Phase II study of brigatinib in ROS1 positive non-small cell lung cancer (NSCLC) patients previously treated with crizotinib: Barossa cohort 2.

Authors

null

Haruko Daga

Department of Medical Oncology, Osaka City General Hospital, Osaka, Japan

Haruko Daga , Seiji Niho , Jun Sakakibara-Konishi , Hiroshi Tanaka , Yasushi Goto , Kadoaki Ohashi , Ryo Toyozawa , Masahiro Kodani , Toshiaki Takahashi , Yoshihiro Hattori , Masahiro Morise , Takaya Ikeda , Shingo Matsumoto , Kiyotaka Yoh , Shogo Nomura , Koichi Goto

Organizations

Department of Medical Oncology, Osaka City General Hospital, Osaka, Japan, National Cancer Center Hospital East, Kashiwa, Japan, Hokkaido University Hospital, Sapporo, Japan, Department of Respiratory Medicine, Niigata Cancer Center Hospital, Niigata, Japan, National Cancer Center Hospital, Tokyo, Japan, Okayama University Hospital, Okayama, Japan, Department of Thoracic Oncology, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan, Faculty of Medicine, Tottori University, Tottori, Japan, Division of Thoracic Oncology, Shizuoka Cancer Center, Shizuoka, Japan, Hyogo Cancer Center, Akashi, Japan, Department of Respiratory Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan, Department of Thoracic Oncology, National Cancer Center Hospital East, Kashiwa-Shi, Chiba, Japan, The University of Tokyo, Tokyo, Japan

Research Funding

Other Government Agency
AMED

Background: Brigatinib is a next-generation tyrosine kinase inhibitor targeting ALK and ROS1. Crizotinib is the first drug approved for the treatment of ROS1 fusion-positive NSCLC. Standard treatment for crizotinib-resistant ROS1 positive NSCLC is not established. Barossa is a multicenter, phase II basket, study of brigatinib in patients with ROS1 positive solid tumors. This study is composed of three cohorts. ROS1 inhibitor-naïve ROS1 positive NSCLC patients were enrolled in the cohort 1, and ROS1 positive NSCLC patients previously treated with crizotinib were enrolled in the cohort 2. Patients with ROS 1 positive solid tumors other than NSCLC were enrolled in the cohort 3. This time we report the cohort 2 results. Methods: Patients with advanced, previously treated with crizotinib, ROS1 positive NSCLC received brigatinib at a dose of 180 mg once daily with a 7-day lead-in period at 90 mg. The primary end point was objective response rate (ORR; RECIST 1.1) by independent review. Key secondary endpoint was PFS, OS, and safety. The sample size was set at 19 patients, with a one-sided alpha of 0.05, beta of 0.2, and threshold and expected values for primary endpoint of 20% and 50%, respectively. Results: From July 2019 and Jan 2020, 19 patients were enrolled from 9 institutions. Baseline characteristics as follows: median age (range): 60 (31-75) years; women, n = 10 (53%); ECOG PS of 0 to 1, n = 18 (95%); never smoker, n = 11 (58%); tumor histopathological type: adenocarcinoma, n = 18 (95%). Five and 6 patients achieved PR and SD, respectively at data cutoff date of 30 Oct 2020. The ORR was 26.3% (90%CI, 11.0-47.6), and the disease control rate was 57.9% (95%CI, 33.5-79.7). The median duration of follow-up for PFS was 12.0 months. The median PFS was 7.3 months (95% CI, 1.3-9.3), and the 1-year PFS rate was 26.9% (95%CI, 9.2-48.6). Grade ≥3 TRAEs were CPK increased (21.1%), infection (5.3%), AST and/or ALT increased (5.3%), hypercalcemia (5.3%), anorexia (5.3%), hypoxia (5.3%), erythema (5.3%), hypertension (5.3%). Pneumonitis was observed in one patient (5.3%, Grade 2). No treatment-related death was observed. Conclusions: Brigatinib has modest activity for ROS1 positive NSCLC patients previously treated with crizotinib. The safety profile of brigatinib was consistent with previous studies. Enrollment of the cohort 1 for ROS1 inhibitor-naïve NSCLC patients is ongoing, and the data will be presented at a future congress. Clinical trial information: JapicCTI-194851.

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Abstract Details

Meeting

2021 ASCO Annual Meeting

Session Type

Poster Session

Session Title

Lung Cancer—Non-Small Cell Metastatic

Track

Lung Cancer

Sub Track

Metastatic Non–Small Cell Lung Cancer

Clinical Trial Registration Number

JapicCTI-194851

Citation

J Clin Oncol 39, 2021 (suppl 15; abstr 9040)

DOI

10.1200/JCO.2021.39.15_suppl.9040

Abstract #

9040

Poster Bd #

Online Only

Abstract Disclosures

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