Zotiraciclib (TG02) for newly diagnosed glioblastoma in the elderly or for recurrent glioblastoma: The EORTC 1608 STEAM trial.

Authors

null

Emilie Le Rhun

University Hospital Zurich, Zurich, Switzerland

Emilie Le Rhun , Thierry Gorlia , Julia Furtner , Joerg Felsberg , Joost Jongen , Claude-Alain Maurage , Francois Ducray , Patrick Roth , Peter Hau , Olivier L. Chinot , Matthias Preusser , Stephanie Cartalat , Martin J. Van Den Bent , Maike Collienne , Guido Reifenberger , Michael Weller

Organizations

University Hospital Zurich, Zurich, Switzerland, EORTC - European Organisation for Research and Treatment of Cancer, Brussel, Belgium, Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Vienna, Austria, Institute of Neuropathology, Medical Faculty, Heinrich Heine University and University Hospital Düsseldorf, Düsseldorf, Germany, Erasmus, Rotterdam, Netherlands, Univ. Lille, UFR3S - Laboratoire d'Histologie, Lille, France, CHU Lyon, Neuro-oncology, Lyon, France, University Hospital Zurich and University of Zurich, Zürich, Switzerland, Department of Neurosurgery, University Hospital Regensburg, Regensburg, Germany, CHU Timone, Marseille, France, Division of Oncology, Department of Medicine I, Medical University of Vienna, Vienna, Vienna, Austria, Hospices Civils de Lyon Cancer Institute, Lyon, France, Erasmus MC Cancer Institute, Rotterdam, Netherlands, European Organisation for Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium, Department of Neurology, University Hospital and University of Zurich, Zürich, Switzerland

Research Funding

Pharmaceutical/Biotech Company
Cothera

Background: Zotiraciclib (TG02) is an oral multi-cyclin dependent kinase (CDK) inhibitor, including CDK-9, that inhibits tumor growth down-stream via depletion of survival proteins such as MCL-1 and MYC. MCL-1 and MYC are frequently overexpressed in glioblastoma. Methods: The EORTC 1608 (NCT03224104) (STEAM) phase 1b trial had a three parallel group (A,B,C) open-label, non-randomized, multicenter design. Groups A and B explored the maximum tolerated dose (MTD) of zotiraciclib in elderly patients (more than 65 years) with IDH1R132H-non-mutant newly diagnosed glioblastoma or anaplastic astrocytoma, in combination with hypofractionated radiotherapy alone (group A) or temozolomide alone (group B), based on O6-methylguanine DNA methyltransferase promoter methylation status determined centrally. Group C explored single agent activity of zotiraciclib in IDH1R132H-non-mutant glioblastoma or anaplastic astrocytoma at first relapse after temozolomide chemoradiotherapy with a primary endpoint of progression-free survival at 6 months. Secondary objectives included efficacy, quality of life, and safety. Results: The MTD was 150 mg in combination with radiotherapy alone (group A, n=12) or temozolomide alone (group B, n=9) in elderly patients. Two dose-limiting toxicities were observed at 150 mg, one in group A (grade 3 seizure) and one in group B (multiple grade 1 events). Main toxicities included neutropenia, gastro-intestinal disorders, and hepatotoxicity. Progression-free survival at 6 months in group C (n=50) was 6.7%. Conclusions: Zotiraciclib exhibits overlapping toxicity with alkylating agents and low clinical activity as a single agent. Larger randomized trials may be required to explore activity in combination with radiotherapy or temozolomide. Clinical trial information: NCT03224104.

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Abstract Details

Meeting

2023 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

NCT03224104

Citation

J Clin Oncol 41, 2023 (suppl 16; abstr 2054)

DOI

10.1200/JCO.2023.41.16_suppl.2054

Abstract #

2054

Poster Bd #

411

Abstract Disclosures

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