Phase Ib study of dabrafenib, trametinib, irinotecan and cetuximab in BRAF V600E-mutated metastatic colorectal cancer.

Authors

null

Yungchang Chen

Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China;

Yungchang Chen , Xiaoqian Li , Man Yuxin , Hai Hu , Liyang Wang , Zhixuan Zhang , Ping Chen , Yang Liu , Jin Lu , Tongyu Lin

Organizations

Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China; , Department of Medical Oncology, Shandong Cancer Hospital, Shandong Academy of Medical Sciences, Jinan 250117, China., Jinan, China; , Department of Pathology, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science & Technology of China, Sichuan, Chengdu, China;

Research Funding

No funding received
None.

Background: The low efficacy of single-agent BRAF inhibitor in metastatic colorectal cancer (mCRC) is usually due to EGFR feedback upregulation caused by BRAF blockade. Therefore, multi-drug combination therapy with BRAF inhibitor has been tried. Here, we reported the preliminary results of quadruple therapy with dabrafenib, a selective BRAF inhibitor, trametinib, a selective MEK inhibitor, irinotecan and cetuximab in patients with BRAF V600E-mutated mCRC. Methods: This was an ongoing phase Ib study, patients with mCRC who relapse or refractory to standard treatments were enrolled. Patients were treated with dabrafenib (150mg/150mg doses orally twice daily), trametinib (2mg orally once daily), irinotecan (80mg/m2 weekly) and cetuximab (400mg/m2 in first dose and 250mg/m2 weekly). Treatment was continued until disease progression, development of unacceptable toxicity, or drawal of consent. The primary end-point was disease control rate (DCR), and the secondary end-points included progression-free survival (PFS) and duration of disease remission (DOR). This trial is registered with Chinese ClinicalTrials.gov, number ChiCTR2200063316. Results: From July 2018 to January 2021, 10 patients were enrolled. The median age was 53.5 (age 25-65), nine with colon cancer and one with rectal cancer. The most common adverse events (AEs) (50% or more) were fatigue, fever, rash, vomit, leukopenia, anemia, ALT elevation, and AST elevation. Four patients suffered rash which was the most common severe AE (SAE). Two patients presented with grade 3/4 anemia. Only one patient suffered grade 3/4 AEs with nausea and vomit. The DCR was 90% (9/10). After a median follow-up of 19.7 months, the median PFS was 7.5 months (range 1.8-32.4 months). The median DOR was 5.2 months (range 0-27.7 months). Conclusions: Dabrafenib, trametinib, irinotecan and cetuximab has tolerable toxicity and promising antitumor activity in BRAF V600E-mutated mCRC. This regimen warrants a further phase II clinical trial. Clinical trial information: ChiCTR2200063316.

Adverse events.

AE, nAll GradeGrade3/4
Fatigue5 (50)1 (10)
Oral mucositis00
Fever5 (50)1 (10)
Rash8 (80)4 (40)
Loss of appetite4 (40)0
Insomnia00
Nausea4 (40)1 (10)
Vomit5 (50)1 (10)
Diarrhea4 (40)1 (10)
Constipation3 (30)0
Pneumonia00
Leukopenia5 (50)0
Anemia6 (60)2 (20)
Thrombocytopenia3 (30)0
Neutropenia2 (20)0
Hypoalbuminemia4 (40)0
ALT elevation5 (50)0
AST elevation5 (50)0
Lipase elevation2 (20)0
Hypercholesteremia3 (30)0
Hypertriglyceridemia3 (30)0

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Abstract Details

Meeting

2023 ASCO Gastrointestinal Cancers Symposium

Session Type

Poster Session

Session Title

Poster Session C: Cancers of the Colon, Rectum, and Anus

Track

Colorectal Cancer,Anal Cancer

Sub Track

Therapeutics

Clinical Trial Registration Number

ChiCTR2200063316

Citation

J Clin Oncol 41, 2023 (suppl 4; abstr 156)

DOI

10.1200/JCO.2023.41.4_suppl.156

Abstract #

156

Poster Bd #

H15

Abstract Disclosures