaparib vs placebo) were nausea (75.8% vs 36.5%), asthenia/fatigue (70.7% vs 44.4%), dysgeusia (39.8% vs 6.9%), and anemia/decreased hemoglobin (39.0% vs 5.3%). The most common grade ≥3 TEAEs were anemia/decreased hemoglobin (21.5% vs 0.5%) and alanine/aspartate aminotransferase increase (10.2% vs 0.0%). Conclusions: Rucaparib significantly improved the clinically meaningful endpoints TFST, PFS2, and TSST vs placebo in all predefined cohorts of pts with platinum-sensitive, recurrent OC. The updated safety profile was consistent with prior reports. Clinical trial information: NCT01968213

BRCA mutant
BRCA mutant or
BRCA wild type/LOH high
ITT
Rucaparib (n=130)Placebo
(n=66)
Rucaparib (n=236)Placebo
(n=118)
Rucaparib (n=375)Placebo
(n=189)
TFST
Median, mo19.07.216.47.612.57.4
HR (95% CI); P value0.29 (0.20–0.42);0.40 (0.30–0.52);0.43 (0.35–0.53);
P<0.0001P<0.0001P<0.0001
PFS226.117.924.717.921.116.5
Median, mo0.44 (0.29–0.69);0.57 (0.41–0.79);0.62 (0.48–0.79);
HR (95% CI); P valueP=0.0003P=0.0006P=0.0001
TSSTNR19.426.519.422.218.6
Median, mo0.49 (0.31–0.78);0.58 (0.41–0.82);0.70 (0.54–0.91);
HR (95% CI); P valueP=0.0024P=0.0018P=0.0064

Visit cutoff Apr 15, 2017 (date of unblinding for primary efficacy analyses).

HRs estimated with a Cox proportional hazards model.

CI, confidence interval; HR, hazard ratio; NR, not reached.

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Abstract Details

Meeting

2019 ASCO Annual Meeting

Session Type

Poster Discussion Session

Session Title

Gynecologic Cancer

Track

Gynecologic Cancer

Sub Track

Ovarian Cancer

Clinical Trial Registration Number

NCT01968213

Citation

J Clin Oncol 37, 2019 (suppl; abstr 5522)

DOI

10.1200/JCO.2019.37.15_suppl.5522

Abstract #

5522

Poster Bd #

345

Abstract Disclosures