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

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Van K. Morris II

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 , E. Gabriela Chiorean , Philip A. Philip

Organizations

The University of Texas MD Anderson Cancer Center, Houston, TX, Fred Hutchinson Cancer Research Center and SWOG Statistics and Data Management Center, Seattle, WA, Brown University, The Miriam Hospital, Providence, RI, University of Pennsylvania, Philadelphia, PA, City of Hope Comprehensive Cancer Center, Duarte, CA, Northwell Health, New Hyde Park, NY, Swedish Cancer Institute, Seattle, WA, University of Washington and Fred Hutchinson Cancer Research Center, Seattle, WA, Henry Ford Cancer Institute, Detroit, MI

Research Funding

National Cancer Institute/U.S. National Institutes of Health
The Hope Foundation for Cancer Research STrS award

Background: Patients with microsatellite stable (MSS), BRAFV600E metastatic colorectal cancer (mCRC) experience poor survival outcomes. Second-line treatment with the BRAF inhibitor encorafenib (E) and anti-EGFR antibody cetuximab (C) is an approved treatment combination, with 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 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 patients 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 median PFS for patients with MSS, BRAFV600E mCRC. Methods: In this prospective phase II clinical trial (N=84), patients with previously treated MSS, BRAFV600E mCRC are 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 patients receive E (300 mg PO daily) and C (500 mg/m2 IV every 14 days), and patients in the experimental arm 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 (hazard ratio 0.57). Additional patient specimens will be collected for exploratory correlative research. As of 2/2024, 50 of 84 planned participants have been enrolled. Clinical trial information: NCT05308446.

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Abstract Details

Meeting

2024 ASCO Annual Meeting

Session Type

Poster Session

Session Title

Gastrointestinal Cancer—Colorectal and Anal

Track

Gastrointestinal Cancer—Colorectal and Anal

Sub Track

Colorectal Cancer–Advanced Disease

Clinical Trial Registration Number

NCT05308446

Citation

J Clin Oncol 42, 2024 (suppl 16; abstr TPS3640)

DOI

10.1200/JCO.2024.42.16_suppl.TPS3640

Abstract #

TPS3640

Poster Bd #

298a

Abstract Disclosures