CYCLONE 1: A phase 2 study of abemaciclib in patients with metastatic castration-resistant prostate cancer (mCRPC) previously treated with a novel hormonal agent and taxane-based chemotherapy.

Authors

Neeraj Agarwal

Neeraj Agarwal

Huntsman Cancer Institute, University of Utah, Salt Lake City, UT

Neeraj Agarwal , Stephane Oudard , Josep M. Piulats , Michael Thomas Schweizer , Aude Flechon , Teresa Alonso Gordoa , Karim Nacerddine , Andrew Lithio , Erica L. Johnston , Matthew Raymond Smith

Organizations

Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, Georges-Pompidou European Hospital HEGP, Paris, France, Instituto Català de Oncologia, Hospital Duran i Reynals, L’Hospitalet de Llobregat, Hospitalet De Llobregat, Spain, University of Washington/Fred Hutchinson Cancer Research Center, Seattle, WA, Department of Medical Oncology, Centre Léon Bérard, Lyon, France, Hospital Universitario Ramón y Cajal, Madrid, Spain, Eli Lilly and Company, Neuilly-Sur-Seine, France, Eli Lilly and Company, Indianapolis, IN, Massachusetts General Hospital Cancer Center, Boston, MA

Research Funding

Pharmaceutical/Biotech Company
Eli Lilly and Company Ltd

Background: In cancer cells, the cyclin-dependent kinases 4 and 6 (CDK4 & 6)/retinoblastoma protein (Rb) pathway is commonly altered, resulting in uncontrolled cell cycle entry and proliferation. CDK4 & 6 inhibitors represent a major advance in the management of hormone receptor-positive (HR+), human epidermal growth factor receptor 2-negative (HER2-) advanced or metastatic breast cancer (ABC or MBC, respectively). Abemaciclib is an oral selective inhibitor of CDK4 & 6 administered on a continuous dosing schedule, approved in combination with endocrine therapy for HR+, HER2- ABC or MBC. In addition, abemaciclib is also approved by the FDA as monotherapy for HR+, HER2- ABC or MBC following endocrine therapy and prior chemotherapy in the metastatic setting. Similar to the estrogen receptor signaling pathway in breast cancer cells, there is evidence that the androgen receptor axis activates CDK4 & 6 to sustain prostate cancer cell proliferation and survival. Preclinical studies in prostate cancer cell lines and xenograft models showed that abemaciclib exhibits single agent activity by inducing cell cycle arrest and tumor growth inhibition. Clinical activity of abemaciclib in combination with abiraterone and prednisone is investigated in a randomized phase 2 study in the first-line mCRPC setting (CYCLONE 2, NCT03706365). Despite recent advances, management of heavily pretreated mCRPC remains a major clinical challenge. Herein, we hypothesize that mCRPC patients whose disease progressed after novel hormonal agents (NHA) and taxane therapies may derive therapeutic benefit from single agent abemaciclib. Methods: CYCLONE 1 is a phase 2, single-arm, multicenter study to assess the safety and efficacy of abemaciclib monotherapy in 40 patients with mCRPC progressing after ≥1 NHA and 2 taxane regimens. Patients will be enrolled at time of prostate specific antigen (PSA) or radiographic progression per PCWG3 criteria and have at least 1 measurable lesion per RECIST 1.1. Metastatic tumor tissue (fresh biopsy or archival material <12 weeks) is required at baseline for biomarker analysis. Patients will receive abemaciclib 200 mg twice daily until unacceptable adverse events or disease progression. The primary objective is investigator-assessed objective response rate (ORR). Key secondary objectives include safety, radiographic progression-free survival, overall survival, PSA response rate, time to PSA progression, time to symptomatic progression, Ki-67 expression, patient-reported outcomes, and pharmacokinetics. Assuming an ORR of 15%, the study has over 73% power to observe a response rate of at least 12.5%. Accrual began in January 2021. Clinical trial information: NCT04408924.

Disclaimer

This material on this page is ©2024 American Society of Clinical Oncology, all rights reserved. Licensing available upon request. For more information, please contact licensing@asco.org

Abstract Details

Meeting

2021 ASCO Annual Meeting

Session Type

Poster Session

Session Title

Genitourinary Cancer—Prostate, Testicular, and Penile

Track

Genitourinary Cancer—Prostate, Testicular, and Penile

Sub Track

Prostate Cancer– Advanced/Castrate-Resistant

Clinical Trial Registration Number

NCT04408924.

Citation

J Clin Oncol 39, 2021 (suppl 15; abstr TPS5086)

DOI

10.1200/JCO.2021.39.15_suppl.TPS5086

Abstract #

TPS5086

Poster Bd #

Online Only

Abstract Disclosures