Phase 1 trial of ruxolitinib, temozolomide, and radiation in high-grade gliomas.

Authors

Manmeet Ahluwalia

Manmeet Singh Ahluwalia

Rose Ella Burkhardt Brain Tumor and Neuro-Oncology Center, Neurological Institute, Taussig Cancer Institute and Cleveland Clinic, Cleveland, OH

Manmeet Singh Ahluwalia , Yasmeen Rauf , Glen Stevens , David M. Peereboom

Organizations

Rose Ella Burkhardt Brain Tumor and Neuro-Oncology Center, Neurological Institute, Taussig Cancer Institute and Cleveland Clinic, Cleveland, OH, Cleveland Clinic, Cleveland, OH

Research Funding

Pharmaceutical/Biotech Company

Background: Ruxolitinib is a novel, selective inhibitor of JAK1 (Janus kinase 1) and JAK2 and JAK3. JAK signaling involves recruitment of signal transducers and activators of transcription (STATs) to cytokine receptors, activation, and subsequent localization of STATs to the nucleus leading to modulation of gene expression. Dysregulation of the JAK/STAT pathway has been associated with several types of cancer and increased proliferation and survival of malignant cells. Preclinical evidence supports inhibition of JAJK STAT pathway arrogated glioma growth. Methods: Ruxolitinib is a novel, selective inhibitor of JAK1 (Janus kinase 1) and JAK2 and JAK3. JAK signaling involves recruitment of signal transducers and activators of transcription (STATs) to cytokine receptors, activation, and subsequent localization of STATs to the nucleus leading to modulation of gene expression. Dysregulation of the JAK/STAT pathway has been associated with several types of cancer and increased proliferation and survival of malignant cells. Preclinical evidence supports inhibition of JAJK STAT pathway arrogated glioma growth. Results: 60 patients were treated on the study and there were no dose limiting toxicity seen on the protocol. Survival data was calculated for GBM. The OS for arm 1 was 18.17 (10.15, NA) and was not reached for arm 2. The 1 year OS was 0.62 for arm 1 and 0.93 for arm 2. Patients that received ruxolitinib + radiation x 60 Gy + daily temozolomide at 75 mg/m2 for 6 weeks over 6 weeks (Arm 2) had significantly better PFS and OS than those that received ruxolitinib + radiation x 60 Gy alone. Conclusions: Dose of 20 mg twice daily of ruxolitinib is safe with radiation and temozolomide. Preliminary survival data appears promising compared to the historical benchmarks and randomized phase 2 trial is planned. Clinical trial information: NCT03514069.

Total NNumber of DeathsMedian OS in Month (95%CI)Rate at 1 Year (95%CI)P-value
All patients3711NA ( 18.17, NA )0.75 ( 0.61, 0.91 )
ArmArm 1221018.17 ( 10.15, NA )0.62 ( 0.44, 0.87 )0.015
Arm 2151NA ( NA, NA )0.93 ( 0.82, 1 )
GenderF164NA ( 15.93, NA )0.8 ( 0.62, 1 )0.554
M217NA ( 18.17, NA )0.71 ( 0.54, 0.94 )

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Abstract Details

Meeting

2022 ASCO Annual Meeting

Session Type

Poster Session

Session Title

Central Nervous System Tumors

Track

Central Nervous System Tumors

Sub Track

Primary CNS Tumors–Glioma

Clinical Trial Registration Number

NCT03514069

Citation

J Clin Oncol 40, 2022 (suppl 16; abstr 2061)

DOI

10.1200/JCO.2022.40.16_suppl.2061

Abstract #

2061

Poster Bd #

399

Abstract Disclosures

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