Primary results from JUPITER, a phase 2 basket trial of combination therapy with trastuzumab and pertuzumab in patients with HER2-amplified solid tumors.

Authors

null

Sadakatsu Ikeda

Tokyo Medical and Dental University, Tokyo, Japan

Sadakatsu Ikeda , Ryo Kudo , Yamato Yamashita , Toshio Kubo , Yukiko Mori , Yohei Harada , Hidekazu Shirota , Hideyuki Hayashi , Masayuki Kano , Yasushi Shimizu , Eri Ishibashi , Ukihide Tateishi , Akihiro Hirakawa , Hirotoshi Akita , Hisahiro Matsubara , Hiroshi Nishihara , Chikashi Ishioka , Naoko Sueoka-Aragane , Manabu Muto , Shinichi Toyooka

Organizations

Tokyo Medical and Dental University, Tokyo, Japan, Tokyo Medical and Dental University, Bunkyo-Ku, Japan, Department of Respiratory Medicine, Okayama University Hospital, Okayama, Japan, Department of Therapeutic Oncology, Graduate School of Medicine, Kyoto University, Kyoto, Japan, Saga University, Saga, Japan, Tohoku University, Sendai, Japan, Keio University, Tokyo, Japan, Chiba University, Chiba, Japan, Department of Medical Oncology, Hokkaido University Graduate School of Medicine, Sapporo, Japan, Department of Clinical Biostatistics, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan, Deparment of Medical Oncology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan, Genomics Unit, Keio Cancer Center, Keio University School of Medicine, Tokyo, Japan, Department of Medical Oncology, Tohoku University Hospital, Sendai, Japan, Department of Clinical Oncology, Kyoto University Hospital, Kyoto, Japan, Okayama University, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Department of General Thoracic Surgery, Breast and Endocrinological Surgery, Okayama, Japan

Research Funding

Other Government Agency

Background: Human epidermal growth factor receptor 2 (HER2) gene amplification or mutations have emerged as oncogenic drivers and therapeutic targets not limited to breast and gastric cancers, but also in a variety of cancers. Despite its considerable therapeutic potential, the evidence has not been established. To address this unmet need, we conducted an organ-agnostic basket trial targeting HER2-amplified solid tumors. Methods: JUPITER is a multicenter, single-arm, phase 2 basket trial for solid tumor patients (pts) with HER2 amplification determined by next-generation sequencing (NGS). Both tissue and liquid NGS results were allowed. HER2 amplification by ISH or HER2 overexpression by IHC were not used for inclusion. Pts had treatment-refractory metastatic tumors, or rare cancers without established standard of care. Breast, gastric, and colorectal cancers were excluded. Pts were treated with intravenous trastuzumab (8 mg/kg loading dose followed by 6 mg/kg) and pertuzumab (840 mg loading dose followed by 420 mg) every 3 weeks until disease progression or any other reason for discontinuation. Tumor response was assessed using RECIST v1.1. Primary endpoint was ORR by blinded independent central review (BICR), and secondary endpoints were ORR assessed by the investigators, progression-free survival (PFS), overall survival (OS), duration of response (DOR), and safety. We set the ORR threshold 5% and expected ORR was 20%. Estimated sample size was 38 patients with one-sided alpha 2.5% and power 80%. Results: Between April 2019 and June 2020, 42 pts were consented, and 40 pts were treated. Median age was 62 (range, 21-86) and 60% were females. The most common diagnosis was biliary tract cancer (20%), followed by salivary ductal carcinoma (12.5%) and endometrial cancer (12.5%). At data cutoff (1 Sep 2021), ORR by BICR was 22.5% (95%CI: 10.8%-38.5%). ORR assessed by the investigator was 25% (95%CI: 12.7%-41.2%). PFS, OS and DOR were not reached at data cutoff; 3 responders remained on treatment. Of 40 pts, 32.5% had grade ≥ 3 adverse events; 10% were treatment-related, including neutropenia, hypertension, peripheral sensory neuropathy and lymphoedema (all grade 3). No treatment-related death was observed. Exploratory biomarker analysis of response and resistance is in progress. Conclusions: Combination therapy with trastuzumab and pertuzumab was well tolerated and showed promising efficacy for the patients with HER2-amplified solid tumors determined by NGS. Clinical trial information: jRCT2031180150.

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Abstract Details

Meeting

2022 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

Tissue-Based Biomarkers

Clinical Trial Registration Number

jRCT2031180150

Citation

J Clin Oncol 40, 2022 (suppl 16; abstr 3131)

DOI

10.1200/JCO.2022.40.16_suppl.3131

Abstract #

3131

Poster Bd #

123

Abstract Disclosures