Updated efficacy and safety of the ALK inhibitor AP26113 in patients (pts) with advanced malignancies, including ALK+ non-small cell lung cancer (NSCLC).
Author(s): Scott N. Gettinger, Lyudmila Bazhenova, Ravi Salgia, Corey J. Langer, Kathryn A. Gold, Rafael Rosell, Alice Tsang Shaw, Glen J. Weiss, Narayana I. Narasimhan, David J. Dorer, Victor M. Rivera, Tim Clackson, Frank G. Haluska, D. Ross Camidge; Yale University, New Haven, CT; UC San Diego Moores Cancer Center, La Jolla, CA; The University of Chicago, Chicago, IL; Abramson Cancer Center of the University of Pennsylvania, Philadelphia, PA; Department of Thoracic Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX; Catalan Institute of Oncology, Barcelona, Spain; Massachusetts General Hospital Cancer Center, Boston, MA; Cancer Treatment Centers of America, Goodyear, AZ; ARIAD Pharmaceuticals, Inc., Cambridge, MA; University of Colorado Cancer Center, Aurora, CO
Abstract Disclosures
Abstract:
Background: AP26113 is a novel orally-active tyrosine kinase inhibitor with preclinical activity against ALK and all 9 clinically-identified crizotinib-resistant mutants tested.
Methods: The Phase (Ph) 2 portion of a Ph1/2 single arm, multicenter study in pts with advanced malignancies is underway. We report updated safety for all treated pts and efficacy data for ALK+ NSCLC pts previously treated with crizotinib.
Results: As of 16 Dec 2013, 114 pts were enrolled: 65 in Ph1 (30-300 mg) and 49 in Ph2 (180 mg). Baseline characteristics: 59% female, median age 57 yr;
diagnoses: NSCLC n=106, other n=8. 66 pts remain on study; median follow-up for all pts is 3.6 mo (max= 21.4 mo, ongoing). 诊断:非小细胞肺癌n = 106,其他n = 8。66继续研究,平均随访
3.6(max = 21.4正在进行)。
The most common treatment-emergent AEs (≥20%) were nausea (38%), diarrhea (31%), fatigue (31%), cough (23%), and headache (20%), which were generally grade 1/2 in severity. 最常见治疗诱发的副作用(≥20%)恶心(38%)、腹泻(31%)、疲劳(31%)、咳嗽(23%)、头痛(20%),通常是1/2级的严重性。Early onset of pulmonary symptoms (dyspnea with hypoxia and/or findings on imaging) observed in 6/45 (13%) pts at 180mg QD. 肺部早期症状(呼吸困难和缺氧和/或发现影像)有6/45(13%)在180 mg每日一次。These symptoms, requiring immediate medical attention, were not observed at 90mg QD (n=8) or in the lead-in dose cohort (n=19; initiated at 90mg QD, escalated to 180mg QD after 1 wk). 有这些症状,需要立即就医,没有观察到90 mg QD(n = 8)或引导剂量组(n = 19;在90 mg 每日一次,一周后升级到180 mg 每日一次)。Pts continue to be enrolled with this dose escalation scheme, and an additional cohort of 90mg QD without escalation will be added. 继续参加这个剂量升级方案,和一个额外的90 mg 每日一次没有升级将被添加。Among 38 evaluable ALK+ NSCLC pts with prior crizotinib, 24 (63%) responded (23 partial response, 1 complete response). 在38个可评价的ALK+非小细胞肺癌之前接受克唑替尼 24(63%)回应(23部分反应,1完整的响应)。Duration of response was
1.6 - 14.7 mo (ongoing). 15 pts had confirmed responses; 5 await confirmation, 4 are unconfirmed. Among 42 evaluable pts with ALK+ NSCLC, median progression free survival is 47 wk. 响应时间为1.6 - 14.7周(正在进行)。15个已证实反应;5等待确认,4是未经证实的。42中可评价的ALK+非小细胞肺癌,PFS是47周。Independent radiological review conducted on 10 pts enrolled with untreated or progressing brain metastases showed 6/10 pts with response in brain, including 4 with undetectable brain metastases following AP26113; 2 pts had stable disease, 2 pts progressed; 8/10 remain on study (range 5-17 mo). 独立的放射学检查进行10个录取与未经处理的或进展大脑脑转移显示6/10响应,包括4个察觉脑转移后AP26113;2个稳定,2个进展;8/10仍在研究。 Conclusions: AP26113 has promising anti-tumor activity in pts with crizotinib-resistant ALK+ NSCLC, including pts with brain metastases. A randomized Ph2 trial evaluating 90 mg QD vs. 90mg QD escalating to 180mg QD in crizotinib-resistant ALK+ NSCLC will begin shortly. Clinical trial information: NCT01449461. 结论:AP26113有前途的抗克唑替尼耐药的ALK+非小细胞肺癌,包括脑转移。随机第二阶段试验评估90 mg QD vs 90 mg QD升级到180 mg QD对克唑替尼耐药的ALK+非小细胞肺癌将很快开始。临床试验信息:NCT01449461。
