A phase II basket trial of dual anti–CTLA-4 and anti–PD-1 blockade in rare tumors (DART) SWOG S1609: The vulvar cancers.

Authors

Young Kwang Chae

Young Kwang Chae

Northwestern University, Chicago, IL

Young Kwang Chae , Megan Othus , Sandip Pravin Patel , Robert P. Edwards , Jennifer Michelle Scalici , Liam Il-Young Chung , Christine McLeod , Helen X. Chen , Elad Sharon , Howard Streicher , Christopher W. Ryan , Charles David Blanke , Razelle Kurzrock

Organizations

Northwestern University, Chicago, IL, Fred Hutchinson Cancer Center, Seattle, WA, UC San Diego Moores Cancer Center, La Jolla, CA, UPMC Magee-Womens Hospital, Pittsburgh, PA, University of South Alabama Mitchell Cancer Institute, Mobile, AL, Northwestern University Feinberg School of Medicine, Chicago, IL, SWOG Data Operations Center, Seattle, WA, National Cancer Institute, Bethesda, MD, National Cancer Institute/National Institutes of Health, Bethesda, MD, OHSU Knight Cancer Institute, Portland, OR, Division of Hematology and Medical Oncology, Oregon Health and Science University, and SWOG Group Chair’s Office, Portland, OR, Medical College of Wisconsin and WIN Consortium, Milwaukee, WI

Research Funding

U.S. National Institutes of Health
U.S. National Institutes of Health, Bristol-Myers Squibb

Background: Dual checkpoint inhibition with Anti-PD-1 and anti-CTLA4 checkpoint inhibitors have proven to be effective in several malignancies but their potential role in various rare solid cancers is yet to be established. The efficacy of immunotherapy in vulvar cancer patients has not been explored. This study presents the first results of ipilimumab and nivolumab in vulvar cancers (cohort 35) of the SWOG S1609 Dual Anti-CTLA-4 & Anti-PD-1 blockade in Rare Tumors (DART) trial. Methods: DART is a prospective, open-label, multicenter/multi-cohort phase 2 clinical trial of ipilimumab (1mg/kg intravenously every 6 weeks) plus nivolumab (240mg intravenously every 2 weeks). The primary endpoint was objective response rate (ORR) (RECIST v1.1) (confirmed complete (CR) and partial responses (PR)); progression-free survival (PFS), overall survival (OS), stable disease (SD) > 6 months, and toxicity are secondary endpoints. Results: Sixteen evaluable patients (median age, 55.5 years) were analyzed. 14 cases were of squamous cell carcinoma histology and 2 were of poorly differentiated carcinoma. ORR was 18.8% (3/16, 25% when including one unconfirmed PR). There was 1 CR (SCC; PFS of 465 days) and 2 PR (both SCC; one with 57% regression with PFS of 1022 days, another with 53% regression with PFS of 501 days). Of note, there was one SCC patient with unconfirmed PR that showed 69% regression with PFS of 209 days. Overall clinical benefit rate (CBR; no progression > 6months) was 31.3% (5/16). The median PFS was 2.2 months, 6-month PFS 33%, 1-year PFS 20%. The median OS was 7.6 months, 6-month OS 62%, 1-year OS 44%. The most common adverse events were diarrhea, fatigue, pruritus, anorexia, and nausea (25%, n = 4 each). Grade 3-4 adverse events occurred in 25% of patients (n = 4). There was 1 grade 3-4 adverse event (6.7%) that led to discontinuation, and 1 (6.7%) grade 5 death adverse event. Conclusions: Ipilimumab plus nivolumab in vulvar cancers resulted in an ORR of 18.8% and CBR of 31.3%, with durable responses seen. Correlative studies to determine response and resistance markers are ongoing. Expanded prospective studies exploring the role of immunotherapy in vulvar cancers are warranted. Clinical trial information: NCT02834013.

Disclaimer

This material on this page is ©2024 American Society of Clinical Oncology, all rights reserved. Licensing available upon request. For more information, please contact licensing@asco.org

Abstract Details

Meeting

2023 ASCO Annual Meeting

Session Type

Poster Discussion Session

Session Title

Gynecologic Cancer

Track

Gynecologic Cancer

Sub Track

Other Gynecologic Cancer

Clinical Trial Registration Number

NCT02834013

Citation

J Clin Oncol 41, 2023 (suppl 16; abstr 5517)

DOI

10.1200/JCO.2023.41.16_suppl.5517

Abstract #

5517

Poster Bd #

211

Abstract Disclosures