Characterization of patients (pts) with long-term responses to rucaparib in recurrent ovarian cancer (OC).

Authors

Elizabeth Swisher

Elizabeth M. Swisher

University of Washington, Seattle, WA

Elizabeth M. Swisher , Rebecca Sophie Kristeleit , Amit M. Oza , Anna Tinker , Isabelle Laure Ray-Coquard , Ana Oaknin , Robert L. Coleman , Howard A. Burris III , Carol Aghajanian , David M. O'Malley , Alexandra Leary , Stephen Welch , Diane M. Provencher , Geoffrey Shapiro , Lee-may Chen , Ronnie Shapira-Frommer , Sandra Goble , Lara Maloney , Kevin K. Lin , Iain A. McNeish

Organizations

University of Washington, Seattle, WA, UCL Cancer Institute, University College London and UCL Hospitals, London, United Kingdom, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada, BC Cancer, Vancouver, BC, Canada, Centre Léon Bérard and University Claude Bernard and Groupe d’Investigateurs Nationaux pour l’Etude des Cancers Ovariens (GINECO), Lyon, France, Vall d’Hebron University Hospital, Vall d’Hebron Institute of Oncology (VHIO), Barcelona, Spain, The University of Texas MD Anderson Cancer Center, Houston, TX, Sarah Cannon Research Institute at Tennessee Oncology, Nashville, TN, Memorial Sloan Kettering Cancer Center, New York, NY, The Ohio State University, James Cancer Center, Columbus, OH, Gustave Roussy Cancer Center, Villejuif, France, London Regional Cancer Centre, London, ON, Canada, Institut du Cancer de Montréal, CHUM Centre hospitalier de l'Université de Montréal, Université de Montréal, Montreal, QC, Canada, Dana-Farber Cancer Institute, Boston, MA, University of California San Francisco, San Francisco, CA, Oncology Institute; Sheba Medical Center, Tel Hashomer, Israel, Clovis Oncology, Inc., Boulder, CO, Imperial College London, London, United Kingdom

Research Funding

Pharmaceutical/Biotech Company
Clovis Oncology, Inc.

Background: Pts who derive durable benefit from PARP inhibitor treatment may provide insights into improving outcomes. Here we describe long-term responders from Study 10 (NCT01482715) and ARIEL2 (NCT01891344), studies of the PARP inhibitor rucaparib for the treatment of high-grade recurrent OC. Methods: This analysis included pts enrolled in Study 10 (Part 2A: BRCA1 or BRCA2 [BRCA]-mutant OC, platinum sensitive, 2–4 prior chemotherapies; Part 2B: any platinum status, 3–4 prior chemotherapies) and ARIEL2 (Part 1: BRCA-mutant or wild-type OC, platinum sensitive; Part 2: any platinum status, 3–4 prior chemotherapies). Final results from Study 10 (n = 54) and ARIEL2 (n = 491) were pooled. Long-term responders were defined as pts with duration of response (DOR) > 1 y, and short-term responders as pts with DOR ≤ 20 weeks; responses were evaluated using RECIST. Targeted next-generation sequencing was used to detect deleterious mutations and loss of heterozygosity (LOH) in tumors. BRCA1 methylation was quantified by digital droplet PCR. Results: Overall, 25% (138/545) of enrolled pts were responders. Of these, 29% (40/138) had long-term responses, including 16/138 (12%) with DOR > 2 y; 21% (29/138) were short-term responders. Both groups received a median of 3 prior anticancer therapies. Among patients with BRCA mutations, BRCA homozygous deletion or rearrangement was detected in 15% (4/27) of long-term responders vs 0% (0/15) of short-term responders. In an expanded analysis of the 95 pts with BRCA mutations and confirmed response, pts with BRCA homozygous deletion or rearrangement had significantly longer DOR than pts with other mutation types (median 3.5 vs 0.6 y; HR = 0.30; p = 0.024). There was no apparent difference in BRCA gene or mutation location for long- vs short-term responders. Ten of the 13 long-term responders with BRCA wild-type OC had high genome-wide LOH (≥16% LOH), a genomic scar indicative of homologous recombination deficiency, including OC associated with BRCA1 hypermethylation (n = 2) and RAD51C/D mutations (n = 2). Conclusions: Long-term responders to rucaparib include OC with BRCA mutation, particularly homozygous deletion or rearrangements, which would not be susceptible to somatic reversion mutations, as well as BRCA1 hypermethylation, and RAD51C/D mutations. Clinical trial information: NCT01482715; NCT01891344

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 Virtual Scientific Program

Session Type

Poster Discussion Session

Session Title

Gynecologic Cancer

Track

Gynecologic Cancer

Sub Track

Ovarian Cancer

Clinical Trial Registration Number

NCT01482715; NCT01891344

Citation

J Clin Oncol 38: 2020 (suppl; abstr 6015)

DOI

10.1200/JCO.2020.38.15_suppl.6015

Abstract #

6015

Poster Bd #

186

Abstract Disclosures