NSABP FC-10: Phase IB study of pembrolizumab in combination with premetrexed + oaliplatin in patients (pts) with chemo-refractory metastatic colorectal cancer (mCRC).

Authors

null

James J. Lee

NSABP Foundation, and The University of Pittsburgh School of Medicine, Pittsburgh, PA

James J. Lee , Greg Yothers , Thomas J. George , John C. Krauss , Bassam Nabih Maalouf , Hiral D. Parekh , Anuradha Krishnamurthy , Kelly R. Vehec , Norman Wolmark , Carmen Joseph Allegra , Samuel A. Jacobs

Organizations

NSABP Foundation, and The University of Pittsburgh School of Medicine, Pittsburgh, PA, The University of Pittsburgh, Pittsburgh, PA, NSABP Foundation, Inc., and The University of Florida Health Cancer Center, Gainesville, FL, NSABP Foundation Inc., and University of Michigan, Ann Arbor, MI, NSABP Foundation, Inc., and Cancer Care Specialists of Illinois/Crossroads Cancer Center, Effingham, IL, University of Florida Health Cancer Center, Gainesville, FL, University of Pittsburgh Medical Center Hillman Cancer Center, Pittsburgh, PA, NSABP Foundation, Inc., Pittsburgh, PA, NSABP Foundation, Inc., and The University of Pittsburgh, Pittsburgh, PA, NSABP Foundation, Inc., and The University of Florida, Gainesville, FL, NSABP Foundation, Inc., and The University of Pittsburgh Cancer Institute, University of Pittsburgh School of Medicine, Pittsburgh, PA

Research Funding

Pharmaceutical/Biotech Company
Merck & Co., Eli Lilly and Compnay, Other Foundation

Background: The majority of mCRC pts are microsatellite stable (MSS), have poor intratumoral CD8+ T cell infiltration, and no clinical response to immunotherapy checkpoint inhibitors. Preclinical studies suggest that chemotherapy may synergize with anti-PD-1. In non-small cell lung cancer (NSCLC), the combination of pembrolizumab (PemB), pemetrexed (PemT), + carboplatin demonstrated synergistic activity. This study will combine PemB with PemT, then that combination + oxaliplatin (Ox). The rationale for addition of Ox to PemT is that enhanced immunogenic cell death may induce CD8+ T cell infiltration into CRC tumors and model the mechanism of cytotoxicity seen in NSCLC. Thus, the combination of PemB+ PemT + Ox may induce synergistic antitumor immune activity. Methods: This multi-center phase Ib trial is actively enrolling pts with incurable mCRC with prior treatment for mCRC including fluoropyrimidine-, oxaliplatin-, and irinotecan-based chemotherapy, and if RAS wild-type, anti-EGFR therapy. Measurable disease by imaging (RECIST 1.1) is required. Standard ineligibility includes active infections, systemic steroid use, or other conditions contraindicating immunotherapy. Cohort 1 will receive PemB + PemT; Cohort 2 will receive PemB + PemT + dose-escalated Ox. Imaging will be performed every 6 wks. The primary aim of Cohort 1: to evaluate for safety and efficacy using doses of PemB and PemT that have been studied in NSCLC. The primary aim of Cohort 2: to evaluate the safety, tolerability, and efficacy of PemB in combination with PemT + Ox. The RP2D of the 3-drug combination will be at the MTD taking into account toxicity profiles of study therapy agents. Secondary aims: to evaluate the clinical benefit rate of the doublet and triplet combinations in pts with chemo-refractory MSS mCRC and to estimate progression-free survival and overall survival in pts with MSS mCRC treated with these combinations. The cohorts will be analyzed separately with descriptive intent only. Maximum enrollment is 33 pts. Support: Merck; Lilly; NSABP Foundation, Inc. Clinical trial information: NCT03626922

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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 C: Anal and Colorectal Cancer

Track

Colorectal Cancer,Anal Cancer

Sub Track

Therapeutics

Clinical Trial Registration Number

NCT03626922

Citation

J Clin Oncol 38, 2020 (suppl 4; abstr TPS262)

Abstract #

TPS262

Poster Bd #

M18

Abstract Disclosures