Preliminary results of a phase 1 study of sea-CD40, gemcitabine, nab-paclitaxel, and pembrolizumab in patients with metastatic pancreatic ductal adenocarcinoma (PDAC).

Authors

David Bajor

David Lawrence Bajor

University Hospitals Seidman Cancer Center, Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH

David Lawrence Bajor , Martin Gutierrez , Gina M. Vaccaro , Ashiq Masood , Ursa Brown-Glaberman , Juneko E. Grilley-Olson , Hedy L. Kindler , Mark Zalupski , Elisabeth I. Heath , Sarina Anne Piha-Paul , Peigen Zhou , Hailing Lu , Sahar Ansari , Jonathan Hayman , Michael W. Schmitt , Andrew L. Coveler

Organizations

University Hospitals Seidman Cancer Center, Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH, John Theurer Cancer Center at Hackensack University Medical Center, Hackensack, NJ, Oregon Health & Science University, Portland, OR, Univ of Maryland Greenebaum Cancer Ctr, Baltimore, MD, UNM Cancer Center, Albuquerque, NM, University of North Carolina at Chapel Hill, Chapel Hill, NC, University of Chicago, Chicago, IL, University of Michigan, Ann Arbor, MI, Karmanos Cancer Institute, Department of Oncology, Wayne State University School of Medicine, Detroit, MI, The University of Texas MD Anderson Cancer Center, Houston, TX, Seagen, Inc., Bothell, WA, Seagen, Inc., Seattle, WA, Seagen Inc., Bothell, WA, University of Washington, Seattle, WA, Seattle Cancer Care Alliance/University of Washington, Seattle, WA

Research Funding

Pharmaceutical/Biotech Company

Background: SEA-CD40 is an investigational nonfucosylated IgG1 monoclonal agonistic antibody targeted to CD40, expressed on antigen-presenting cells. SEA-CD40 binds with increased affinity to FcγRIIIa resulting in enhanced effector function and CD40 agonism, allowing amplification of immune stimulation and antitumor activity. PDAC can be treated with gemcitabine + nab-paclitaxel (GnP), often with poor survival. Combining chemotherapeutic agents with SEA-CD40 could facilitate robust antigen release and amplified presentation to CD8+ T cells. In preclinical models, the combination of SEA-CD40 and chemotherapy resulted in significant antitumor activity which is further enhanced with anti-PD1 treatment. We present data from an ongoing Phase 1 study (SGNS40-001) in a PDAC cohort evaluating the combination of SEA-CD40, GnP, and pembrolizumab (pembro). Methods: Patients (pts) ≥18 years old with untreated metastatic PDAC and Eastern Cooperative Oncology Group performance scores of 0 or 1 were enrolled. GnP were administered on Days 1, 8, and 15 of each 28-day cycle with 10 or 30 μg/kg SEA-CD40 IV on Day 3. Pembro was administered every 42 days starting on Day 8. Results: As of July 9, 2021, 61 pts were treated: 40 and 21 pts at 10 and 30 μg/kg SEA-CD40, respectively. Minimum follow-up was 5 months. The most frequent treatment-emergent adverse events (TEAEs) are shown in Table. 5 (8%) pts experienced an AE leading to treatment (tx) discontinuation (3 and 2 in 10 and 30 μg/kg SEA-CD40 dose, respectively), 35 (57%) pts experienced a serious TEAE (22 and 13 pts in 10 and 30 μg/kg, respectively). Two tx-related deaths occurred: colitis attributed to pembro, and septic shock attributed to GnP. Pts had transient increases in circulating cytokines and chemokines associated with immune activation and trafficking as well as increases in markers of activation on peripheral NK cells and T cells. Conclusions: The combination of SEA-CD40 + GnP + pembro demonstrated a tolerable safety profile. Evidence of immune activation was observed, consistent with the proposed mechanism of action. Follow-up for response and survival are ongoing. Clinical trial information: NCT02376699.

Summary of most frequent TEAEs (≥50% of pts) (SEA-CD40 + GnP + pembro).


10 μg/kg

(n=40)
30 μg/kg

(n=21)
Overall

(n=61)
Preferred Term
Any grade
Grade ≥ 3
Any grade
Grade ≥ 3
Any grade
Grade ≥ 3
Fatigue
31 (78%)
7 (18%)
17 (81%)
4 (19%)
48 (79%)
11 (18%)
Nausea
26 (65%)
1 (3%)
18 (86%)
1 (5%)
44 (72%)
2 (3%)
Neutropenia
26 (65%)
23 (58%)
15 (71%)
14 (67%)
41 (67%)
37 (61%)
Infusion related reaction
23 (58%)
4 (10%)
16 (76%)
1 (5%)
39 (64%)
5 (8%)
Chills
24 (60%)
0
14 (67%)
0
38 (62%)
0
Diarrhoea
23 (58%)
5 (13%)
13 (62%)
4 (19%)
36 (59%)
9 (15%)
Pyrexia
22 (55%)
1 (3%)
13 (62%)
1 (5%)
35 (57%)
2 (3%)

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Abstract Details

Meeting

2022 ASCO Gastrointestinal Cancers Symposium

Session Type

Poster Session

Session Title

Poster Session B: Cancers of the Pancreas, Small Bowel, and Hepatobiliary Tract

Track

Pancreatic Cancer,Hepatobiliary Cancer,Neuroendocrine/Carcinoid,Small Bowel Cancer

Sub Track

Therapeutics

Clinical Trial Registration Number

NCT02376699

DOI

10.1200/JCO.2022.40.4_suppl.559

Abstract #

559

Poster Bd #

G10

Abstract Disclosures

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