Florida Cancer Specialists and Sarah Cannon Research Institute, Sarasota, FL
Manish R. Patel , Gerald Steven Falchook , Judy Sing-Zan Wang , Esteban Rodrigo Imedio , Sanjeev Kumar , Pejvack Motlagh , Kowser Miah , Ganesh M. Mugundu , Suzanne Fields Jones , David R. Spigel , Erika Paige Hamilton
Background: Adavosertib (AZD1775; A) is a highly selective inhibitor of WEE1. This Phase I study (NCT02617277) investigated a range of doses and schedules for oral A plus IV durvalumab (DV), a human monoclonal antibody targeting PD-L1, to determine the maximum tolerated dose (MTD) and recommended Phase II dose (RP2D) in patients (pts) with advanced solid tumors. Methods: Four 28-day schedules (Sch) were evaluated with pts receiving DV 1500 mg on day (d) 1 of each schedule (Table). Patients continued treatment if they showed clinical benefit in the absence of any discontinuation criteria. Pts received A monotherapy for PK analysis prior to the start of combination therapy in Sch B, C (d –7 to –5) and D (d –9 to –5). MTD was determined using a 3+3 dose-escalation cohort design. Predefined dose-limiting toxicities (DLTs) were evaluated during the first cycle of study treatment. Results: 54 pts received A (most common primary tumor sites: colon, 19%; lung, 13%; breast, 11%). The most common grade ≥3 AEs were fatigue (15%), diarrhea (11%) and nausea (9%). DLTs were nausea (n = 2) and diarrhea (n = 1). 7 pts (13%) had A-related SAEs, including reversible and confounded drug-induced liver injury (Sch B 125 mg and Sch C; 1 each). Disease control rate (DCR) for the total cohort was 36%. Preliminary PK at 150 mg BID suggests adequate coverage for cell kill activity and no drug–drug interaction. Conclusions: The MTD/RP2D was A 150 mg BID (3 d on, 4 d off; treatment d 15–17, 22–24) with DV 1500 mg (d 1 Q4W); safety profile was considered acceptable. Preliminary evidence of antitumor activity was observed. Clinical trial information: NCT02617277
Sch | A dose (days on/off) | A treatment days | N | DLTs, n (%) | Grade ≥3 AEs, n (%) | A discontinuations due to AE, n (%) | A dose reductions due to AE, n (%) | DCR, n (%) |
---|---|---|---|---|---|---|---|---|
A | 125 mg BID (5/9) | 1–5, 15–19 | 6 | 2 (33) | 4 (67) | 1 (17) | 1 (17) | 1 (17) |
B | 125 mg BID (3/4) | 15–17, 22–24 | 7* | 0 | 3 (43) | 0 | 0 | 3 (50)* |
150 mg BID (3/4) | 15–17, 22–24 | 12 | 0 | 7 (58) | 0 | 1 (8) | 5 (42) | |
175 mg BID (3/4) | 15–17, 22–24 | 7 | 0 | 5 (71) | 1 (14) | 2 (29) | 4 (57) | |
C | 125 mg BID (3/4) | 8–10, 15–17, 22–24 | 7† | 1 (17)† | 6 (86) | 1 (14) | 0 | 1 (14) |
D | 200 mg QD (5/2) | 15–19, 22–26 | 6 | 0 | 3 (50) | 0 | 0 | 2 (33) |
250 mg QD (5/2) | 15–19, 22–26 | 6 | 0 | 4 (67) | 1 (17) | 1 (17) | 3 (50) | |
300 mg QD (5/2) | 15–19, 22–26 | 3 | 0 | 2 (67) | 0 | 1 (33) | 0 |
*Only 6 pts received DV; †DLT evaluable in 6 pts only
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