ENVASARC: A pivotal trial of envafolimab and envafolimab in combination with ipilimumab in patients with advanced or metastatic undifferentiated pleomorphic sarcoma or myxofibrosarcoma who have progressed on prior chemotherapy.

Authors

null

Richard F. Riedel

Duke Cancer Institute, Duke University Medical Center, Durham, NC

Richard F. Riedel , Sant P. Chawla , Mihaela Druta , Robin Lewis Jones , Scott Schuetze , Joelle Lam , Dongliang Zhuang , James L. Freddo , Bonne J. Adams , Charles P. Theuer , Sandra P. D'Angelo

Organizations

Duke Cancer Institute, Duke University Medical Center, Durham, NC, Sarcoma Oncology Center, Santa Monica, CA, Department of Sarcoma, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, Royal Marsden Hospital and Institute of Cancer Research, London, United Kingdom, Department of Internal Medicine, University of Michigan, Rogel Cancer Center, Ann Arbor, MI, TRACON Pharmaceuticals, San Diego, CA, Tracon Pharmaceuticals, San Diego, CA, Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York, NY

Research Funding

Pharmaceutical/Biotech Company
TRACON Pharmaceuticals

Background: Metastatic undifferentiated pleomorphic sarcoma (UPS) and the genetically related myxofibrosarcoma (MFS) are soft tissue sarcoma (STS) subtypes with poor prognoses. While responses to first-line chemotherapy can approach 20%, efficacy remains limited in the 2nd-line setting and beyond. Pazopanib, the only FDA approved treatment in the refractory setting, has demonstrated an objective response rate (ORR) of 4%. Envafolimab is a single domain PD-L1 antibody administered by rapid subcutaneous (SQ) injection that is approved for the treatment of microsatellite instability-high (MSI-H) cancer in China. The activity of envafolimab appears to be similar to other PD-1 antibodies administered intravenously (i.v.). Envafolimab demonstrated a 32% ORR in MSI-H colorectal cancer patients with progressive disease following three approved chemotherapeutics, similar to the ORR of 28% and 33% with nivolumab and pembrolizumab in these patients, respectively. The rationale for the ENVASARC is based on envafolimab activity in STS in phase 1 trials and previously reported activity of checkpoint inhibition in UPS/MFS: single-agent pembrolizumab demonstrated a 23% ORR, while the combination of nivolumab and ipilimumab demonstrated a 29% ORR in refractory UPS/MFS. Methods: ENVASARC (NCT 04480502) is a pivotal multicenter (at 30 U.S. and U.K. centers) open-label, randomized, non-comparative, parallel cohort study of envafolimab 600 mg every 3 weeks by SQ injection (n = 80) or envafolimab 600 mg every 3 weeks by SQ injection combined with ipilimumab 1 mg/kg every 3 weeks i.v. for four doses (n = 80) in patients with locally advanced, unresectable or metastatic UPS/MFS with disease progression on one or two lines of prior therapy. The primary objective of each of parallel cohort is to demonstrate an ORR with a lower limit of the 95% confidence interval that excludes 5.0% in each cohort. If ≥ 9 responders are observed among the 80 patients enrolled in each cohort, then the lower bound of the 95% confidence interval will exclude 5.0%. Secondary endpoints include duration of response, PFS and OS. Key inclusion criteria: ≤ 2 prior lines of therapy ([neo]adjuvant therapy excluded), ECOG ≤ 1. Clinical trial information: NCT04480502.

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Abstract Details

Meeting

2023 ASCO Annual Meeting

Session Type

Poster Session

Session Title

Sarcoma

Track

Sarcoma

Sub Track

Soft Tissue Tumors

Clinical Trial Registration Number

NCT 04480502

Citation

J Clin Oncol 41, 2023 (suppl 16; abstr TPS11583)

DOI

10.1200/JCO.2023.41.16_suppl.TPS11583

Abstract #

TPS11583

Poster Bd #

515a

Abstract Disclosures