RESILIENT part I, an open-label, safety run-in of liposomal irinotecan in adults with small cell lung cancer (SCLC) who have progressed with platinum-based first-line (1L) therapy: Subgroup analyses by platinum sensitivity.

Authors

David Spigel

David R. Spigel

Sarah Cannon Research Institute, Nashville, TN

David R. Spigel , Luis G. Paz-Ares , Yuanbin Chen , Maria Jove , Oscar Juan-Vidal , Patricia Rich , Theresa M. Hayes , M Vanesa Gutierrez Calderon , Reyes Bernabe Caro , Alejandro Navarro , Afshin Dowlati , Bin Zhang , Yan Moore , Haofei Tiffany Wang , Jaba Kokhreidze , Natalya Nazarenko , Santiago Ponce Aix , Paul Bunn

Organizations

Sarah Cannon Research Institute, Nashville, TN, Hospital Universitario 12 de Octubre, Madrid, Spain, Cancer and Hematology Centers of Western Michigan, Grand Rapids, MI, Institut Català d’Oncologia, Barcelona, Spain, Hospital Universitario y Politécnico La Fe, Valencia, Spain, Cancer Treatment Centers of America, Atalanta, GA, South West Healthcare, Warrnambool, VIC, Australia, Hospital Regional Universitario de Málaga, Málaga, Spain, Hospital Universitario Virgen Del Rocio, Seville, Spain, Hospital Universitari Vall d'Hebron, Barcelona, Spain, Case Western Reserve University, Cleveland, OH, Ipsen Bioscience, Boston, MA, Hospital Universitario 12 De Octubre, Madrid, Spain, University of Colorado, Denver, CO

Research Funding

Pharmaceutical/Biotech Company
Ipsen

Background: Most patients with extensive SCLC develop drug resistance to platinum-based 1L therapy or discontinue for other reasons, and second-line (2L) therapies are limited. RESILIENT (NCT03088813) is a two-part phase 2/3 study assessing the safety, tolerability and efficacy of 2L liposomal irinotecan monotherapy in adults with SCLC who progressed with platinum-based 1L therapy. Preliminary data from RESILIENT part 1 (cut-off May 8 2019; ≥ 12 weeks follow-up) showed that liposomal irinotecan 70 mg/m2 free base every 2 weeks was generally well tolerated and had encouraging antitumor activity (Paz-Ares et al. WCLC 2019 OA03.03). Objective response rate (ORR; secondary endpoint) was 44% (11/25). Here we report efficacy analyses in post hoc subgroups by platinum sensitivity. Methods: RESILIENT part 1 was an open-label, single-arm study comprising dose-finding and dose-expansion phases. Eligible patients were aged ≥ 18 y, with an ECOG performance status score of 0/1 and adequate organ function; a single line of prior immunotherapy was allowed. Participants received liposomal irinotecan 70 mg/m2 or 85 mg/m2 free base every 2 weeks, with tumor assessments every 6 weeks (RECIST v1.1). Analyses were undertaken for the dose-finding phase recommended dose (RD) in subgroups of platinum-resistant/sensitive patients (with/without progression within 90 days from completion of 1L therapy). Results: During dose finding, 5 patients received liposomal irinotecan 85 mg/m2 (deemed not tolerable; dose-limiting toxicity) and 12 received 70 mg/m2 (deemed tolerable; RD for dose-expansion phase in which 13 more patients were included). Analyses included all 25 patients receiving the RD (mean exposure, 13.95 weeks [median 14.86; SD 7.222]). In the platinum-sensitive subgroup (33.3% men; median age 62.0 y) ORR was 53.3% (8/15) and 12-week disease control rate (DCR12wks) was 60% (9/15); in the platinum-resistant subgroup (50% men, median age 58.0 y) both ORR and DCR12wks were 30% (3/10). Overall and progression-free survival (secondary endpoints) are not yet mature. Conclusions: ORR and DCR12wks were numerically higher in platinum-sensitive than in platinum-resistant patients with SCLC who had progressed with platinum-based 1L therapy before receiving 2L liposomal irinotecan 70 mg/m2 in this phase 2 study. RESILIENT part 2, an ongoing, phase 3, randomized controlled trial vs topotecan, will provide further data. Clinical trial information: NCT03088813

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Abstract Details

Meeting

2020 ASCO Virtual Scientific Program

Session Type

Poster Session

Session Title

Lung Cancer—Non-Small Cell Local-Regional/Small Cell/Other Thoracic Cancers

Track

Lung Cancer

Sub Track

Small Cell Lung Cancer

Clinical Trial Registration Number

NCT03088813

Citation

J Clin Oncol 38: 2020 (suppl; abstr 9069)

DOI

10.1200/JCO.2020.38.15_suppl.9069

Abstract #

9069

Poster Bd #

262

Abstract Disclosures