A phase 1/2 study of the TORC1/2 inhibitor onatasertib combined with toripalimab in patients with advanced solid tumors: Cervical cancer cohort.

Authors

Li Yuan

Li Yuan

Chongqing University Cancer Hospital, Chongqing, China

Li Yuan , Pei Shu , Xiaoyu Li , Guiling Li , Keqiang Zhang , Lin Lai , Jinsheng Hong , Chu-Ying Huang , Yongsheng Wang , Hui Xie , Li Zheng , Qi Zhou

Organizations

Chongqing University Cancer Hospital, Chongqing, China, Clinical Trial Center, National Medical Products Administration Key Laboratory for Clinical Research and Evaluation of Innovative Drugs, West China Hospital, State Key Laboratory of Biotherapy, Sichuan University, Chengdu, China, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China, Hunan Cancer Hospital, Changsha, China, Department of Abdominal Oncology, The Central Hospital of Enshi Tujia and Miao Autonomous Prefecture, Enshi, China, Department of Radiotherapy, Cancer Center, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China, Hubei Selenium and Human Health Institute, The Central Hospital of Enshi Tujia and Miao Autonomous Prefecture, Enshi, China, West China Hospital, Sichuan University, Chengdu, China, Department of Clinical Research and Development, Antengene Corporation, Shanghai, China

Research Funding

No funding sources reported

Background: Preliminary clinical data of oral TORC1/2 inhibitor, onatasertib (ATG-008), demonstrated anti-tumor activity and acceptable tolerability when combined with toripalimab (tori), an anti-PD-1 monoclonal antibody in solid tumors, especially in cervical cancer (CC). Here, we present results from the anti-PD1 naïve CC cohort of the TORCH-2 study who had at least prior 1 line of chemotherapy with the combination of onatasertib and tori. Methods: The TORCH-2 study is a phase 1/2 open-label, dose escalation and expansion trial of Onatasertib in combination with tori in patients (pts) with advanced solid tumours (NCT04337463). Eligibility criteria included at least one measurable lesion, ECOG 0-1 and adequate organ function. Pts with prior PI3K/AKT/mTOR inhibitor therapy were excluded, regardless of PD-L1 expression. Onatasertib was administered 15mg orally once a day (QD) in combination with tori 240 mg, once every 21 days (Q3W), which is the recommended phase 2 dose for the combination based on previous data. Efficacy assessments were reported based on RECIST1.1 criteria. Results: As of Oct 20, 2023, 31 checkpoint inhibitor (CPI) naïve advanced CC pts who had at least prior 1 line of systemic chemotherapy were enrolled. Median age was 54 years. Baseline ECOG scores were 0 (11 pts) and 1 (20 pts); 29 pts had stage IV disease. There were 19 and 12 pts who had received 1 and ≥2 prior lines of systemic therapy, respectively. The median time from last prior systemic therapy was 16.7 months(m). The efficacy-evaluable population (30 CC pts) had an overall response rate (ORR; best response) of 53.3% (16/30, 3 responders unconfirmed), including 4 CR and 12 PR. The disease control rate was 86.7%. The median time to response was 1.4 months. Median progression free survival (PFS) and 24m PFS rate was 8.4 m and 31.0%, respectively. Median overall survival (OS) was not reach and 24m OS rate was 51.6%. The ORRs of PD-L1 positive, PD-L1 negative, and PD-L1 NA populations were 61.5% (8/13), 55.6% (5/9), and 37.5% (3/8), respectively. One CC pt with negative PD-L1 expression achieved CR and remains on treatment for over 3 years. Thirty pts (96.8%) had ≥ 1 TEAEs; 13 (41.9%) pts had grade ≥ 3 TRAEs. The most common grade ≥ 3 TRAEs included rash (12.9%), lymphocyte count decreased (9.7 %), and decreased platelet count (6.5%). Conclusions: Onatasertib in combination with tori is tolerable with encouraging response rate and disease stabilisation in CC pts at the RP2D combination dose, regardless of PD-L1 expression. Enrolment in the expansion cohort for CPI-treated CC is ongoing, and updated data will be presented. Clinical trial information: NCT04337463.

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Abstract Details

Meeting

2024 ASCO Annual Meeting

Session Type

Clinical Science Symposium

Session Title

Stronger Together: Novel Combinations Across the Gynecologic Cancer Spectrum

Track

Gynecologic Cancer

Sub Track

Cervical Cancer

Clinical Trial Registration Number

NCT04337463

Citation

J Clin Oncol 42, 2024 (suppl 16; abstr 5509)

DOI

10.1200/JCO.2024.42.16_suppl.5509

Abstract #

5509

Abstract Disclosures

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