Clinical activity and safety of the RET inhibitor pralsetinib in patients with RET fusion-positive solid tumors: Update from the ARROW trial.

Authors

Vivek Subbiah

Vivek Subbiah

University of Texas MD Anderson Cancer Center, Houston, TX

Vivek Subbiah , Philippe A. Cassier , Salvatore Siena , Guzman Alonso , Luis G. Paz-Ares , Pilar Garrido , Ernest Nadal , Giuseppe Curigliano , Jacqueline Vuky , Gilberto Lopes , Gregory Peter Kalemkerian , Daniel W. Bowles , Mahesh Seetharam , Jianhua Chang , Hui Zhang , Chaoyang Ye , Jennifer Green , Alena Zalutskaya , Martin H. Schuler , Yun Fan

Organizations

University of Texas MD Anderson Cancer Center, Houston, TX, Centre Léon Bérard, Lyon, France, Università degli Studi di Milano, Niguarda Cancer Center, Grande Ospedale Metropolitano Niguarda, Milan, Italy, Vall d’Hebron Institute of Oncology and Vall d'Hebron University Hospital, Barcelona, Spain, Hospital Universitario 12 de Octubre, Madrid, Spain, IRYCIS. Hospital Universitario Ramón y Cajal, Madrid, Spain, Catalan Institute of Oncology, Hospital Duran i Reynals, Barcelona, Spain, European Institute of Oncology, IRCCS and University of Milano, Milan, Italy, Oregon Health and Science University, Portland, OR, University of Miami Health System, Miami, FL, University of Michigan, Ann Arbor, MI, University of Colorado School of Medicine, Aurora, CO, Mayo Clinic Hospital, Phoenix, AZ, Fudan University Shanghai Cancer Center, Shanghai, China, Blueprint Medicines Corporation, Cambridge, MA, West German Cancer Centre, University Hospital Essen, Essen, Germany, Zhejiang Cancer Hospital, Hangzhou, China

Research Funding

Other
Blueprint Medicines Corporation

Background: RET fusions are targetable oncogenic drivers in multiple solid tumor types. ARROW study (NCT03037385) data supported the US FDA approval of pralsetinib, a once-daily (QD) oral highly potent and selective RET inhibitor, for RET-altered metastatic non-small cell lung cancer (NSCLC) and advanced/metastatic thyroid cancer. Here we provide an update on the clinical activity of pralsetinib in patients (pts) with advanced RET fusion-positive solid tumors other than NSCLC and thyroid cancer (“other”RET fusion–positive solid tumors). Methods: The global ongoing ARROW study (84 sites in 13 countries) includes phase 1 dose-escalation (30–600 mg [QD or twice daily]) and phase 2 expansion cohorts (400 mg QD) defined by tumor type and RET alteration status. Primary objectives are overall response rate (ORR; blinded independent central review per RECIST v1.1) and safety. Results: Updated analyses were completed as of Nov 6, 2020 (data cut-off) for 21 pts with other RET fusion–positive solid tumors enrolled by May 22, 2020 (enrollment cut-off) (lung other than NSCLC, n = 4; pancreatic, n = 3; colon, n = 3; cholangiocarcinoma, n = 3; unknown primary [UP], n = 2; other, n = 6). Overall, 11 (52%) pts received ≥2 prior lines of therapy for metastatic disease. The most common RET fusion partners were CCDC6 and KIF5B (24% each), NCOA4 (19%), other (10%), and unknown (24%). Two pts with colon cancer were excluded from efficacy analyses due to other driver mutations (KRAS, PIK3CB). In 19 evaluable pts, ORR was 53% (95% CI, 2976) with 2 (11%) complete responses (CR) and 8 (42%) partial responses (PR). Responses occurred across multiple tumor types including 3/3 pts with pancreatic cancer (including a CR ongoing at 20.8 months on treatment), 2/2 pts with UP, 2/3 pts with cholangiocarcinoma, and in pts with mesenchymal, salivary duct, and lung carcinoid tumors. Median duration of response was 19.0 months (95% CI, 5.5–not estimable). Clinical benefit rate (proportion with CR, PR, or stable disease persisting ≥16 weeks) was 68% (95% CI, 43–87). Tumor shrinkage was observed in 89% of 18 evaluable pts with post-baseline tumor assessment. In all pts enrolled in ARROW who received pralsetinib 400 mg QD irrespective of tumor type (n = 471) the most common (≥25%) treatment-related adverse events (TRAEs) were increased aspartate aminotransferase (39%), anemia (35%), increased alanine aminotransferase (28%), constipation (26%), and hypertension (25%). Overall, 6% of pts discontinued treatment due to TRAEs. Conclusions: Pralsetinib showed robust, durable antitumor activity in patients with multiple RET fusion‒positive, heavily pre-treated, advanced solid tumors, and was well tolerated. These data highlight the need for broad RET testing to identify candidates who could benefit from treatment with pralsetinib. Enrollment of patients with other RET fusion–positive solid tumors in ARROW is ongoing. Clinical trial information: NCT03037385

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

Developmental Therapeutics—Molecularly Targeted Agents and Tumor Biology

Track

Developmental Therapeutics—Molecularly Targeted Agents and Tumor Biology

Sub Track

New Targets and New Technologies (non-IO)

Clinical Trial Registration Number

NCT03037385

Citation

J Clin Oncol 39, 2021 (suppl 15; abstr 3079)

DOI

10.1200/JCO.2021.39.15_suppl.3079

Abstract #

3079

Poster Bd #

Online Only

Abstract Disclosures

Similar Abstracts

First Author: Justin F. Gainor

Abstract

2020 ASCO Virtual Scientific Program

Clinical activity of the RET inhibitor pralsetinib (BLU-667) in patients with RET fusion+ solid tumors.

First Author: Vivek Subbiah

Abstract

2021 Gastrointestinal Cancers Symposium

Clinical activity of the RET inhibitor pralsetinib (BLU-667) in patients with RET fusion–positive solid tumors.

First Author: Vivek Subbiah

First Author: Alissa Jamie Cooper