Preliminary efficacy data of triple-negative breast cancer cohort of NCI 9881 study: A phase II study of cediranib in combination with olaparib in advanced solid tumors.

Authors

null

Navid Hafez

Yale University School of Medicine, New Haven, CT

Navid Hafez , Hatem Hussein Soliman , Siqing Fu , Karen A. Gelmon , Albiruni Ryan Abdul Razak , Pamela N. Munster , Ulka N. Vaishampayan , Shumei Kato , Primo Lara Jr., Elizabeth M. Swisher , Andrew B. Nixon , Abhijit Patel , Yu Shyr , S. Percy Ivy , Patricia LoRusso , Joseph W. Kim

Organizations

Yale University School of Medicine, New Haven, CT, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, The University of Texas MD Anderson Cancer Center, Houston, TX, Department of Medical Oncology, BC Cancer, Vancouver, BC, Canada, Princess Margaret Cancer Centre, Toronto, ON, Canada, University of California San Francisco, San Francisco, CA, Karmanos Cancer Institute, Detroit, MI, University of California San Diego, Moores Cancer Center, La Jolla, CA, University of California, Sacramento, CA, University of Washington School of Medicine, Seattle, WA, Duke University Medical Center, Durham, NC, Yale School of Medicine, New Haven, CT, Vanderbilt-Ingram Cancer Center, Nashville, TN, National Cancer Institute at the National Institutes of Health, Rockville, MD, Yale Cancer Center, Yale School of Medicine, New Haven, CT

Research Funding

U.S. National Institutes of Health
U.S. National Institutes of Health

Background: Cediranib, a pan-vascular endothelial growth factor receptor tyrosine kinase inhibitor, suppresses expression of BRCA1, BRCA2, and RAD51 and increases sensitivity of tumors to poly-(ADP-ribose) polymerase (PARP) inhibitors in vitro. Olaparib, a PARP inhibitor, demonstrates clinical efficacy in patients with germline BRCA1/2 mutations and HER2-negative metastatic breast cancer. We therefore tested the anti-tumor activity of the combination of cediranib and olaparib in patients (pts) with metastatic triple-negative breast cancer (TNBC). Methods: This multi-institutional, two-stage, phase II study enrolled patients with metastatic TNBC previously treated with a minimum of one prior line of systemic therapy in the advanced setting. Patients were treated with cediranib 30mg po daily plus olaparib 200mg po BID until disease progression or unacceptable toxicity. The primary endpoint was objective response rate by RECIST v1.1. Baseline tumor biopsies were obtained for biomarker analyses. Results: Baseline characteristics of the 37pts enrolled are summarized below. The overall objective response rate was 14% (95% CI: 0.025, 0.2453). Median duration of response was 2.0 months (mos) with a range of 1.8 to 6.3 mos. Disease control rate ((# of pts with CR, PR or SD)/(# of evaluable pts)) was 81% (95% CI: 0.6846, 0.937). Median PFS was 3.7 mos (95% CI: 2.1, 4.3). Grade 3/4 adverse events (G3/4 AEs), irrespective of attribution, occurred in 25 of 38 (66%).G3/4 AEs occurring in > 5% of pts were hypertension (24%) and dyspnea (11%), diarrhea (8%) vomiting (8%). Conclusions: The cediranib/olaparib combination resulted in promising objective responses in 14% of biomarker-unselected patients with heavily pre-treated, metastatic TNBC. The regimen required prompt initiation of antihypertensives, but AEs were overall manageable. Analyses of mutation status in homologous recombination DNA repair genes are ongoing and will be correlated with clinical outcome. Clinical trial information: NCT02498613.

Total N = 37,
Median (range)
Age49 (32-68)
ECOG PS1 (0-1)
# of prior therapies4 (2-11)
Prior platinum-based chemotherapy92%
Platinum-sensitive ( > 90 days interval to start subsequent therapy)19%
Prior immunotherapy41%

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Abstract Details

Meeting

2020 ASCO Virtual Scientific Program

Session Type

Poster Session

Session Title

Breast Cancer—Metastatic

Track

Breast Cancer

Sub Track

Triple-Negative

Clinical Trial Registration Number

NCT02498613

Citation

J Clin Oncol 38: 2020 (suppl; abstr 1077)

DOI

10.1200/JCO.2020.38.15_suppl.1077

Abstract #

1077

Poster Bd #

162

Abstract Disclosures