Phase II basket trial evaluating the efficacy of pembrolizumab (PE) combined with vorinostat (VO) in patients (pts) with recurrent and/or metastatic squamous cell carcinoma (SCC).

Authors

null

Christophe Le Tourneau

Curie Institute, Paris, France

Christophe Le Tourneau , Frédéric Bigot , Damien Vansteene , Maud Kamal , François Ghiringhelli , Luca Mazzarella , Christian Borel , Raphael Chaltiel , Benoit You , Carlos A. Gomez-Roca , Sophie Cousin , Elodie Coquan , Aurélien Lambert , Esma Saada-Bouzid , Xavier Durando , François Legrand , Amellie Lusque , Fabrice Andre , Thomas Filleron

Organizations

Curie Institute, Paris, France, Institut de Cancerologie de l'Ouest, Angers, France, ICO Institut de Cancerologie de l'Ouest, Saint-Herblain, France, Drug Development and Innovation Department, Institut Curie, Paris, France, Center Georges-Francois Leclerc, Dijon, France, IEO, European Institute of Oncology IRCCS, Milano, Italy, Centre Paul Strauss, Strasbourg, France, Institut Godinot, Reims, France, Lyon Sud Hospital, Pierre-Bénite, France, Institut Claudius Regaud, IUCT-Oncopole, Toulouse, France, Medical Oncology Department, Institut Bergonié, Bordeaux, France, Centre François Baclesse, Caen, France, Institut De Cancerologie De Lorraine, Vandoeuvre Les Nancy, France, Centre de Lutte Contre le Cancer Antoine Lacassagne, Nice, France, Centre de Lutte contre le Cancer, Clermont-Ferrand, France, Unicancer, Paris, France, IUCT Oncopole - Institut Universitaire du Cancer de Toulouse, Toulouse, France, Gustave Roussy, Villejuif, France, Institut Universitaire du Cancer Oncopole - Institut Claudius Regaud, Toulouse, France

Research Funding

Institutional Funding
Fondation ARC, MSD, ERAPERMED;Agence National pour la recherche

Background: Epigenetic modulation plays a major role in escaping tumor immunosurveillance and confers resistance to immune checkpoint inhibitors. Preclinical evidence suggests that modulating the epigenome might improve the efficacy of immunotherapy. Patients and Methods: PEVOsq is an open-label, non-randomized, multi-center, basket phase II trial, evaluating the efficacy of pembrolizumab in combination with vorinostat in patients with recurrent and/or metastatic squamous cell carcinoma of the cervix, head and neck, anus, vulva/vagina, penis, and lung. Patients had to be PD1/PD-L1 antagonist-naïve. There was no selection based on PD-L1 expression nor on HPV status, and no restriction in terms of prior lines of treatments. Pembrolizumab dose was 200 mg Q3W IV, and vorinostat 400 mg QD PO. Sample size was determined for each cohort using an A’Hern design. Primary endpoint was objective response rate (ORR) according to RECISTv1.1. Secondary endpoints included safety, progression-free survival (PFS), overall survival (OS), and duration of response (DOR). Results: Among 112 included patients, 111 were evaluable for safety and 107 for efficacy. The lung cohort was closed prematurely because of lack of enrollment. Median age was 61 years old [range: 18-85] and the median number of prior lines of therapies was 1 [range: 0-4]. ORR, PFS, G3/4 treatment related adverse events (TRAE), and OS are reported. 28 patients (26%) had an objective response and median DOR was 9.7 months [95%CI: 3.1-15.2]. Results per PD-L1 status will be presented at the meeting. Pembrolizumab and vorinostat were stopped for toxicity in 9% and 39% of patients, respectively. 60% of patients had a dose-reduced of vorinostat for toxicity. Pembrolizumab safety was as expected. Main vorinostat toxicities included hematological toxicity, gastrointestinal disorders, and asthenia and creatinine increase. Conclusions: Pembrolizumab combined with vorinostat showed encouraging antitumor activity in squamous cell carcinoma with unselected PD1/PD-L1 status, especially in cervical and anal cancer, although vorinostat dose had to be reduced because of toxicity in a substantial proportion of patients. Clinical trial information: NCT04357873.

Efficacy and safety summary per cohorts.

Primary endpointSecondary endpoints
CohortORR
N (%)
PFS (month)
Median [95%CI]
OS (month)
Median [95%CI]
G3/4 TRAEs
N (%)
Cervix9/23 (39)4.2 [2.3-8.2]10.3 [5.7-NR]11/25 (44)
Anus9/29 (31)5.8 [2.7-11.0]18.8 [12.8-NR]18/29 (62)
Head and Neck5/26 (19)4.1 [1.5-4.4]9.2 [6.8-14.4]10/27 (37)
Vulva/Vagina3/16 (19)1.3 [1.1-4.3]17.5 [2.3-NR]4/17 (24)
Penis2/11 (18)2.4 [0.5-4.1]4.4 [1.6-11.0]5/11 (45)
Lung0/2 (0)NANA1/2 (50)
Overall28/107 (26)4.0 [2.6-4.3]11.1 [9.2-17.4]49/111 (44)

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Abstract Details

Meeting

2023 ASCO Annual Meeting

Session Type

Poster Session

Session Title

Developmental Therapeutics—Immunotherapy

Track

Developmental Therapeutics—Immunotherapy

Sub Track

PD1/PD-L1 Inhibitor Combinations

Clinical Trial Registration Number

NCT04357873

Citation

J Clin Oncol 41, 2023 (suppl 16; abstr 2597)

DOI

10.1200/JCO.2023.41.16_suppl.2597

Abstract #

2597

Poster Bd #

439

Abstract Disclosures