Efficacy and safety of dostarlimab in patients (pts) with mismatch repair deficient (dMMR) solid tumors: Analysis of 2 cohorts in the GARNET study.

Authors

Thierry Andre

Thierry Andre

Sorbonne University, Saint-Antoine Hospital, AP-HP, Paris, France

Thierry Andre , Dominique Berton , Giuseppe Curigliano , Begona Jimenez-Rodriguez , Susan Ellard , Adriano Gravina , Rowan Miller , Anna Tinker , Andrea Jewell , Joanna Pikiel , Ana Oaknin , Tao Duan , Sybil Zildjian , Eleftherios Zografos , Jennifer Taylor Veneris , Susana N. Banerjee

Organizations

Sorbonne University, Saint-Antoine Hospital, AP-HP, Paris, France, GINECO & Institut de Cancerologie de l'Ouest, Centre René Gauducheau, Saint-Herblain, France, European Institute of Oncology IRCCS, University of Milan, Milan, Italy, Unidad De Gestión Clínica Intercentros De Oncología Médica, Hospitales Universitarios Regional y Virgen De La Victoria, 29010 Malaga, Spain, Málaga, Spain, BC Cancer-Kelowna, Vancouver, BC, Canada, S.C. Sperimentazioni Cliniche Istituto Nazionale Tumori di Napoli IRCCS - Fondazione, Naples, Italy, BC Cancer-Vancouver, Vancouver, BC, Canada, British Columbia Cancer Agency, Vancouver, BC, Canada, University of Kansas Medical Hospital/The Women’s Cancer Center, Overland Park, KS, Regional Center of Oncology, Gdansk, Poland, Vall d'Hebron Institute of Oncology, Hospital Universitari Vall d’Hebron, and Vall d’Hebron Barcelona Hospital Campus, Barcelona, Spain, GlaxoSmithKline, Pennington, NJ, GlaxoSmithKline, Cambridge, MA, GlaxoSmithKline, London, United Kingdom, Dana Farber Cancer Institute, Boston, MA, The Royal Marsden NHS Foundation Trust and Institute of Cancer Research, National Cancer Research Institute (NCRI), London, United Kingdom

Research Funding

Pharmaceutical/Biotech Company

Background: Dostarlimab is a programmed death 1 (PD-1) inhibitor approved in the US as a monotherapy in pts with dMMR solid tumors that have progressed on or after prior treatment, with no satisfactory alternative treatment options; or dMMR advanced/recurrent (AR) endometrial cancer (EC) that has progressed on or after treatment with a platinum-based chemo; and in the EU as a monotherapy in pts with dMMR/microsatellite instability?high (MSI-H) AR EC that has progressed on or after treatment with a platinum-based chemo. Here we report on efficacy and safety in 2 expansion cohorts that enrolled pts with dMMR solid tumors. Methods: GARNET is a multicenter, open-label, single-arm phase 1 study. Cohort A1 enrolled pts with dMMR/MSI-H AR EC; cohort F enrolled pts with dMMR/MSI-H/POLε-mut non-EC solid tumors. Pts received 500 mg of IV dostarlimab Q3W for 4 cycles, then 1000 mg Q6W until PD, discontinuation, or withdrawal. Primary endpoints were ORR and DOR by BICR per RECIST v1.1. Biomarker status was based on local assessment. Results: For this third interim analysis, 153 pts with dMMR/MSI-H EC and 210 pts with dMMR/MSI-H/POLε-mut non-EC solid tumors (56% colorectal cancer, 11% gastric) were enrolled and treated. Efficacy analysis was performed for 143 dMMR/MSI-H EC and 204 dMMR/MSI-H/POLε-mut non-EC pts who had measurable disease at baseline and ≥6 mo of follow-up. ORRs were 45.5% (dMMR/MSI-H EC) and 43.1% (dMMR/POLε-mut non-EC solid tumors; Table). Probability of PFS at 6, 9, and 12 mo was 49.5%, 48.0%, and 46.4% in dMMR/MSI-H EC and 51.8%, 48.1%, and 46.4% in dMMR/MSI-H/POLε-mut non-EC. Median (m) DOR and mOS were not reached for either cohort. A total of 13 pts (8.5%) with dMMR/MSI-H EC and 12 pts (5.7%) with dMMR/MSI-H/POLε-mut non-EC solid tumors discontinued owing to a treatment-related adverse event (TRAE). TRAEs occurring in ≥12% of pts were diarrhea, asthenia, fatigue, nausea, and pruritis (dMMR/MSI-H EC) and diarrhea, asthenia, and pruritus (dMMR/MSI-H/POLε-mut non-EC solid tumors). 2 deaths (1 hepatic ischemia, 1 suicide) were attributed by investigators to dostarlimab in pts with non-EC solid tumors. Conclusions: Dostarlimab demonstrated durable antitumor activity across 16 tumor types in pts with dMMR solid tumors, confirming efficacy in a larger sample size with extended follow-up. The safety profile was acceptable, with manageable toxicities. Clinical trial information: NCT02715284.


dMMR/MSI-H EC
N = 143
dMMR/MSI-H/POLε-mut non-EC
N = 204
Median follow-up time, mo
27.6
27.7
ORR, n (%, 95% CI)
65 (45.5; 37.1?54.0)
88 (43.1; 36.2?50.2)
Response ongoing, n (%)
54 (83.1)
77 (87.5)
mDOR (range), mo
NR (1.18+ to 47.21+)
NR (2.76 to 41.49+)
mPFS (95% CI), mo
6.0 (4.1?18.0)
7.1 (3.6?19.5)
Estimated probability of PFS, % (95% CI)
6 mo
9 mo
12 mo

49.5 (41.0?57.5)
48.0 (39.4?56.0)
46.4 (37.8?54.5)

51.8 (44.6?58.5)
48.1 (40.9?54.8)
46.4 (39.3?53.2)
mOS (95% CI), mo
NR (25.7?NR)
NR (21.7?NR)

NR, not reached.

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Abstract Details

Meeting

2022 ASCO Annual Meeting

Session Type

Poster Session

Session Title

Developmental Therapeutics—Immunotherapy

Track

Developmental Therapeutics—Immunotherapy

Sub Track

PD1/PD-L1 Inhibitor Monotherapy

Clinical Trial Registration Number

NCT02715284

Citation

J Clin Oncol 40, 2022 (suppl 16; abstr 2587)

DOI

10.1200/JCO.2022.40.16_suppl.2587

Abstract #

2587

Poster Bd #

242

Abstract Disclosures