A phase I study of veliparib incorporated into front-line platinum based cheotherpy and bevacizumab in epithelial ovarian cancer (NCT00989651): A GOG/nrg trial.

Authors

Deborah Armstrong

Deborah Kay Armstrong

The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University, Baltimore, MD

Deborah Kay Armstrong , Kathleen N. Moore , Austin Miller , Katherine M. Bell-McGuinn , Russell J. Schilder , Paula M. Fracasso , Joan L. Walker , Linda R. Duska , Cara Amanda Mathews , Alice P. Chen , David M. O'Malley , Heidi J. Gray , Roisin Eilish O'Cearbhaill , Saketh R Guntupalli , Andrea R. Hagemann , Carol Aghajanian

Organizations

The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University, Baltimore, MD, Stephenson Cancer Center at the University of Oklahoma, Oklahoma City, OK, Roswell Park Comprehensive Cancer Center, Buffalo, NY, Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York, NY, Thomas Jefferson University, Philadelphia, PA, Bristol-Myers Squibb, Princeton, NJ, The University of Oklahoma Health Sciences Center, Oklahoma City, OK, University of Virginia, Charlottesville, VA, Women & Infants Hospital, Providence, RI, Developmental Therapeutics Clinic/Early Clinical Trials Development Program, Division of Cancer Treatment and Diagnosis, National Cancer Institute, Bethesda, MD, The Ohio State University College of Medicine, Columbus, OH, Department of Obstetrics and Gynecology, University of Washington, Seattle, WA, University of Colorado Anschutz, Aurora, CO, Washington University School of Medicine in St. Louis and Siteman Cancer Center, St. Louis, MO, Memorial Sloan Kettering Cancer Center, New York, NY

Research Funding

Other Government Agency

Background: Veliparib, a poly-(ADP-ribose)-polymerase inhibitor, increases anti-tumor activity when combined with platinum chemotherapy and has monotherapy activity in BRCA deficient tumors. This study was done to determine the recommended phase II dose (RP2D) of veliparib in combination with front line treatment for epithelial ovarian cancer (EOC). Methods: Eligible patients had newly diagnosed, stage II-IV EOC. Six regimens were evaluated, 3 variations of chemo delivery with either continuous (D1-21) or intermittent (days-2-5) veliparib BID. Chemo included 1: IV q3week carboplatin (C) (AUC 6) and paclitaxel(T) (175mg/m2); 2, IV q3week C (AUC 6) and weekly T(80mg/m2); and 3, IV T (135mg/m2, day 1), IP cisplatin (75mg/m2, day 1 or 2) and IP T (60mg/m2, day 8). Bevacizumab 15mg/kg started cycle 2 and continued as monotherapy cycles 7-22. A 3+3 dose escalation design evaluated dose-limiting toxicities (DLTs) in cycles 1 and 2. Once < 2/6 patients experienced a DLT, that dose level was expanded to evaluate feasibility over 4 cycles. Results: The study accrued 424 treated patients. For regimen 1, continuous (Reg1c) the maximum tolerated dose (MTD) was 250mg veliparib BID but the feasible dose was found to be 150mg BID. For regimen 1, intermittent (Reg1i) the MTD and feasible dose were 400 and 250mg BID respectively. For Reg2c the MTD and feasible dose were the same at 150mg BID. For Reg2i the MTD and feasible dose were 250 and 150mg BID respectively. For Reg3c the MTD and feasible dose are both 150mg BID and for Reg3i, the MTD was 400mg BID and the feasible dose felt to be 300mg BID. Median PFS by residual disease and BRCA status is: (Positive residual disease) 14.6, 19.1 and 16.9 months for BRCA+, BRCAwt and BRCA ukn respectively. For no gross residual disease the PFS is NR, 34.2 and 24.5 months respectively. Conclusions: Given the difficulty with toxicity not defined as a DLT, the RP2D for all regimens is veliparib 150mg BID. This data informed the dose that moved into the phase III trial GOG 3005/Velia: NCT02470585. Velia also incorporated maintenance veliparib instead of maintenance bevacizumab among all high grade serous patients (BRCA+ and wt). These results will determine utilization of veliparib in this space. Clinical trial information: NCT00989651

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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

NCT00989651

Citation

J Clin Oncol 37, 2019 (suppl; abstr 5523)

DOI

10.1200/JCO.2019.37.15_suppl.5523

Abstract #

5523

Poster Bd #

346

Abstract Disclosures