Zanidatamab (zani), a HER2-targeted bispecific antibody, in combination with docetaxel as first-line therapy (1L) for patients (pts) with advanced HER2-positive breast cancer (BC): Updated results from a phase Ib/II study.

Authors

Xiaojia Wang, III

Xiaojia Wang

Department of Oncology, Zhejiang Cancer Hospital, Hangzhou, China

Xiaojia Wang , Keun Seok Lee , Xiaohua Zeng , Tao Sun , Young-Hyuck Im , Huiping Li , Kun Wang , Huiyan Li , Ping Zhou , Yuanyuan Bao , Zefei Jiang

Organizations

Department of Oncology, Zhejiang Cancer Hospital, Hangzhou, China, Department of Oncology, National Cancer Center, Goyang-Si, South Korea, Department of Breast Oncology, Chongqing University Cancer Hospital, Chongqing, China, Department of Breast Oncology, Liaoning Cancer Hospital, Liaoning, China, Department of Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea, Department of Breast Oncology, Beijing Cancer Hospital, Beijing, China, Department of Breast Cancer, Cancer Center, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, Guangdong, China, Clinical Development, BeiGene (Shanghai) Co., Ltd., Shanghai, China, The Fifth Medical Center of Chinese PLA General Hospital, Beijing, China

Research Funding

Pharmaceutical/Biotech Company
BeiGene, Ltd., This study was sponsored by BeiGene, Ltd. Medical writing support for the development of this abstract, under the direction of the authors, was provided by Emily Finn, MSc, of Ashfield MedComms, an Inizio company, and was funded by BeiGene, Ltd.

Background: Despite HER2-targeted agents improving outcomes in HER2-positive (+) BC, some pts develop resistance, relapse, or do not respond to current 1L therapies. Zani, also known as ZW25, is a novel HER2-targeted bispecific antibody that binds to two distinct extracellular domains of HER2. Preliminary results from this Phase Ib/II trial (NCT04276493) showed that zani plus docetaxel had a manageable safety profile and demonstrated promising antitumor activity in pts with advanced HER2+ BC; here we present the updated data following enrollment completion. Methods: Cohort 1 of this open-label study is evaluating zani in combination with docetaxel as a 1L therapy in adult females with advanced HER2+ BC who may have received prior neoadjuvant/adjuvant therapy. Cohort 1a pts received zani 30 mg/kg intravenously (IV), Cohort 1b pts received zani 1800 mg IV, both with docetaxel 75 mg/m2 IV every 3 weeks. The primary endpoints were safety and investigator (INV)-assessed objective response rate (ORR) per RECIST v1.1. Secondary endpoints included INV-assessed duration of response (DoR) and disease control rate (DCR). Results: As of Nov 22, 2022, 37 pts(median age 55.0 years [range: 33-80]) were assigned to Cohort 1a (n=10) or 1b (n=27). Median study follow-up was 15.5 months (range: 1.1-29.3); patients received a median of 13 treatment cycles (range 1-37) and 18 (48.6%) pts remained on treatment. Of the 33-efficacy evaluable (EE) pts, confirmed ORR was 90.9% (95% confidence interval [CI]: 75.7, 98.1). Efficacy data are summarized in the table. In total, 36 (97.3%) pts experienced ≥1 treatment-related adverse event (TRAE); 25 (67.6%) pts experienced ≥grade 3 TRAEs. The most common ≥grade 3 TRAEs were decreased neutrophil count, experienced by 18 (48.6%) pts, and decreased white blood cell count, experienced by 7 (18.9%) pts. Serious TRAEs occurred in 6 (16.2%) pts; no TRAEs led to death. Conclusions: Zani combined with docetaxel demonstrated promising antitumor activity as 1L therapy for advanced HER2+ BC, with a manageable safety profile. Clinical trial information: NCT04276493.

Prediction overview of IRSN-23.

Cohort 1a
(n=8)
Cohort 1b
(n=25)
Total
(n=33)
Confirmed best overall response, n (%)
Complete response1 (12.5)1 (4.0)2 (6.1)
Partial response7 (87.5)21 (84.0)28 (84.8)
Stable disease0 (0.0)2 (8.0)2 (6.1)
Progressive disease0 (0.0)1 (4.0)1 (3.0)
Confirmed ORR, n (%)
95% CI
8 (100)
63.1, 100
22 (88.0)
68.8, 97.5
30 (90.9)
75.7, 98.1
Confirmed DCR, n (%)
95% CI
8 (100)
63.1, 100
24 (96.0)
79.6, 99.9
32 (97.0)
84.2, 99.9
Median DoR, months
(95% CI)
12.4
5.5, NE
NE
12.1, NE
NE
12.1, NE
Confirmed DoR, range3.5-23.54.3-16.53.5-23.5

*Four pts without any postbaseline tumor assessments were excluded from the EE analysis set.

Data cut off: November 22, 2022.

Censored.

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Abstract Details

Meeting

2023 ASCO Breakthrough

Session Type

Rapid Oral Abstract Session

Session Title

Rapid Abstract Session A: Trials and Experimental Therapeutics

Track

Breast Cancer,Central Nervous System Tumors,Developmental Therapeutics,Genitourinary Cancer,Gynecologic Cancer,Head and Neck Cancer,Gastrointestinal Cancer,Hematologic Malignancies,Quality of Care,Genetics/Genomics/Multiomics,Healthcare Equity and Access to Care,Healthtech Innovations,Models of Care and Care Delivery,Population Health,Thoracic Cancers,Viral-Mediated Malignancies,Other Malignancies or Topics

Sub Track

Targeted Therapies

Clinical Trial Registration Number

NCT04276493

Citation

JCO Global Oncology 9, 2023 (suppl 1; abstr 1)

DOI

10.1200/GO.2023.9.Supplement_1.1

Abstract #

1

Abstract Disclosures