Association of co-occurring gene alterations and clinical activity of rucaparib in patients with BRCA1 or BRCA2 mutated (BRCA+) metastatic castration-resistant prostate cancer (mCRPC).

Authors

null

Wassim Abida

Memorial Sloan Kettering Cancer Center, New York, NY

Wassim Abida , Akash Patnaik , David Campbell , Jeremy David Shapiro , Alan Haruo Bryce , Raymond S. McDermott , Brieuc Sautois , Nicholas J. Vogelzang , Richard M Bambury , Eric Voog , Jingsong Zhang , Josep M. Piulats , Charles J. Ryan , Axel Stuart Merseburger , Karim Fizazi , Darrin Despain , Andrea Loehr , Melanie Dowson , Tony Golsorkhi , Simon Chowdhury

Organizations

Memorial Sloan Kettering Cancer Center, New York, NY, University of Chicago, Chicago, IL, Barwon Health, University Hospital Geelong, Geelong, VIC, Australia, Cabrini Hospital, Malvern, VIC, Australia, Mayo Clinic, Phoenix, AZ, Adelaide and Meath Hospital (Incorporating the National Children's Hospital), Dublin, Ireland, University Hospital of Liège, CHU Sart Tilman, Liège, Belgium, Comprehensive Cancer Centers of Nevada, Las Vegas, NV, Cork University Hospital, Wilton, Cork, Ireland, Clinique Victor Hugo Centre Jean Bernard, Le Mans, France, H. Lee Moffitt Cancer Center, Tampa, FL, Institut Català d’Oncologia, Barcelona, Spain, University of Minnesota, Minneapolis, MN, Lübeck University Hospital, Lübeck, Germany, Institut Gustave Roussy, University of Paris Saclay, Villejuif Cedex, France, Clovis Oncology, Inc., Boulder, CO, Clovis Oncology UK, Ltd, Cambridge, CO, United Kingdom, Guy’s, King's, and St. Thomas' Hospitals, and Sarah Cannon Research Institute, London, United Kingdom

Research Funding

Pharmaceutical/Biotech Company
Clovis Oncology, Inc

Background: The poly(ADP-ribose) polymerase (PARP) inhibitor rucaparib was granted accelerated approval by the US Food and Drug Administration for patients with BRCA+ mCRPC based on results from the phase 2 TRITON2 study (NCT02952534). The TP53 tumor suppressor gene is among the most frequently mutated genes in human cancers, including mCRPC, and alterations in TP53, PTEN, and RB1 are associated with poor prognosis in patients with prostate cancer and other tumor types. We present data on co-occurring alterations in patients with BRCA+ mCRPC treated with rucaparib in TRITON2. Methods: Patients had progressed on 1–2 lines of androgen receptor-directed therapy and 1 taxane-based chemotherapy and were treated with rucaparib 600 mg BID. Tissue and/or cell-free DNA extracted from plasma samples were profiled comprehensively for genomic alterations using Foundation Medicine, Inc., next-generation sequencing assays. Objective response rate (ORR) was assessed per modified Response Evaluation Criteria in Solid Tumors and Prostate Cancer Working Group 3 criteria by independent radiologic review of patients with measurable disease. Prostate-specific antigen (PSA) response rate (≥50% decrease from baseline) was assessed in all patients. Results: Tissue and/or plasma samples were available for 114/115 patients with BRCA+ mCRPC (visit cutoff date: Dec. 23, 2019). Among patients with BRCA+ mCRPC who had samples available for comprehensive genomic profiling, 36.8% (42/114) had a co-occurring alteration in TP53. Deleterious alterations in PTEN were observed in 34.2% (39/114) of patients, 44% (17/39) of which were homozygous deletions of PTEN. RB1 loss was observed in 12.3% (14/114) of patients and was seen more frequently in patients with measurable disease (18.0%, 11/61) than in patients with non-measurable disease (5.7%, 3/53). Although patients with and without TP53 mutations had generally similar baseline demographics and disease characteristics, visceral disease was more prevalent in patients with TP53 mutations (54.8%; 23/42) than in those without them (29.2%; 21/72). Similar ORR and PSA response rates were seen in patients with BRCA+ mCRPC with or without TP53 mutation, with a non-significant trend towards lower response rates in patients with co-occurring TP53 alterations. Conclusions: Results from TRITON2 showed antitumor activity for rucaparib in patients with BRCA+ mCRPC associated with or without co-occurring alterations in TP53. Demographics and additional efficacy analyses in genomic subgroups with co-occurring alterations in TP53, PTEN, and RB1 will be reported. Clinical trial information: NCT02952534

Outcome measureCo-occurring TP53 alterationNo known TP53 alteration
ORR %, n/N36.0 (9/25)50.0 (18/36)
[95% CI, %][18.0–57.5][32.9–67.1]
PSA response rate %, n/N45.2 (19/42)59.7 (43/72)
[95% CI, %][29.8–61.3][47.5–71.1]

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Abstract Details

Meeting

2021 Genitourinary Cancers Symposium

Session Type

Poster Session

Session Title

Poster Session: Prostate Cancer - Advanced Disease

Track

Prostate Cancer - Advanced

Sub Track

Therapeutics

Clinical Trial Registration Number

NCT02952534

Citation

J Clin Oncol 39, 2021 (suppl 6; abstr 80)

DOI

10.1200/JCO.2021.39.6_suppl.80

Abstract #

80

Poster Bd #

Online Only

Abstract Disclosures