Cediranib in combination with olaparib in patients without a germline BRCA1/2 mutation with recurrent platinum-resistant ovarian cancer: Phase IIb CONCERTO trial.

Authors

null

Jung-Min Lee

National Cancer Institute, Bethesda, MD

Jung-Min Lee , Richard G. Moore , Sharad A. Ghamande , Min S. Park , John Paul Diaz , Julia A. Chapman , James Erasmus Kendrick IV, Brian M. Slomovitz , Krishnansu Sujata Tewari , Elizabeth S. Lowe , Tsveta Milenkova , Sanjeev Kumar , Mike Dymond , Iwanka Kozarewa , Joyce F. Liu

Organizations

National Cancer Institute, Bethesda, MD, Wilmot Cancer Institute, Rochester, NY, Georgia Cancer Center, Augusta University, Augusta, GA, Swedish Cancer Institute, Seattle, WA, Miami Cancer Institute, Miami, FL, University of Kansas Medical Center, Westwood, KS, Advent Health Orlando, Orlando, FL, University of Miami, Miami, FL, University of California, Irvine, CA, AstraZeneca Pharmaceuticals, Gaithersburg, MD, AstraZeneca, Cambridge, United Kingdom, Dana-Farber Cancer Institute, Boston, MA

Research Funding

Pharmaceutical/Biotech Company
AstraZeneca and Merck Sharp & Dohme Corp, a subsidiary of Merck & Co, Inc, Kenilworth, NJ, USA

Background: A Phase I trial (NCT01116648) of cediranib (cedi) in combination with olaparib (ola) (cedi + ola) demonstrated an overall response rate of 44% in patients (pts) with recurrent ovarian cancer (OC), including pts without a deleterious or suspected deleterious gBRCAm (non-gBRCAm; Liu et al. Eur J Cancer 2013). The subsequent Phase II trial (NCT01116648) showed significant improvement in progression-free survival (PFS) with cedi + ola versus ola monotherapy in recurrent platinum-sensitive OC pts, notably in non-gBRCAm pts (Liu et al. Lancet Oncol 2014). We report data from the Phase IIb, single-arm, open-label CONCERTO study investigating cedi + ola in non-gBRCAm pts with recurrent platinum-resistant OC who had received ≥3 previous lines of therapy for advanced OC (NCT02889900). Methods: Pts with disease progression <6 months from the last receipt of platinum-based chemotherapy received cedi tablets (30 mg once daily) plus ola tablets (200 mg twice daily) until progression or unacceptable toxicity. gBRCAm pts were ineligible. Primary endpoint: objective response rate (ORR) by independent central review (ICR; RECIST 1.1). Key secondary endpoints: PFS and safety. Results: 60 pts from the USA were included (median age: 64.5 years; median number of previous systemic treatment regimens: 4 [range: 2–9]; previous bevacizumab: 53). All pts had high-grade OC (90% serous; 3.3% clear cell; 3.3% endometrioid; 3.3% other). 7% of pts had tumor BRCA2 (confirmed somatic) mutations, 80% of pts had no tumor BRCA mutation (non-tBRCAm) and 13% of pts were not evaluable for tBRCAm. Five (8%) pts who were non-tBRCAm carried somatic homologous recombination repair gene mutations (FoundationOne Clinical Trial Assay, Foundation Medicine, Inc). The Table shows results of key endpoints. Most common grade ≥3 adverse events (AEs) that occurred in pts were hypertension (30%), fatigue (22%) and diarrhea (13%). 37% of pts reported serious AEs, of which nausea (7%) was most common. Dose interruptions, reductions and discontinuations were caused by AEs in 55%, 18% and 18% of pts, respectively, who received cedi + ola. Conclusions: Cedi + ola showed evidence of antitumor activity in heavily pretreated non-gBRCAm pts with recurrent platinum-resistant OC. Toxicity was manageable with dose modifications. Clinical trial information: NCT02889900

EndpointCedi + ola (n=60)95% CI
Confirmed ORR,* %15.37.2–27.0
Median PFS,* months5.13.5–5.5
Median duration of response,* months8.35.6–10.3
Median overall survival, months13.29.4–16.4

*By ICR; n=59; n=9

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Abstract Details

Meeting

2020 ASCO Virtual Scientific Program

Session Type

Poster Session

Session Title

Gynecologic Cancer

Track

Gynecologic Cancer

Sub Track

Ovarian Cancer

Clinical Trial Registration Number

NCT02889900

Citation

J Clin Oncol 38: 2020 (suppl; abstr 6056)

DOI

10.1200/JCO.2020.38.15_suppl.6056

Abstract #

6056

Poster Bd #

227

Abstract Disclosures