Safety and efficacy of anti–PD-1 antibody dostarlimab in patients (pts) with mismatch repair-deficient (dMMR) solid cancers: Results from GARNET study.

Authors

Thierry Andre

Thierry Andre

Sorbonne Université and Hôpital Saint Antoine, Paris, France

Thierry Andre , Dominique Berton , Giuseppe Curigliano , Susan Ellard , Jose Manuel Trigo Pérez , Hendrik-Tobias Arkenau , Cyril Abdeddaim , Victor Moreno , Wei Guo , Ellie Im , Naureen Starling

Organizations

Sorbonne Université and Hôpital Saint Antoine, Paris, France, GINECO & Institut de Cancerologie de l'Ouest, Centre René Gauducheau, Saint-Herblain, France, Division of Early Drug Development for Innovative Therapies, IEO, European Institute of Oncology IRCCS, and University of Milano, Milan, Italy, BC Cancer, Kelowna, BC, Canada, Medical Oncology Department, Hospital Ramón y Cajal, Madrid, Spain, Sarah Cannon Research Institute UK Limited, London, United Kingdom, Centre de Lutte Contre le Cancer-Centre Oscar Lambret, Lille, France, START Madrid-FJD, Fundación Jiménez Díaz Hospital, Madrid, Spain, GlaxoSmithKline, Waltham, MA, Royal Marsden Hospital NHS Foundation Trust, London and Surrey, United Kingdom

Research Funding

Pharmaceutical/Biotech Company
GlaxoSmithKline.

Background: Dostarlimab is a humanized anti–PD-1 monoclonal antibody that binds the PD-1 receptor, blocking interaction with ligands PD-L1 and PD-L2. The ongoing phase 1 GARNET study (NCT02715284) is evaluating dostarlimab in pts with advanced solid tumors. Here we present safety and efficacy data from cohort F. Methods: Cohort F of the GARNET trial enrolled pts with dMMR or POLEmut non-endometrial solid tumors; the majority were gastrointestinal (GI) in origin. Pts must have progressed per blinded independent central review (BICR) following prior systemic therapy for advanced disease and had dMMR status by local immunohistochemistry. Pts received 500 mg dostarlimab Q3W for 4 cycles and 1000 mg Q6W until discontinuation. Objective response rate (ORR) and duration of response (DOR) were assessed by BICR per RECIST v1.1. Pts were included in the efficacy analysis if they received ≥1 dose of dostarlimab, had measurable disease at baseline, and 6 mo of follow up. All pts who received ≥1 dose were included in the safety analysis. Results: 144 pts were included in the safety analysis, with 106 dMMR pts in the efficacy analysis (1 POLEmut pt with a confirmed PR was not included in this population). Of the 106 pts, 99 (93.4%) had GI tumors. Confirmed ORR in dMMR pts was 38.7% (95% CI: 29.4, 48.6), with a complete response rate of 7.5%. ORR was consistent across tumor type (Table). At the data cutoff, median duration of follow-up (n = 107; dMMR and POLEmut pts) was 12.4 months and median DOR was not reached. The Kaplan–Meier estimated probability of maintaining response at 12 and 18 months was 91.0% and 80.9% respectively. Treatment-related adverse events (TRAEs) were reported in 68.8% of pts; 8.3% of pts experienced at least 1 grade ≥3 TRAE. The most common was lipase increased in 2 (1.4%) pts. Treatment-related serious AEs (SAEs) were reported in 6 (5.5%) pts, and 2 pts (1.8%) discontinued dostarlimab due to a TRAE. No deaths were attributed to dostarlimab. Conclusions: Dostarlimab demonstrated durable antitumor activity in a cohort of dMMR solid tumor pts, the majority of whom had GI cancers. The safety profile was consistent with other cohorts in GARNET, with immune-related TRAEs infrequent and low grade. Clinical trial information: NCT02715284

Tumor typeNConfirmed ORR (RECIST v1.1)
n (%)95% CI*
Overall10641 (38.7)29.4–48.6
CRC6925 (36.2)25.0–48.7
Non-CRC3716 (43.2)27.1–60.5
Small Intestinal Cancer124 (33.3)(9.9–65.1)
Gastric Cancer83 (37.5)(8.5–75.5)
Pancreatic Carcinoma40(0.0–60.2)
Liver Cancer2PR, PD
Ovarian Cancer2PR, SD
Adrenal Cortical1PR
Biliary Neoplasm1CR
Breast Cancer1CR
Esophageal Cancer1PD
Gallbladder11CR
Genital Neoplasm Malignant Female1PR
Pleural1PR
Renal Cell Carcinoma1SD
Unknown Origin (Possibly GI tract)1PR

*Exact, 2-sided 95% CI for the binomial proportion.

CR = complete response, PR = partial response, SD = stable disease, PD = progressive disease.

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Abstract Details

Meeting

2021 Gastrointestinal Cancers Symposium

Session Type

Oral Abstract Session

Session Title

Oral Abstract Session: Anal and Colorectal Cancer

Track

Colorectal Cancer,Anal Cancer

Sub Track

Therapeutics

Clinical Trial Registration Number

NCT02715284

Citation

J Clin Oncol 39, 2021 (suppl 3; abstr 9)

DOI

10.1200/JCO.2021.39.3_suppl.9

Abstract #

9

Abstract Disclosures