Phase II study of the combination of abemaciclib and pembrolizumab in locally advanced unresectable or metastatic gastroesophageal adenocarcinoma: Big Ten Cancer Research Consortium BTCRC-GI18-149.

Authors

null

Nataliya Volodymyrivna Uboha

University of Wisconsin, Carbone Cancer Center, Madison, WI

Nataliya Volodymyrivna Uboha , Jens C. Eickhoff , Chandrikha Chandrasekharan , Shadia Ibrahim Jalal , Al Bowen Benson III, Dustin A. Deming , Stephen Lindemann , Howard S. Hochster

Organizations

University of Wisconsin, Carbone Cancer Center, Madison, WI, Department of Biostatistics, University of Wisconsin, Madison, WI, University of Iowa, Iowa City, IA, Indiana University School of Medicine, Indianapolis, IN, Northwestern Medicine, Chicago, IL, University of Wisconsin Carbone Cancer Center, and ECOG-ACRIN, Madison, WI, Purdue University, West Lafayette, IN, Rutgers Cancer Institute, New Brunswick, NJ

Research Funding

Pharmaceutical/Biotech Company
Eli Lilly

Background: Metastatic gastroesophageal adenocarcinoma (GEA) has poor prognosis. Overall survival (OS) remains around 12 months (mo) with current therapies. Pembrolizumab is approved for advanced GEA that has progressed on at least 2 prior lines of systemic therapy. However, the majority of patients progress on this treatment, and less than 15% of patients experience objective response (OR). This study will evaluate efficacy of pembrolizumab in combination with cyclin-dependent kinase 4/6 (CDK4/6) inhibitor, abemaciclib, in patients with advanced GEA. Preclinical studies have demonstrated that CDK4/6 inhibitors can increase anti-tumor immunity and can synergize with immune checkpoint inhibitors. Based on these data, we hypothesize that abemaciclib will augment response to pembrolizumab in GEA. Methods: This is a multi-institutional, single arm, open label, phase II study of abemaciclib in combination with pembrolizumab in patients with advanced GEA who have progressed or were intolerant to at least 2 prior lines of therapy. Patients previously treated with immune checkpoint inhibitors or with microsattelite unstable tumors will be excluded. Treatments will be given on a 21 day cycle until disease progression or intolerable toxicities. Pembrolizumab, 200 mg intravenously, will be given on day 1, and abemaciclib, 150 mg, will be taken orally twice a day on days 1-21. Primary endpoint is progression free survival (PFS). Secondary endpoints include PFS rate at 6 mo, disease control rate, OS and OR rate. Correlative endpoints will examine relationship between PDL1 status, genomic signature and treatment response. Saliva samples will be collected for microbiome analysis. Archival tumor tissue and blood samples will be banked for future studies. A total of 31 evaluable subjects will be enrolled to detect an anticipated increase in the median PFS from 2 months (null hypothesis) to 4 months with 80% power at the one-sided 0.05 significance level. The trial is open to enrollment. Clinical trial information: NCT03997448

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Abstract Details

Meeting

2020 Gastrointestinal Cancers Symposium

Session Type

Trials in Progress Poster Session

Session Title

Trials in Progress Poster Session A: Esophageal and Gastric Cancer and Other GI Cancers

Track

Esophageal and Gastric Cancer,Other GI Cancer

Sub Track

Therapeutics

Clinical Trial Registration Number

NCT03997448

Citation

J Clin Oncol 38, 2020 (suppl 4; abstr TPS461)

Abstract #

TPS461

Poster Bd #

L5

Abstract Disclosures