A randomized phase II study comparing single-agent olaparib, single-agent cediranib, and the combinations of cediranib/olaparib, olaparib/durvalumab (MEDI4736), cediranib/durvalumab (MEDI4736), and olaparib/AZD5363 (capivasertib) in women with recurrent, persistent, or metastatic endometrial cancer.

Authors

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B.J. Rimel

Cedars-Sinai Medical Center, Los Angeles, CA

B.J. Rimel , David Bender , Danielle Enserro , Shannon Neville Westin , Debra L. Richardson , Laura L. Holman , Nitya Alluri , Ashley Stuckey , Ruchi Garg , Sarah Gill , Edward Tanner , Charles A. Leath III, Floor Jenniskens Backes , Aimee Fleury , Helen Mackay

Organizations

Cedars-Sinai Medical Center, Los Angeles, CA, University of Iowa Hospitals and Clinics, Iowa City, IA, NRG Oncology, Buffalo, NY, University of Texas MD Anderson Cancer Center, Houston, TX, Stephenson Cancer Center/University of Oklahoma Health Sciences Center and Sarah Cannon Research Institute, Oklahoma City, OK, University of Oklahoma Health Sciences Center, Oklahoma City, OK, Pacific Cancer Research Consortium NCORP/St. Luke's Cancer Institute, Boise, ID, Women and Infants Hospital of Rhode Island, Providence, RI, City of Hope, Atlanta, GA, Nancy N and J C Lewis Cancer and Research Pavilion, Savannah, GA, Northwestern University Feinberg School of Medicine, Chicago, IL, University of Alabama at Birmingham, Birmingham, AL, Division of Gynecologic Oncology, Ohio State University Wexner Medical Center and James Cancer Hospital, Columbus, OH, Womens Cancer Centre of Nevada, Las Vegas, NV, Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, ON, Canada

Research Funding

U.S. National Institutes of Health
U.S. National Institutes of Health

Background: Identifying new approaches for the treatment of advanced endometrial cancer (EC) is a priority. A platform study design allows for a faster investigation of novel drug combinations. NRG-GY012 is an ongoing platform study investigating drug combinations with the PARP inhibitor olaparib (O) and the anti-angiogenic agent cediranib (C). Results from the first set of arms established improved PFS for combination cediranib/olaparib over C alone, but did not meet its prespecified statistical significance. In this second set of arms, based on preclinical data, we are investigating the combination of O with an AKT inhibitor (capivasertib), O with durvalumab and C with durvalumab compared to the reference arm of C alone. Methods: This is a multicenter randomized four arm study for patients with recurrent, metastatic or persistent EC. Patients are randomized 1:1:1:1 to cediranib PO 30 mg Daily; olaparib 300 mg PO BID and capivasertib 400mg 4 day on/3 off schedule; olaparib 300 mg PO BID and durvalumab 1500mg q28 days; or the combination of cediranib 20 mg PO Daily 5 days on/2 days and durvalumab 1500mg q28. All treatment cycles are 28 days. Primary endpoint is progression free survival (PFS). The study is powered to detect a doubling in median PFS from 3.6 (based on cediranib alone) to 7.2 months with 90% power, using a one-sided test with α = 0.05 per comparison. Forty patients will be enrolled per arm, with an interim futility analysis planned at 50% information time. Eligibility includes endometroid, serous, and mixed histology EC; at least 1 prior line of chemotherapy (no more than 2 lines for metastatic disease), prior endocrine or immunotherapy alone is allowed; prior treatment with lenvatinib and pembrolizumab is excluded. Archival tumor tissue and blood samples are being collected for translational studies. The study is open across the NRG network; 76 of a planned 168 patients are enrolled to date. Safety analysis at the time of 36 patients enrolled did not demonstrate any new safety signals and the study was approved to continue enrollment. Clinical trial information: NCT03660826.

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Abstract Details

Meeting

2023 ASCO Annual Meeting

Session Type

Poster Session

Session Title

Gynecologic Cancer

Track

Gynecologic Cancer

Sub Track

Uterine Cancer

Clinical Trial Registration Number

NCT03660826

Citation

J Clin Oncol 41, 2023 (suppl 16; abstr TPS5629)

DOI

10.1200/JCO.2023.41.16_suppl.TPS5629

Abstract #

TPS5629

Poster Bd #

315b

Abstract Disclosures