SWOG S2107: Randomized phase II trial of encorafenib and cetuximab with or without nivolumab for patients with previously treated, microsatellite stable, BRAFV600E metastatic and/or unresectable colorectal cancer.

Authors

null

Van K. Morris II

Department of Gastrointestinal Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX

Van K. Morris II, Katherine A. Guthrie , Scott Kopetz , Rimini Breakstone , Thomas Benjamin Karasic , Zishuo Ian Hu , Sarah Colby , Marwan Fakih , Sepideh Gholami , Philip Jordan Gold , Philip A. Philip

Organizations

Department of Gastrointestinal Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, Fred Hutchinson Cancer Research Center and SWOG Statistics and Data Management Center, Seattle, WA, The University of Texas MD Anderson Cancer Center, Houston, TX, Brown University, The Miriam Hospital, Providence, RI, University of Pennsylvania, Philadelphia, PA, City of Hope, Duarte, CA, Northwell Health, New Hyde Park, NY, Swedish Cancer Institute, Seattle, WA, Wayne State University School of Medicine, Detroit, MI

Research Funding

NCI
The Hope Foundation for Cancer Research STrS award

Background: Patients with microsatellite stable (MSS), BRAFV600E metastatic colorectal cancer (mCRC) experience poor survival outcomes. Treatment with the BRAF inhibitor encorafenib (E) and anti-EGFR antibody cetuximab (C) is an approved treatment combination, with a reported overall response rate (ORR) of 20% and median progression-free survival (PFS) of 4.1 months. Anti-PD-1 antibodies like nivolumab (N) are ineffective as monotherapy for patients with MSS, BRAFV600E mCRC. In preclinical models of MSS, BRAFV600E CRC, inhibition of BRAF and EGFR induces a loss of expression of mismatch repairs genes and promotes a microsatellite instability-high phenotype, which may prime these tumors for response to immunotherapy. In support of these findings, a single-institution clinical trial of E + C + N for 26 participants with MSS, BRAFV600E mCRC reported an ORR of 50% and median PFS of 7.2 months. We hypothesize that the addition of N to E + C will improve PFS for participants with MSS, BRAFV600E mCRC. Methods: In this prospective phase II clinical trial (N=75), participants with previously treated MSS, BRAFV600E mCRC will be randomized 2:1 into 2 arms, respectively: experimental treatment (E + C + N) or standard treatment (E + C). No prior BRAF, EGFR, or immunotherapy agents are allowed. All participants will receive E (300 mg PO daily) and C (500 mg/m2 IV every 14 days), and participants in the experimental arm will receive N (480 mg IV every 28 days). The primary endpoint is PFS. Secondary endpoints include overall survival, best overall response, duration of response, and safety/tolerability. Using a one-sided α= .10 and power 80%, we target an improvement in median PFS from 4.2 to 7.3 months and a hazard ratio of 0.57. Additional participants specimens will be collected for exploratory correlative research. As of 9/2023, 37 of 75 planned participants have been enrolled. Clinical trial information: NCT05308446.

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Abstract Details

Meeting

2024 ASCO Gastrointestinal Cancers Symposium

Session Type

Trials in Progress Poster Session

Session Title

Trials in Progress Poster Session C: Cancers of the Colon, Rectum, and Anus

Track

Colorectal Cancer,Anal Cancer

Sub Track

Therapeutics

Clinical Trial Registration Number

NCT05308446

Citation

J Clin Oncol 42, 2024 (suppl 3; abstr TPS234)

DOI

10.1200/JCO.2024.42.3_suppl.TPS234

Abstract #

TPS234

Poster Bd #

P2

Abstract Disclosures