Phase II trial of palbociclib in recurrent RB-positive anaplastic oligodendroglioma: A Spanish group for research in neurooncology (GEINO) trial.

Authors

null

Juan Manuel Sepulveda-Sanchez

Hospital Universitario 12 de Octubre, Madrid, Spain

Juan Manuel Sepulveda-Sanchez , Miguel J. Gil Gil , Miriam Alonso , María Ángeles Vaz Salgado , Elena Vicente , Carlos Mesia Barroso , Angel Rodriguez Sanchez , Gema Durán , Ramon De Las Penas , José Muñoz-Langa , Guillermo de Velasco , Aurelio Hernandez-Lain , Amaya Hilario , L Miguel Navarro , Manuel Benavides , Laura Oleaga , Diana Cantero , Yolanda Ruano , Pilar Sanchez-Gomez , Estela Pineda

Organizations

Hospital Universitario 12 de Octubre, Madrid, Spain, Breast Cancer Unit & Medical Oncology Department, Institut Català d'Oncologia, IDIBELL, Barcelona, Spain, Hospital Universitario Virgen del Rocío, Seville, Spain, Medical Oncology Department, Ramon y Cajal University Hospital, Madrid, Spain, Complejo Hospitalario Insular, Las Palmas de Gran Canaria, Spain, Institut Català d'Oncologia Hospital Duran i Reynals, Barcelona, Spain, Hospital of Leon, Leon, Spain, Complejo Hospitalario Regional de Málaga, Malaga, Spain, Oncology Service Hospital Provincial of Castellon, Castellón, Spain, Hospital Universitario La Fé, València, Spain, Department of Medical Oncology, University Hospital 12 de Octubre, i + 12, Madrid, Spain, Madrid, Spain, 12 de Octubre Universitary Hospital, Madrid, Spain, Department of Medical Oncology, Complejo Asistencial Universitario de Salamanca, Salamanca, Spain, Hospital Regional Universitario y Virgen de la Victoria, Málaga, Spain, Hospital Clinic Barcelona, Barcelona, Spain, Instituto de Salud Carlos III, Majadahonda, Spain, Medical Oncology, Hospital Clinic Barcelona, Barcelona, Spain

Research Funding

Pharmaceutical/Biotech Company

Background: The pRB-dependent cell cycle checkpoint is altered in the vast majority of anaplastic oligodendrogliomas (AO), either by homozygous deletion or by hypermethylation of CDKN2A and/or CDKN2B, or by amplification and/or overexpression of CDK4. Palbociclib is an oral inhibitor of CDK4 and 6 that has already been shown to be highly active in breast cancer. Methods: We conducted a multicenter, open-label, phase II trial evaluating efficacy and safety of Palbociclib in patients with AO that progressed to radiotherapy and more than one chemotherapy regimen containing Temozolomide and/or Lomustine. Inclusion criteria included: histologically and molecularly confirmed grade III oligodendroglioma (WHO 2016 classification, IDH1/2 mutation and 1p/19 codeletion were mandatory), recurrence after radiotherapy and 1 or 2 chemotherapy regimens and conserved RB protein expression by immunohistochemistry (IHC). Patients were treated with Palbociclib 125 mg/daily 3 weeks on/1off. The primary objective of the study was progression-free survival at 6 months (6M-PFS). Results: Between October 2015 and September 2018, 34 patients were enrolled across ten hospitals. The study was stopped early secondary to lack of efficacy, with 74% of evaluable patients progressing within 6 months. Number of patients alive and free from progression at 6 months after the enrollment was 9 (26%) out of the first 34 patients, below the minimum number required (18 out of 40) to consider Palbociclib as an active drug in this population. With a median follow-up of 11.2 months, the median PFS was 3 months (95% CI: 2.5-3.5 months). Median overall survival (OS) was 23.1 months (95% CI: 17.2-25 months). There were no partial or complete responses and only 11 patients (32%) achieved stable disease as best response. Palbociclib was well tolerated with neutropenia (Grade 3 or 4: 40%) and thrombocytopenia (Grade 3 or 4: 15%) as the most common adverse effects (AEs). Both AEs had no significant impact since there were no episodes of febrile neutropenia or bleeding. Conclusions: Despite the good tolerance and drug exposure, Palbociclib monotherapy did not show favorable activity in recurrent AO. Clinical trial information: NCT02530320

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Abstract Details

Meeting

2019 ASCO Annual Meeting

Session Type

Poster Session

Session Title

Central Nervous System Tumors

Track

Central Nervous System Tumors

Sub Track

Central Nervous System Tumors

Clinical Trial Registration Number

NCT02530320

Citation

J Clin Oncol 37, 2019 (suppl; abstr 2038)

DOI

10.1200/JCO.2019.37.15_suppl.2038

Abstract #

2038

Poster Bd #

227

Abstract Disclosures