Cobimetinib plus vemurafenib (C+V) in patients (Pts) with colorectal cancer (CRC) with BRAF V600E mutations: Results from the TAPUR Study.

Authors

Kelsey Klute

Kelsey Klute

University of Nebraska Medical Center, Omaha, NE

Kelsey Klute , Elizabeth Garrett-Mayer , Susan Halabi , Pam K. Mangat , Reza Nazemzadeh , Kathleen J Yost , Nicole L. Butler , Venu Perla , Richard L. Schilsky

Organizations

University of Nebraska Medical Center, Omaha, NE, Medical University of South Carolina, Charleston, SC, Duke University Medical Center, Durham, NC, American Society of Clinical Oncology, Alexandria, VA, Levine Cancer Institute, Atrium Health, Charlotte, NC, Cancer Research Consortium of West Michigan NCORP, Grand Rapids, MI

Research Funding

Pharmaceutical/Biotech Company
Genentech

Background: TAPUR is a phase II basket study evaluating anti-tumor activity of commercially available targeted agents in pts with advanced cancers with genomic alterations. Results in a cohort of CRC pts with BRAF V600E mutation treated with C+V are reported. Methods: Eligible pts had advanced CRC, no standard treatment (tx) options, measurable disease, ECOG PS 0-2, and adequate organ function. Genomic testing was performed in CLIA-certified, CAP-accredited site selected labs. Pts had BRAF V600E/D/K/R mutation and no MAP2K1/2, MEK1/2, NRAS mutations. Recommended dosing was C, 60 mg orally once daily for 21 days, 7 days off and V, 960 mg orally twice daily. Simon two-stage design was used to test the null rate of 15% vs. 35% (power = 0.85; α = 0.10). If ≥2 of 10 pts in stage 1 have disease control (DC) (objective response (OR) or stable disease at 16 weeks (wks) according to RECIST (SD16+)), 18 more pts enrolled. If ≥7 of 28 pts have DC, the tx is worthy of further study. Secondary endpoints are progression-free survival (PFS), overall survival (OS) and safety. Results: Thirty pts enrolled from August 2016 to August 2018; 2 were not evaluable for efficacy. Demographics and outcomes are summarized in Table. All pts had BRAF V600E mutations. Eight PR and 8 SD16+ were observed for DC and OR rates of 57% (90% CI, 43% to 67%) and 29% (95% CI, 13% to 49%), respectively. Twelve pts had at least 1 grade 3 AE or SAE at least possibly related to C+V including elevated liver enzymes, decreased lymphocytes, dyspnea, diarrhea, fatigue, hypercalcemia, hypophosphatemia, rash, photosensitivity, upper GI hemorrhage, and vomiting. Conclusions: The combination of C+V showed anti-tumor activity in heavily pre-treated CRC pts with BRAF V600E mutations. Further study is warranted to confirm the efficacy of C+V in this population. Clinical trial information: NCT02693535

Median age, yrs (range) 62 (37, 77)
Female, % 63
ECOG Performance Status, %
0 23
1 57
2 20
Prior systemic regimens, %
1-2 37
≥3 63
DC rate, % (OR or SD16+) (90% CI)1 57 (43, 67)
OR rate, % (CR or PR) (95%)1 29 (13, 49)
Median PFS, wks (95% CI)1 15.8 (14.4, 18.1)
Median OS, wks (95% CI)1 38.9 (26.1, 49.4)
Tx-related AEs, SAEs (% pts)
    AEs, grade 3 33
    SAEs 20

1N=28

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Abstract Details

Meeting

2020 Gastrointestinal Cancers Symposium

Session Type

Poster Session

Session Title

Poster Session C: Anal and Colorectal Cancer

Track

Colorectal Cancer,Anal Cancer

Sub Track

Therapeutics

Clinical Trial Registration Number

NCT02693535

Citation

J Clin Oncol 38, 2020 (suppl 4; abstr 122)

Abstract #

122

Poster Bd #

F8

Abstract Disclosures