Phase (Ph) 1b/2 evaluation of olaratumab in combination with gemcitabine and docetaxel in advanced soft tissue sarcoma (STS).

Authors

null

Steven Attia

Mayo Clinic, Jacksonville, FL

Steven Attia , Victor Manuel Villalobos , Nadia Hindi , Brian Andrew Van Tine , Andrew J. Wagner , Bartosz Chmielowski , Donna Elise Levy , Matteo Ceccarelli , Robin Lewis Jones , Mark Andrew Dickson

Organizations

Mayo Clinic, Jacksonville, FL, University of Colorado Denver School of Medicine, Aurora, CO, Instituto de Biomedicina de Sevilla, IBiS/Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla and Medical Oncology, Hospital Universitario Virgen del Rocio, Seville, Spain, Division of Medical Oncology, Washington University in St. Louis, St Louis, MO, Department of Medical Oncology, Dana-Farber Cancer Institute, and Harvard Medical School, Boston, MA, UCLA Jonsson Comprehensive Cancer Center, Los Angeles, CA, Syneos Health, Morrisville, NC, Eli Lilly and Company, Indianapolis, IN, Royal Marsden Hospital/Institute of Cancer Research, London, United Kingdom, Memorial Sloan Kettering Cancer Center, New York, NY

Research Funding

Pharmaceutical/Biotech Company
Eli Lilly

Background: Doxorubicin (doxo) remains standard first-line therapy for advanced STS. Doxo in combination with olaratumab (O) demonstrated superior clinical activity compared to doxo alone in a Ph 2 trial (NCT01185964), although this was not confirmed in the subsequent Ph 3 trial (NCT02451943). Gemcitabine (G) plus docetaxel (D) is a second line therapy for advanced STS. Here, we report a concurrent Ph 2 study that explored a second-line addition of O to G and D for advanced STS (ANNOUNCE 2 NCT02659020). Methods: Adult patients (pts) with unresectable locally advanced or metastatic STS, ≤ 2 prior lines of systemic therapy, and ECOG PS 0-1 were eligible. Pts were enrolled from 2 cohorts: O-naïve and O-pretreated. In both cohorts, pts were randomized 1:1 to either O, G plus D or placebo (PBO), G plus D. Pts received 21-day cycles of O (20 mg/ kg cycle 1 and 15 mg/kg other cycles, day (d) 1 and d8), G (900 mg/m2, d1 and d8) and D (75 mg/m2, d8). Pts continued treatment until progression, toxicity, or withdrawal. Randomization was stratified by histology (leiomyosarcoma [LMS] vs non-LMS), prior systemic therapy, ECOG PS, and prior pelvic radiation. The primary objective was overall survival (OS) in the O-naïve population using an alpha level of 0.20. Secondary endpoints included OS (O-pretreated) and other efficacy parameters, as well as safety and pharmacokinetics (PK). Results: 167 pts were enrolled in the O-naïve cohort and 89 pts in the O-pretreated cohort. Baseline patient characteristics were well balanced. OS for O-naïve pts was 16.8 vs 18.0 months (m) (hazard ratio [HR] = 0.95, 95% CI: 0.64-1.40; p = 0.78) for the investigational vs control arm, respectively. Other efficacy outcomes are presented in the table. Safety was manageable across treatment arms. PK parameter estimates for O were consistent with previous studies. Conclusions: There was no statistically significant difference in OS between the two arms in the O-naïve population. However, while not statistically significant, the combination of O, G and D demonstrated favorable OS in the O-pretreated cohort, and PFS and objective response rate (ORR) in both cohorts. For O-naïve pts, a clinically meaningful progression-free survival (PFS) improvement was observed. Further investigations in specific histological subtypes are ongoing. Clinical trial information: NCT02659020

Cohort
O-Naïve
O-Pretreated
O+G+D
N = 81
Control
N = 86
HR (95% CI)/
p-value*
O+G+D
N = 46
Control
N = 43
HR (95% CI)/
p-value*
Endpoint

95% CI
95% CI

95% CI

95% CI

OS, median m
16.8
15.3, 25.4
18.0
13.2, 22.9
0.95 (0.64, 1.40)/0.78
19.8
14.2, -
17.3
10.8, 20.3
0.67 (0.39, 1.16)/0.15
PFS, median m
7.6
5.1, 8.5
4.4
2.9, 6.9
0.69 (0.48, 1.01)/0.06
5.5
2.8, 8.7
4.2
2.2, 6.9
0.83 (0.49, 1.40)/0.48
ORR, %
32.1
22.2, 43.4
23.3
14.8, 33.6
0.19
30.4
17.7, 45.8
14
5.3, 27.9
0.06

CI = confidence interval; N = total number of pts *Log-rank p-value (2-sided).

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Abstract Details

Meeting

2021 ASCO Annual Meeting

Session Type

Poster Discussion Session

Session Title

Sarcoma

Track

Sarcoma

Sub Track

Soft Tissue Tumors

Clinical Trial Registration Number

NCT02659020

Citation

J Clin Oncol 39, 2021 (suppl 15; abstr 11517)

DOI

10.1200/JCO.2021.39.15_suppl.11517

Abstract #

11517

Abstract Disclosures