Subgroup analysis in patients (pts) with non-squamous (N-Sq), EGFR-wild type (wt), second/third-line NSCLC from the global phase (Ph) 3 trial DUBLIN-3 (BPI-2358-103) with the plinabulin/docetaxel (Plin/Doc) combination versus Doc alone.

Authors

Baohui Han

Baohui Han

Department of Pulmonary Medicine, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China

Baohui Han , Trevor Feinstein , Yuankai Shi , Michael Chen , Lan Huang , Ramon W. Mohanlal , Yan Sun

Organizations

Department of Pulmonary Medicine, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China, Piedmont Cancer Institute, Fayetteville, GA, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing Key Laboratory of Clinical Study on Anticancer Molecular Targeted Drugs, Beijing, China, TCM Groups, Inc., Berkeley Heights, NJ, BeyondSpring Pharmaceuticals, Inc., New York, NY, BeyondSpring Pharmaceuticals, New York, NY, Department of Medical Oncology, Beijing Key Laboratory of Clinical Study on Anticancer Molecular Targeted Drugs, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China

Research Funding

Pharmaceutical/Biotech Company

Background: With PD-1/PD-L1 inhibitors moving to first line in NSCLC, 2nd/3rd line NSCLC is a severe unmet medical need, dominated by docetaxel-based therapies with > 40% severe neutropenia and limited survival. Plin, a novel immune-enhancing small molecule, enhances dendritic cell maturation and T-Cell proliferation. In the ITT population, the Plin/Doc combination had superior Efficacy (mOS; HR = 0.82, p = 0.0399), Safety (lower Gr3/4 AE rate/pt/year (yr); p = 0.038) and better Quality of Life (QTWiST; p = 0.026) versus (vs) standard of care (SoC) Doc alone in advanced and metastatic NSCLC pts in DUBLIN-3 (Han, ESMO 2021) who failed platinum therapy. Here we report on the N-Sq pts subgroup. Methods: DUBLIN-3(NCT02504489) was a randomized, single-blind (pts only), active controlled Ph3 study in 2nd/3rd line stage IIIB/IV, EGFR wt NSCLC pts with a measurable lesion (RECIST 1.1) in the lung, and ECOG ≤ 2, conducted in US, Australia and China. Pts (n = 559) were randomized 1:1 to Plin/Doc or Doc/Placebo (21-day (D) cycle (C)). Doc (75 mg/m2 on D1 and Plin 30 mg/m2 on D1 and D8 were given by IV infusion. A post-hoc analysis of median Overall Survival (mOS) and restricted mean survival time (RMST) from K-M curves, OS rate at 24,36 and 48 month (Mo), and grade 4 neutropenia (Gr4N) rates was performed for the N-Sq patients (n = 153 for Plin/doc and n = 178 for Doc). Results: Baseline characteristics were balanced between both groups. Primary and key secondary objectives in the ITT population were met (Han, ESMO 2021). Plin/Doc was well tolerated. Estimated Adverse Event Rate per Year [95% CI] was 1.43 [1.13,1.81] for Plin/Doc versus 2.77 [2.33,3.28] for Doc alone (p < 0.001). The median OS benefit is 2.6 months (p = 0.023). The table below summarizes the results for the N-Sq subgroup. Conclusions: The addition of Plin to Doc was superior to SoC Doc alone for efficacy and safety in the clinically relevant subgroup of non-squamous EGFR-wild type, 2nd/3rd line NSCLC pts. Clinical trial information: NCT02504489.

N-Sq subset
mOS Mo [95% CI]
RMST Mo [SE]
24 Mo OS-Rate (%)
36 Mo OS-Rate (%)
48 Mo OS-Rate (%)
Gr4N Rate (%)
Plin/Doc

(n = 153)
11.4

[9.37;12.4]
16.1

[1.188]
24.9%
14.2%
11.85%
13.9
Doc

(n = 178)
8.8

[8.05;10.9]
12.8

[0.845]
14.1%
4.68%
0%
37.9
HR
0.75
NA
NA
NA
NA

P value
0.023
0.025
0.025
0.03
NA
< 0.001

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Abstract Details

Meeting

2022 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

NCT02504489

Citation

J Clin Oncol 40, 2022 (suppl 16; abstr 9090)

DOI

10.1200/JCO.2022.40.16_suppl.9090

Abstract #

9090

Poster Bd #

77

Abstract Disclosures