Phase I/II study to evaluate the safety and clinical efficacy of atezolizumab (atezo; aPDL1) in combination with temozolomide (TMZ) and radiation in patients with newly diagnosed glioblastoma (GBM).

Authors

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Shiao-Pei S. Weathers

The University of Texas MD Anderson Cancer Center, Department of Neuro-Oncology, Houston, TX

Shiao-Pei S. Weathers , Carlos Kamiya-Matsuoka , Rebecca A. Harrison , Diane D. Liu , Shannon Dervin , Cindy Yun , Monica Elena Loghin , Marta Penas-Prado , Nazanin Majd , W. K. Alfred Yung , Barbara Jane O'Brien , John Frederick De Groot

Organizations

The University of Texas MD Anderson Cancer Center, Department of Neuro-Oncology, Houston, TX, The University of Texas, MD Anderson Cancer Center, Department of Neuro-Oncology, Houston, TX, The University of Texas MD Anderson Cancer Center, Houston, TX, Genentech, Inc., San Francisco, CA, MD Anderson Cancer Center, Houston, TX

Research Funding

Pharmaceutical/Biotech Company
Genentech

Background: Immunotherapy strategies such as PD-1/PD-L1 inhibition may work synergistically with radiation, which is known to increase antigen presentation and promote a pro-inflammatory tumor microenvironment. This trial evaluated the safety and clinical efficacy of concurrent atezo with radiation therapy and TMZ followed by adjuvant atezo and TMZ in patients with newly diagnosed GBM, unselected for MGMT status. Methods: Eligibility criteria included patients with newly diagnosed GBM age > 18 yrs who had undergone only surgery. The primary endpoint was safety in Phase I (n = 10) and OS in Phase II (n = 50). Secondary endpoints included progression free survival (PFS), overall response rate (ORR), and duration of response. All 60 patients were evaluated for efficacy. Correlative endpoints include profiling of tumor immune cell populations and peripheral blood for evaluation of circulating chemokines/cytokines. Results: 60 patients were enrolled. With median follow-up time of 16.7 months (data cutoff = 30 Dec 2019), 24 patients had died and 32 had progressed. Median OS was 17.1 months (95% CI: 13.9, not reached). Median PFS was 9.7 months (95% CI: 7.6-15). Median PFS in MGMT methylated patients (n = 18) was 16.7 months (95% CI: 7.85, not reached) and 7.9 months (95% CI: 6.70-12.4) in MGMT unmethylated patients (n = 33). Treatment-related adverse events with maximum CTCAE grade > 3 occurred in 33 patients; the most common were LFT elevation (n = 5) and lymphopenia (n = 23). To date, 17 of the enrolled 60 patients underwent re-resection post treatment with atezo. The matched paired tumor analysis of pre and post treatment tissue will provide valuable insights into mechanisms of anti-PD-L1 therapy resistance. Tumor immunocorrelative studies are pending. Conclusions: Concurrent use of atezo with radiation and TMZ was tolerable and demonstrated modest efficacy. Clinical trial information: NCT03174197.

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Abstract Details

Meeting

2020 ASCO Virtual Scientific Program

Session Type

Poster Discussion Session

Session Title

Central Nervous System Tumors

Track

Central Nervous System Tumors

Sub Track

Central Nervous System Tumors

Clinical Trial Registration Number

NCT03174197

Citation

J Clin Oncol 38: 2020 (suppl; abstr 2511)

DOI

10.1200/JCO.2020.38.15_suppl.2511

Abstract #

2511

Poster Bd #

2

Abstract Disclosures