The anti–PD-1 antibody spartalizumab (S) in combination with dabrafenib (D) and trametinib (T) in previously untreated patients (pts) with advanced BRAF V600–mutant melanoma: Updated efficacy and safety from parts 1 and 2 of COMBI-I.

Authors

Georgina Long

Georgina V. Long

Melanoma Institute Australia, The University of Sydney, and Royal North Shore and Mater Hospitals, Sydney, Australia

Georgina V. Long, Celeste Lebbe, Victoria Atkinson, Mario Mandalà, Paul D. Nathan, Ana Arance, Erika Richtig, Naoya Yamazaki, Caroline Robert, Dirk Schadendorf, Hussein Abdul-Hassan Tawbi, Paolo Antonio Ascierto, Antoni Ribas, Keith Flaherty, Dung-Yang Lee, Aisha Masood, Eduard Gasal, Reinhard Dummer

Organizations

Melanoma Institute Australia, The University of Sydney, and Royal North Shore and Mater Hospitals, Sydney, Australia, APHP Dermatology and CIC, U976, Université de Paris, Hôpital Saint-Louis, Paris, France, Greenslopes Private Hospital, Gallipoli Medical Research Foundation, University of Queensland, Queensland, Australia, Papa Giovanni XXIII Cancer Center Hospital, Bergamo, Italy, Mount Vernon Cancer Centre, Northwood, United Kingdom, Hospital Clínic de Barcelona, Barcelona, Spain, Medical University of Graz, Graz, Austria, National Cancer Center Hospital, Tokyo, Japan, Institut Gustave Roussy and Paris-Sud University, Villejuif, France, University Hospital Essen, Essen, Germany, and German Cancer Consortium, Heidelberg, Germany, The University of Texas MD Anderson Cancer Center, Houston, TX, Istituto Nazionale Tumori Fondazione Pascale, Naples, Italy, UCLA Medical Center, Los Angeles, CA, Dana-Farber Cancer Institute/Harvard Medical School and Massachusetts General Hospital, Boston, MA, Novartis Pharmaceuticals Corporation, East Hanover, NJ, University Hospital Zürich Skin Cancer Center, Zürich, Switzerland

Research Funding

Pharmaceutical/Biotech Company
Novartis.

Background: Checkpoint inhibitors and targeted therapies have improved outcomes in pts with BRAF V600–mutant advanced melanoma; however, many pts progress and new treatment (tx) strategies are needed. BRAF inhibition increases T-cell infiltration, melanoma antigen expression, and PD-1/PD-L1 expression, which may lead to synergistic activity with anti–PD-1 therapy. Methods: COMBI-i is investigating first-line S 400 mg Q4W + D 150 mg BID + T 2 mg QD in pts with unresectable or metastatic BRAF V600–mutant melanoma (NCT02967692). Here we report pooled efficacy and safety data from parts 1 (run-in cohort) and 2 (biomarker cohort). Response was assessed per RECIST v1.1. Results: 36 pts were enrolled (part 1: n = 9; part 2: n = 27); 18 (50%) had stage IV M1c and 15 (42%) had elevated LDH levels. At the data cutoff (median follow-up, 15.2 mo), tx was ongoing in 17 pts (47%). The confirmed objective response rate (ORR) by investigator assessment was 75% (n = 27), with 33% complete responses (CRs; n = 12). Medians for duration of response (DOR; 7/27 pts with events), progression-free survival (PFS; 13/36 pts with events), and overall survival (OS; 7/36 pts with events) were not reached. 12-mo DOR rate was 71.4% (95% CI, 49%-85%). 12-mo PFS and OS rates were 65.3% (95% CI, 47%-79%) and 85.9% (95% CI, 69%-94%), respectively. In pts with high baseline LDH: ORR was 67%, with 3 CRs (20%), median PFS was 10.7 mo (events in 10/15 pts [67%]), and median OS was not reached, with events in 6/15 pts (40%). All pts had ≥ 1 AE; 27 (75%) had grade ≥ 3 AEs. 6 pts (17%) had AEs leading to discontinuation of all 3 study drugs. Any-grade AEs in ≥ 40% of pts included pyrexia, chills, fatigue, cough, and arthralgia. Grade ≥ 3 AEs in > 3 pts were neutropenia, pyrexia, and increased lipase. One pt died of cardiac arrest that was not considered related to study tx. Conclusions: S+D+T showed promising and durable ORR (75%) with CR in 33% of pts. With > 15 mo of follow-up, median PFS was not reached. The safety profile was manageable reflecting individual toxicities of D, T, and S. The global, placebo-controlled, randomized phase 3 (part 3) of COMBI-i is ongoing. Clinical trial information: NCT02967692

Disclaimer

This material on this page is ©2024 American Society of Clinical Oncology, all rights reserved. Licensing available upon request. For more information, please contact licensing@asco.org

Abstract Details

Meeting

2020 ASCO-SITC Clinical Immuno-Oncology Symposium

Session Type

Poster Session

Session Title

Poster Session B

Track

Breast and Gynecologic Cancers,Developmental Therapeutics,Genitourinary Cancer,Head and Neck Cancer,Lung Cancer,Melanoma/Skin Cancers,Gastrointestinal Cancer,Combination Studies,Implications for Patients and Society,Miscellaneous Cancers,Hematologic Malignancies

Sub Track

Immune Checkpoints and Stimulatory Receptors

Clinical Trial Registration Number

NCT02967692

Citation

J Clin Oncol 38, 2020 (suppl 5; abstr 57)

Abstract #

57

Poster Bd #

C4

Abstract Disclosures