IMMUNOSARC: a collaborative Spanish (GEIS) and Italian (ISG) sarcoma groups phase I/II trial of sunitinib and nivolumab in advanced soft tissue and bone sarcoma: Results from the phase II part, bone sarcoma cohort.

Authors

null

Emanuela Palmerini

IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy

Emanuela Palmerini , Antonio Lopez-Pousa , Giovanni Grignani , Andres Redondo , Nadia Hindi , Silvia Stacchiotti , Ana Sebio , Jose A. Lopez-Martin , Claudia Maria Valverde Morales , Javier Martinez-Trufero , Antonio Gutierrez , Enrique de Alava , Lorenzo D'Ambrosio , Paola Collini , Piero Picci , Paolo Giovanni Casali , Javier Martin Broto

Organizations

IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy, Hospital Sant Pau, Barcelona, Spain, Division of Medical Oncology, Candiolo Cancer Institute, FPO-IRCCS, Candiolo (TO), Italy, Hospital Universitario La Paz-IdiPAZ, Madrid, Spain, Istituto Nazionale del Tumori, Milan, Italy, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy, Hospital de la Santa Creu i Sant Pau, Medical Oncology Department, Barcelona, Spain, Medical Oncology Department, Hospital 12 de Octubre, Madrid, Spain, Vall d'Hebron University Hospital, Barcelona, Spain, Hospital Universitario Miguel Servet, Zaragoza, Spain, Hospital Universitario Son Espases, Palma De Mallorca, Spain, Centro de Investigación del Cáncer, CSIC-Universidad de Salamanca, Salamanca, Spain, Soft Tissue and Bone Pathology, Histopathology and Pediatric Pathology Unit, Department of Diagnostic Pathology and Laboratory Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy, Italian Sarcoma Group, Bologna, Italy, Adult Mesenchymal and Rare Tumor Unit, Department of Cancer Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy, Virgen del Rocio University Hospital, Institute of Biomedicine Research (IBIS)/CSIC/Universidad de Sevilla, Seville, Spain

Research Funding

Other
Pfizer, Bristol-Myers Squibb, Matteo Amitrano Onlus

Background: Herein, we present the results of the cohort on advanced bone sarcoma patients of the phase II part of the IMMUNOSARC study (NCT03277924), a European multicentre phase I-II trial aimed at investigating the activity of the combination of sunitinib (SU) and nivolumab (NI) in selected advanced sarcoma subtypes. Methods: Adult, pre-treated, progressing patients, ECOG 0-1, with a diagnosis of osteosarcoma, high-grade bone sarcoma, Ewing sarcoma, chondrosarcoma or dedifferentiated chondrosarcoma were eligible. SU 37.5 mg/day as induction was given days 1-14 and then reduced to 25mg/day continuously. NI was administered at 3 mg/Kg every 2 weeks from week 3. SU-NI was maintained up to progression or intolerance. Primary end-point was progression-free survival rate (PFSR) at 6 months (H1: PFSR 6-months: 15%). Secondary end-points: overall survival (OS), objective response rate (ORR) by RECIST v 1.1 and toxicity. Results: From Nov 2017 to Dec 2018, 40 eligible patients were included: (M/F = 27/13), median age 47 years (range 21-74), ECOG 0 in 11 (27%) cases, 36 (90%) were metastatic, 4 (10%) locally advanced. Histology: 17 osteosarcomas (43%), 14 chondrosarcomas (35%) (4 dedifferentiated), 8 Ewing sarcomas (20%), 1 bone undifferentiated pleomorphic sarcoma (2%). PFSR at 6 months based on local evaluation was 32%. At a median FU of 12.5 months (2-26), median PFS was 3.7 months (95% IC 3.4-4) while median OS was 14.2 months (95%CI: 7.1-21.3). OS rate at 3 and 6 months were 87% and 73%, respectively. ORR by RECIST: 1 CR (2.5%) (1 patient with dedifferentiated chondrosarcoma, lasting 22 months and on going), 1 PR (2.5%) (1 patient with osteosarcoma, lasting 5.7 months), 22 SD (55%, lasting > 6 months in 45% of the cases) and 16 PD (40%). G3/5 toxicities are detailed in Table. Conclusions: The trial met its primary endpoint in the cohort of patients with advanced bone sarcoma, with > 30% of patients free from progression at 6 months. Pre-planned tumor microenvironment genomic, exploratory analysis on pre and post-treatment tumor samples is on going. Clinical trial information: NCT03277924.

Grade 3-5 side effects in 40 patients with bone sarcoma after sunitinib and nivolumab.

ToxicityGrade 3-4Grade 5
Neutropenia4 (10%)0
Anaemia4 (10%)0
ALT/AST increased3 (7.5%)0
Fatigue2 (5.0%)0
Oral mucositis2 (5.0%)0
Thrombocytopenia1 (2.5%)0
Dysphagia1 (2.5%)0
Gastric haemorrhage1 ( 2.5%)0
Malaise1 (2.5%)0
Thromboembolic event1 (2.5%)0
Pneumonitis (toxic death)01 (2.5%)

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Abstract Details

Meeting

2020 ASCO Virtual Scientific Program

Session Type

Poster Session

Session Title

Sarcoma

Track

Sarcoma

Sub Track

Bone Tumors

Clinical Trial Registration Number

NCT03277924

Citation

J Clin Oncol 38: 2020 (suppl; abstr 11522)

DOI

10.1200/JCO.2020.38.15_suppl.11522

Abstract #

11522

Poster Bd #

410

Abstract Disclosures