Emory University, Atlanta, GA
Suresh S. Ramalingam , Caicun Zhou , Tae Min Kim , Sang-We Kim , James Chih-Hsin Yang , Gregory J. Riely , Tarek Mekhail , Danny Nguyen , Maria Rosario García Campelo , Enriqueta Felip , Sylvie Vincent , Shu Jin , Veronica Bunn , Jianchang Lin , Huamao Mark Lin , Minal Mehta , Pasi A. Janne
Background: No approved targeted therapies are available for EGFR ex20ins+ mNSCLC. Mobocertinib, a first-in-class, potent, oral TKI targeting EGFR ex20ins mutations, has Breakthrough Therapy Designation in the US and China for post-platinum-based chemotherapy pts with EGFR ex20ins+ mNSCLC. Methods: This 3-part, open-label, multicenter study (NCT02716116) has dose-escalation/expansion and extension (EXCLAIM) cohorts. Pts with EGFR ex20ins+ mNSCLC, ECOG status 0–1, and ≥1 prior line of therapy for locally advanced/metastatic disease received mobocertinib 160 mg QD. Primary endpoint was confirmed objective response rate (ORR; RECIST v1.1) assessed by independent review committee (IRC). We present additional efficacy and safety data for 114 platinum-pretreated pts (PPP) and 96 pts from EXCLAIM safety cohort. Results: Results are from Nov 1, 2020, data cutoff. Among PPP pts (n=114; median age 60 y [27–84 y]), 66% were female, 60% were Asian, and 59% had ≥2 prior systemic anticancer lines. Confirmed ORR per IRC was 28%, including 1 complete response (CR); disease control rate (DCR) was 78% [95% CI: 69–85]; median duration of response (DOR) was 17.5 mo (Table). In EXCLAIM (n=96; median age 59 y [27–80 y]), 65% were female, 69% were Asian, and 49% had ≥2 prior lines. Confirmed ORR per IRC was 25%, with 1 CR; DCR was 76% [95% CI: 66–84]; median DOR was not reached (Table). In EXCLAIM, baseline brain metastases were present in 33/96 pts (34%); the first site of disease progression by IRC was the brain in 40% of all pts and 73% of pts with baseline brain metastases. Confirmed responses were seen in all prespecified subgroups in PPP and EXCLAIM. Efficacy by EGFR ex20ins mutation variant will be presented. Treatment-related adverse events (TRAEs; >20%) in PPP were diarrhea (91%), rash (45%), paronychia (38%), decreased appetite (35%), nausea (34%), dry skin (31%), vomiting (30%), increased blood creatinine (25%), stomatitis (24%), and pruritus (21%); the only grade ≥3 TRAE in ≥5% was diarrhea (22%). AEs leading to discontinuation in >2% were diarrhea (4%) and nausea (4%). A similar safety profile was observed in EXCLAIM. Conclusions: Mobocertinib demonstrated clinically meaningful benefit for pts with EGFR ex20ins+ mNSCLC in PPP and EXCLAIM cohorts, with a manageable safety profile.Clinical trial information: NCT02716116
PPP(n=114) | EXCLAIM(n=96) | |
---|---|---|
Median follow-up, mo | 14.2 | 13.0 |
Confirmed ORR, n (%) [95% CI] Per IRC | 32 (28) [20–37] | 24 (25) [17–35] |
Per investigator | 40 (35) [26–45] | 31 (32) [23–43] |
Median DOR, mo [95% CI] Per IRC | 17.5 [7.4–20.3] | NE [5.6–NE] |
Per investigator | 11.2 [5.6–NE] | 11.2 [7.0–NE] |
Median progression-free survival, mo [95% CI] Per IRC* | 7.3 [5.5–9.2] | 7.3 [5.5–9.1] |
Median OS, mo [95% CI] | 24.0 [14.6, 28.8] | NE [13.1, NE] |
6 mo OS rate, % | 87% | 87% |
12 mo OS rate, % | 70% | 69% |
*Investigator-assessed median PFS was similar in both cohorts.
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Abstract Disclosures
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