Abemaciclib in patients (pts) with esophageal cancer (EC) with CDKN2A loss or mutation (mut): Results from the Targeted Agent and Profiling Utilization Registry (TAPUR) study.

Authors

null

Tareq Al Baghdadi

Michigan Cancer Research Consortium, IHA Hematology Oncology, Ypsilanti, MI

Tareq Al Baghdadi , Michael Rothe , Pam K. Mangat , Elizabeth Garrett-Mayer , Kathleen J Yost , Vi Kien Chiu , Herbert Leon Duvivier , Meredith McKean , Jens Rueter , Mark A. Taylor , Gina N. Grantham , Abby Gregory , Dominique C. Hinshaw , Richard L. Schilsky , Susan Halabi

Organizations

Michigan Cancer Research Consortium, IHA Hematology Oncology, Ypsilanti, MI, American Society of Clinical Oncology, Alexandria, VA, Cancer Research Consortium of West Michigan, Grand Rapids, MI, The Angeles Clinic and Research Institute, A Cedars-Sinai Affiliate, Los Angeles, CA, City of Hope Atlanta, Newnan, GA, Sarah Cannon Research Institute, Tennessee Oncology, Nashville, TN, The Jackson Laboratory, Brewer, ME, Lewis Cancer & Research Pavilion, Savannah, GA, Duke University Medical Center, Durham, NC

Research Funding

Eli Lilly and Company
AstraZeneca, Bayer, Boehringer Ingelheim, Bristol Myers Squibb, Genentech, Merck, Pfizer, Seagen, Taiho Oncology

Background: TAPUR is a phase II basket study evaluating antitumor activity of commercially available targeted agents in pts with advanced cancers with specific genomic alterations. Results in a cohort of pts with EC with CDKN2A loss or mut treated with abemaciclib are reported. Methods: Eligible pts had measurable disease, ECOG performance status (PS) 0-2, adequate organ function, and no standard treatment (tx) options. Genomic testing was performed in CLIA-certified, CAP-accredited site selected labs. Pts received 200 mg (four 50 mg tablets) of abemaciclib twice daily for a total daily dose of 400 mg until disease progression. Primary endpoint was disease control (DC) per investigator defined as complete or partial (PR) response per RECIST v. 1.1, or stable disease of at least 16 weeks (wks) duration (SD16+). Simon 2-stage design tested the null DC rate of 15% vs. 35% (power = 0.85; α = 0.10). If ≥2 of 10 pts in stage 1 have DC, 18 more pts are enrolled; otherwise, the cohort is closed. If ≥7 of 28 pts have DC, the null DC rate is rejected. Secondary endpoints were objective response (OR), progression-free survival (PFS), overall survival (OS), duration of response (DOR) and safety. DOR is defined as time from pt’s first documented OR to progressive disease. Results: 10 pts with EC (8 adenocarcinoma, 2 squamous) and CDKN2A loss (n=5) or CDKN2A mut (n=5) were enrolled from Dec 2019 to June 2022. 6 pts had HER2 negative EC, 1 pt had HER2 low EC, 1 pt had HER2 positive EC, and 2 pts were not tested for HER2. All pts were evaluable for efficacy and toxicity. Table summarizes pt demographics and outcomes. 1 pt with CDKN2A loss had a 27-wk PR for a DC rate of 10% (1-sided 90% CI, 1% to 100%) and OR rate of 10% (95% CI, <1% to 45%). The null DC rate was not rejected (p=0.80). Median PFS was 8 wks (95% CI, 2 to 13) and median OS was 17 wks (95% CI, 9 to 35). The pt with PR had HER2 negative adenocarcinoma, ECOG PS of 1 and 2 prior lines of therapy. 4 pts had 12 serious adverse events at least possibly related to tx, including anemia, atrial fibrillation, increased creatinine, dehydration, dyspnea, generalized muscle weakness, heart failure, lung infection, pericardial effusion and thrombocytopenia. 4 pts had a drug-related grade 3 AEs including anemia, increased bilirubin and thrombocytopenia. Conclusions: Abemaciclib monotherapy did not demonstrate sufficient clinical activity in pts with advanced EC with CDKN2A loss or mut for continued evaluation in this pt population. Other tx should be considered for these pts, including tx offered in clinical trials. Clinical trial information: NCT02693535.

Demographics, baseline characteristics and efficacy outcomes (N=10).

Median age, years (range)68 (58-82)
ECOG PS, %03 (30)
17 (70)
Prior systemic regimens, %24 (40)
≥36 (60)
DC rate, % (OR or SD16+) (1-sided 90% CI)10 (1, 100)
OR rate, % (95% CI)10 (<1, 45)
Median PFS, wks (95% CI)8 (2, 13)
Median OS, wks (95% CI)17 (9, 35)

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

2024 ASCO Gastrointestinal Cancers Symposium

Session Type

Poster Session

Session Title

Poster Session A: Cancers of the Esophagus and Stomach and Other Gastrointestinal Cancers

Track

Esophageal and Gastric Cancer,Other GI Cancer

Sub Track

Therapeutics

Clinical Trial Registration Number

NCT02693535

Citation

J Clin Oncol 42, 2024 (suppl 3; abstr 308)

DOI

10.1200/JCO.2024.42.3_suppl.308

Abstract #

308

Poster Bd #

E8

Abstract Disclosures