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Abstract OT1-02-01: Phase I trial of bicalutamide and ribociclib in androgen receptor-positive triple negative breast cancer 摘要:比卡鲁胺联合核糖环尼治疗雄激素受体阳性三阴性乳腺癌的I期临床试验
Pub Date : 2019-02-15 DOI: 10.1158/1538-7445.SABCS18-OT1-02-01
M. Sharifi, K. Wisinski, M. Burkard, Amye J. Tevaarwerk, D. Tamkus, N. Chan, C. Truica, Oc Danciu, K. Hoskins, R. O'Regan
Background: To date, the use of anti-androgens in the subset of triple negative breast cancers (TNBC) that express androgen receptor (AR) has shown modest response rates, indicating anti-androgen-resistance in the majority of these tumors. Based on data that Cyclin D kinase (CDK) inhibitors reverse resistance to anti-androgens in prostate cancer cell lines, we hypothesize that the use of CDK inhibition may enhance the activity of anti-androgens in AR-positive TNBC. Methods: Key eligibility include: patients with centrally confirmed AR-positive TNBC, defined as AR expression >0%; 0 to 1 line of prior therapy for metastatic disease; and measurable disease. Patients are treated with bicalutamide 150mg orally once daily plus ribociclib at one of 3 dose levels (see table). Results: AR expression was positive by trial criteria in 74% of screened patients. Three patients have been accrued at each dose level. Median age is 56 and 6 and 3 patients were treated in first and second-line settings, respectively. Median AR expression was 50% (range 5 to 75%). Toxicity data is available for 6-patients treated on dose levels 1 and 2. No dose-limiting toxicities were noted. As anticipated with ribociclib, the most common toxicity is neutropenia (1 patient grade 4 and 2 patients grade 3). Two patients experienced grade 3 hypertension and 1 experienced grade 3 lymphopenia. Grade 2 or lower toxicities included fatigue, nausea, hyperglycemia and mucositis. One patient experienced grade 1 QT interval prolongation. Conclusion: The combination of bicalutamide and ribociclib is tolerable without unexpected toxicities. Data on the 3-patients treated at dose level 3 and dose expansion will be included. Phase 2 dosing schedule will be decided based on phase 1 results. Citation Format: Sharifi M, Wisinski KB, Burkard ME, Tevaarwerk AJ, Tamkus D, Chan N, Truica C, Danciu O, Hoskins K, O9Regan RM. Phase I trial of bicalutamide and ribociclib in androgen receptor-positive triple negative breast cancer [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr OT1-02-01.
背景:迄今为止,在表达雄激素受体(AR)的三阴性乳腺癌(TNBC)亚群中使用抗雄激素已显示出适度的反应率,表明大多数这些肿瘤具有抗雄激素耐药性。基于细胞周期蛋白D激酶(CDK)抑制剂逆转前列腺癌细胞对抗雄激素的耐药性的数据,我们假设使用CDK抑制剂可能增强ar阳性TNBC中抗雄激素的活性。方法:关键入选条件包括:中央确诊的AR阳性TNBC患者,定义为AR表达>0%;转移性疾病的既往治疗0 - 1线;以及可测量的疾病。患者接受比卡鲁胺150mg口服,每日一次,加核糖环尼3种剂量水平之一的治疗(见表)。结果:根据试验标准,74%的筛查患者AR表达阳性。每个剂量水平累积了3例患者。中位年龄为56岁,分别有6名和3名患者在一线和二线接受治疗。中位AR表达率为50%(范围5 - 75%)。有6名接受剂量水平1和2治疗的患者的毒性数据。未发现剂量限制性毒性。正如预期的那样,最常见的毒性是中性粒细胞减少(1例4级,2例3级)。2例患者出现3级高血压,1例出现3级淋巴细胞减少。2级或更低的毒性包括疲劳、恶心、高血糖和粘膜炎。1例患者出现1级QT间期延长。结论:比卡鲁胺与核波西尼合用可耐受,无不良反应。3名接受剂量水平3和剂量扩大治疗的患者的数据将包括在内。第二阶段的给药时间表将根据第一阶段的结果决定。引文格式:Sharifi M, Wisinski KB, Burkard ME, Tevaarwerk AJ, Tamkus D, Chan N, Truica C, Danciu O, Hoskins K, O9Regan RM。比卡鲁胺联合核糖环尼治疗雄激素受体阳性三阴性乳腺癌的I期临床试验[摘要]。2018年圣安东尼奥乳腺癌研讨会论文集;2018年12月4-8日;费城(PA): AACR;中国癌症杂志,2019;79(4增刊):1-02-01。
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引用次数: 6
Abstract OT2-02-01: A confirmation study of omitting axillary dissection in patients with breast cancer and positive sentinel nodes 摘要OT2-02-01:乳腺癌前哨淋巴结阳性患者省略腋窝清扫的确证研究
Pub Date : 2019-02-15 DOI: 10.1158/1538-7445.SABCS18-OT2-02-01
N. Jibiki, A. Hirano, T. Ochi, Akiko Sakamoto, Kiyomi Horiuchi, Eiichiro Noguchi, Yoko Omi, K. Ogura, H. Inoue, T. Kamio, Y. Naritaka, M. Fujibayashi, K. Hiroshima, Y. Nagashima, S. Sakai, K. Karasawa, T. Okamoto
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引用次数: 0
Abstract OT2-07-07: Image-guided de-escalation of neoadjuvant chemotherapy in HER2-positive breast cancer: The TRAIN-3 study 摘要:图像引导下her2阳性乳腺癌新辅助化疗的降级:TRAIN-3研究
Pub Date : 2019-02-15 DOI: 10.1158/1538-7445.SABCS18-OT2-07-07
A. V. D. Voort, V. Dezentjé, WA van der Steeg, Gonneke A. O. Winter-Warnars, R. Schipper, A. Scholten, J. Wesseling, E. Werkhoven, F. Duijnhoven, M. Peeters, G. Sonke
Background The addition of pertuzumab to trastuzumab containing chemotherapy has boosted pathologic complete response (pCR) rates after neoadjuvant chemotherapy for HER2-positive breast cancer. PCR rates over 80% have been described and achieving a pCR is associated with a favorable long-term outcome. In addition, achieving a radiologic complete response (rCR) is predictive of the pathologic response in HER2-positive tumors. Therefore it is hypothesized that image-guided evaluation based on the early occurrence of rCR can be used to tailor the number of chemotherapy cycles. Trial design This is a single arm, multicenter study evaluating the efficacy of image-guided de-escalation of neoadjuvant treatment with paclitaxel, Herceptin®, carboplatin, and pertuzumab (PTC-ptz). Radiologic evaluation with contrast-enhanced breast MRI and ultrasound of the axilla (in cN+ patients) is performed at baseline and after 3, 6, and 9 cycles of treatment. In case of rCR of the breast (and axilla) after 3 or 6 cycles, early surgery will be performed. If residual tumor is present after 3 and 6 cycles, patients will continue the PTC-ptz regimen to complete a total of 9 cycles. All patients will receive adjuvant Herceptin® and pertuzumab to complete 1 year of anti-HER2 blockade and endocrine treatment according to local guidelines if HR-positive. The study will be performed in the Netherlands in approximately 35 centers. Eligibility criteria Eligible patients have histologically proven stage II/III HER2-positive primary breast cancer with known hormone-receptor status. Patients must have a measurable breast tumor on baseline MRI and can be either node negative or node positive. Specific aims The aim is to evaluate the efficacy of image-guided de-escalation of neoadjuvant chemotherapy in HER2-positive breast cancer on event-free survival (EFS) at 3 years as primary endpoint. Secondary endpoints are overall survival, rCR, concordance between rCR and pCR (ypT0/is, ypN0), differences in EFS and OS following pCR between patients who received 3, 6, or 9 cycles, and toxicity. Statistical methods This is a single-arm, two stage study with one interim-analysis and a final analysis. Statistics will be performed for each hormone receptor subgroup separately. Stopping rules are based on 3-year EFS-rates described in literature (88% for HR-negative tumors and 90% for HR-positive tumors) and calculated using the exact conditional Poisson distribution. The study is successful with ≤34 EFS-events in the HR-negative subgroup and ≤38 events in the HR-positive subgroup after 700 patient-years of follow-up. The three-year EFS-estimate will be calculated using Kaplan-Meier statistics. Present accrual and target accrual Target accrual is 231 patients for the HR-negative group and 231 patients for the HR-positive group. Present accrual will follow. Funding Investigator initiated trial sponsored by the Dutch Breast Cancer Research Group (BOOG), funded by Roche. Contact information for people
背景:在曲妥珠单抗化疗的基础上加入帕妥珠单抗,提高了her2阳性乳腺癌新辅助化疗后的病理完全缓解(pCR)率。PCR率超过80%已被描述,实现PCR与有利的长期结果相关。此外,达到放射学完全缓解(rCR)可以预测her2阳性肿瘤的病理反应。因此,假设基于早期rCR发生的图像引导评估可用于定制化疗周期数。试验设计:这是一项单组、多中心研究,评估图像引导下紫杉醇、赫赛汀、卡铂和帕妥珠单抗(PTC-ptz)新辅助治疗降级的疗效。在基线和治疗3,6和9个周期后,用对比增强乳房MRI和腋窝超声进行放射学评估(cN+患者)。如果在3或6个周期后乳房(和腋窝)发生rCR,将进行早期手术。如果在3和6个周期后仍有残余肿瘤存在,患者将继续PTC-ptz方案,共完成9个周期。如果hr阳性,所有患者将接受赫赛汀和帕妥珠单抗辅助治疗,完成1年的抗her2阻断和内分泌治疗。这项研究将在荷兰大约35个中心进行。入选标准:组织学证实的II/III期her2阳性原发性乳腺癌,且已知激素受体状态。患者必须在基线MRI上有可测量的乳腺肿瘤,可以是淋巴结阴性或淋巴结阳性。目的是评估图像引导下降低her2阳性乳腺癌新辅助化疗升级对3年无事件生存期(EFS)的疗效。次要终点是总生存期、rCR、rCR和pCR之间的一致性(ypT0/is、ypN0)、接受3、6或9个周期的患者在pCR后EFS和OS的差异以及毒性。这是一项单臂、两阶段的研究,其中有一个中期分析和一个最终分析。对每个激素受体亚组分别进行统计。停止规则基于文献中描述的3年efs率(hr阴性肿瘤为88%,hr阳性肿瘤为90%),并使用精确的条件泊松分布计算。该研究是成功的,在700患者年的随访中,hr阴性亚组的efs事件≤34起,hr阳性亚组的efs事件≤38起。三年的efs估计将使用Kaplan-Meier统计来计算。当前累积和目标累积目标累积为hr阴性组231例,hr阳性组231例。当期应计收益将随之而来。研究者发起的试验由荷兰乳腺癌研究小组(BOOG)赞助,由罗氏公司资助。对试验有特殊兴趣的人的联系信息研究负责人:a van der Voort, MD荷兰癌症研究所1006 BE Amsterdam E: a.vd.voort@nki.nl, P:+31 20 512 2951引文格式:van der Voort a, Dezentje VO, van der Steeg WA, Winter-Warnars GA, Schipper R-J, Scholten AN, Wesseling J, van Werkhoven ED, van Duijnhoven FH, Vrancken Peeters M-JT, Sonke GS。图像引导下her2阳性乳腺癌新辅助化疗降级:TRAIN-3研究[摘要]。2018年圣安东尼奥乳腺癌研讨会论文集;2018年12月4-8日;费城(PA): AACR;中国癌症杂志,2019;79(4增刊):OT2-07-07。
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引用次数: 1
Abstract OT1-13-01: MammaPrint, BluePrint, and full-genome data linked with clinical data to evaluate new gene expression profiles (FLEX) OT1-13-01:将MammaPrint、BluePrint和全基因组数据与临床数据联系起来,评估新的基因表达谱(FLEX)
Pub Date : 2019-02-15 DOI: 10.1158/1538-7445.sabcs18-ot1-13-01
A. Brufsky, J. Crozier, I. Grady, T. Lomis, P. Whitworth, E. Rehmus, G. Srkalović, Ll Lee, P. Blumencranz, P. Baron, B. Mavromatis, S. Untch, L. Blumencranz, E. Yoder, W. Audeh
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引用次数: 0
Abstract OT1-01-04: Phase 1 study of D-0502, an orally bioavailable SERD with optimized pharmacological and PK/PD property for ER-positive breast cancer 摘要:D-0502是一种口服生物可利用的SERD,具有优化的药理和PK/PD特性,用于er阳性乳腺癌的i期研究
Pub Date : 2019-02-15 DOI: 10.1158/1538-7445.SABCS18-OT1-01-04
Lianshan Zhang, D. Dai, Zhongcheng Shi, Jingting Jiang, Yungui Wang
Background: Endocrine therapy such as selective estrogen receptor degrader (SERD) fulvestrant has been used effectively to extend the life of HR+ (ER+ and PR+) and HER2- breast cancer patient, either alone or in combination with CDK4/6 inhibitors such as palbociclib or abemaciclib. D-0502 is an orally bioavailable SERD with potent activity in various HR+ and HER2- breast cancer cell lines and xenograft models. Its combination with palbociclib in both MCF-7 xenograft model and ESR-1 mutated (Y537S) patient derived breast cancer xenograft models resulted in further tumor growth inhibition or regression. Drug metabolism and pharmacokinetic studies both in vitro and in vivo demonstrated that D-0502 exhibits favorable PK profiles suitable for clinical development. Trial Design: D-0502 is currently being evaluated in a phase 1 trial of women with advanced or metastatic HR+, HER2- breast cancer (MBC) (NCT03471663). This is a multicenter, open-label phase I study of D-0502 single agent and D-0502 in combination with standard dose of palbociclib. The primary objective is to characterize the safety and tolerability of D-0502 and D-0502 in combination with palbociclib, to identify an MTD and/or RP2D. The secondary objective is to evaluate the PK properties and the preliminary anti-tumor activities. Patients will receive D-0502 orally every day and treatment will be administered as 28-day cycles. The study has two parts: Dose Escalation (phase 1a) and Dose Expansion and Combination (phase 1b). In phase Ia, patients will be enrolled using a conventional dose-escalation algorithm (3+3 subjects per dose level) with 4 sequential dose cohorts to identify the MTD and RDE (recommended dose for expansion) in phase 1b) which will be at or below MTD. In phase 1b, there will be 2 cohorts, one is D-0502 single agent administered at RDE and the other is D-0502 in combination with standard dose of palbociclib, each with approximately 12 patients. Key Eligibility Criteria: Eligible patients included women with confirmed HR+, HER2- MBC who have previously received no more than 2 prior chemotherapies for MBC; ECOG 0-1; evaluable (phase 1a) or measurable (phase 1b) disease (RECIST v1.1); premenopausal or postmenopausal status; adequate hematologic, hepatic and renal functions. Current Status and Contact Information: At the time of abstract submission, the first cohort of 50 mg patients have started the study treatment. For inquiry of the study, please contact ling.zhang@inventisbio.com. Citation Format: Zhang L, Dai D, Shi Z, Jiang J, Wang Y. Phase 1 study of D-0502, an orally bioavailable SERD with optimized pharmacological and PK/PD property for ER-positive breast cancer [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr OT1-01-04.
背景:内分泌治疗如选择性雌激素受体降解剂(SERD)氟维司汀已被有效地用于延长HR+ (ER+和PR+)和HER2-乳腺癌患者的生命,无论是单独使用还是与CDK4/6抑制剂如帕博西尼或阿贝马昔利联合使用。D-0502是一种口服生物可利用的SERD,在各种HR+和HER2-乳腺癌细胞系和异种移植模型中具有有效活性。在MCF-7异种移植模型和ESR-1突变(Y537S)患者来源的乳腺癌异种移植模型中,该药与palbociclib联合使用可进一步抑制肿瘤生长或使肿瘤消退。体外和体内的药物代谢和药代动力学研究表明,D-0502具有良好的PK谱,适合临床开发。试验设计:D-0502目前正在一项晚期或转移性HR+, HER2-乳腺癌(MBC) (NCT03471663)妇女的1期试验中进行评估。这是一项多中心、开放标签的I期研究,涉及D-0502单药和D-0502联合标准剂量帕博西尼。主要目的是表征D-0502和D-0502联合帕博西尼的安全性和耐受性,以确定MTD和/或RP2D。次要目的是评价其PK特性和初步的抗肿瘤活性。患者将每天口服D-0502,治疗将以28天为周期进行。该研究分为两部分:剂量递增(1a期)和剂量扩展与联合(1b期)。在Ia期,患者将使用传统的剂量递增算法(每个剂量水平3+3名受试者)入组,有4个顺序剂量队列,以确定MTD和RDE(扩展推荐剂量)在1b期达到或低于MTD。在1b期,将有2个队列,一个是D-0502单药给药RDE,另一个是D-0502与标准剂量palbociclib联合,每个队列大约有12名患者。主要资格标准:符合条件的患者包括确认为HR+, HER2- MBC的女性,既往接受过不超过2次的MBC化疗;ECOG 0 - 1;可评估(1a期)或可测量(1b期)疾病(RECIST v1.1);绝经前或绝经后状态;血液、肝肾功能正常。目前状况及联系信息:在提交摘要时,第一组50 mg患者已开始研究治疗。如对本次研究有任何疑问,请联系ling.zhang@inventisbio.com。张丽,戴迪,石忠,姜军,王勇。口服生物利用SERD D-0502治疗er阳性乳腺癌的1期临床研究[摘要]。2018年圣安东尼奥乳腺癌研讨会论文集;2018年12月4-8日;费城(PA): AACR;中国癌症杂志,2019;79(4增刊):01- 01-04。
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引用次数: 1
Abstract OT3-01-01: BEGONIA: Phase Ib/II open-label, platform study of safety and efficacy of durvalumab, paclitaxel and other novel oncology therapy agents as first-line (1L) therapy in patients with metastatic triple negative breast cancer (mTNBC) OT3-01-01: BEGONIA: durvalumab,紫杉醇和其他新型肿瘤治疗药物作为转移性三阴性乳腺癌(mTNBC)患者一线(1L)治疗的安全性和有效性的Ib/II期开放标签平台研究
Pub Date : 2019-02-15 DOI: 10.1158/1538-7445.SABCS18-OT3-01-01
P. Schmid, At Nunes, R. Lall, C. D’Cruz, L. Grinsted, M. Lanasa
Background: Immuno-oncology therapies have shown durable clinical responses in a subset of patients with mTNBC. Combination therapy with checkpoint inhibition and chemotherapy is under investigation; preliminary research showed improved objective response rate (ORR) with combination therapy versus chemotherapy alone.1 Durvalumab is a selective, high-affinity, engineered, human monoclonal antibody that blocks programmed cell death-ligand 1 (PD-L1) binding to programmed cell death 1 (PD-1) and CD80 allowing T cells to recognize and kill tumor cells. This study is designed to assess the efficacy and safety of durvalumab + paclitaxel as 1L treatment in patients with mTNBC. Additionally, this study will also evaluate potential novel triplet treatment regimens of durvalumab + paclitaxel in combination with immune-modulating agents, selumetinib (ARRY-142886; AZD6244, an inhibitor of mitogen activated protein kinase/extracellular signal regulated kinase [MAPK/ERK]), danvatirsen (AZD9150, an antisense oligonucleotide designed to down-regulate expression of signal transducer and activator of transcription 3 protein), oleclumab (MEDI9447, an anti-CD73 monoclonal antibody), and capivasertib (AZD5363, a highly selective, oral, small molecule AKT inhibitor) that may provide further benefit to patients with mTNBC. Methods: BEGONIA is a phase Ib/II, open-label, multicenter, platform study (EudraCT No: 2018-000764-29) consisting of 2 parts: Part 1 is a phase Ib study planned to be conducted in approximately 100 patients (20 per arm) to assess the safety and tolerability of durvalumab (1500 mg intravenous [IV], q4w) + paclitaxel (90 mg/m2 IV, 4 week cycle, 3 weeks once weekly [days 1, 8, 15], 1 week off) (arm 1); and durvalumab + paclitaxel in combination with selumetinib (arm 2), danvatirsen (arm 3), oleclumab (arm 4) and capivasertib (arm 5) until disease progression. Dosing of the immune-modulating agents will be based on the previously defined recommended phase 2 doses of the component doublets (where available) in combination with durvalumab + paclitaxel using a rolling 6-patient design to evaluate for toxicity. Part 2 is a phase II study planned to be conducted in approximately 150 to 225 patients to evaluate efficacy of up to 2 best triplet combination arms based on their safety and efficacy outcomes in Part 1. The primary objective of Part 1 is safety and of Part 2 is efficacy (primary endpoint: progression free survival [PFS]); additionally, efficacy will be assessed in both parts, including overall survival, ORR, PFS, and duration of response (RECIST 1.1). Immunotherapy naive adult patients (≥18 years) with locally assessed and confirmed TNBC, ECOG PS 0 or 1, stage IV breast adenocarcinoma and no prior systemic treatment for metastatic disease will be enrolled. 1Adams et al., J Clin Oncol 2016;34(Suppl):abstr 1009 Citation Format: Schmid P, Nunes AT, Lall R, D9Cruz C, Grinsted L, Lanasa MC. BEGONIA: Phase Ib/II open-label, platform study of safety and ef
背景:免疫肿瘤学治疗在一部分mTNBC患者中显示出持久的临床反应。检查点抑制和化疗联合治疗正在研究中;初步研究表明,联合治疗比单独化疗可提高客观缓解率Durvalumab是一种选择性、高亲和力、工程化的人单克隆抗体,可阻断程序性细胞死亡配体1 (PD-L1)与程序性细胞死亡1 (PD-1)和CD80的结合,使T细胞能够识别和杀死肿瘤细胞。本研究旨在评估durvalumab +紫杉醇作为1L治疗mTNBC患者的有效性和安全性。此外,该研究还将评估durvalumab +紫杉醇联合免疫调节剂selumetinib (ARRY-142886;AZD6244(一种丝裂原活化蛋白激酶/细胞外信号调节激酶[MAPK/ERK])的抑制剂,danvarirsen (AZD9150,一种旨在下调信号换能器和转录激活因子3蛋白表达的反意义寡核苷酸),oleclumab (MEDI9447,一种抗cd73单克隆抗体)和capivasertib (AZD5363,一种高选择性口服小分子AKT抑制剂)可能为mTNBC患者提供进一步的疗效。方法:BEGONIA是一项Ib/II期、开放标签、多中心、平台研究(EudraCT No: 2018-000764-29),由两部分组成:第一部分是一项Ib期研究,计划在大约100名患者(每组20名)中进行,以评估durvalumab (1500mg静脉注射[IV], q4w) +紫杉醇(90mg /m2 IV, 4周周期,3周,每周一次[第1、8、15天],1周休息)(第1组)的安全性和耐受性;durvalumab +紫杉醇联合selumetinib(第2组)、danvarirsen(第3组)、oleclumab(第4组)和capivasertib(第5组)直至疾病进展。免疫调节剂的剂量将基于先前定义的推荐的2期剂量,双组分(如有)与durvalumab +紫杉醇联合使用,使用滚动6例患者设计来评估毒性。第二部分是一项II期研究,计划在大约150至225名患者中进行,根据第一部分的安全性和有效性结果评估最多2种最佳三联疗法的疗效。第一部分的主要目标是安全性,第二部分的主要目标是有效性(主要终点:无进展生存期[PFS]);此外,疗效将在两个部分进行评估,包括总生存期、ORR、PFS和反应持续时间(RECIST 1.1)。免疫治疗初治成年患者(≥18岁),局部评估和确诊TNBC, ECOG PS 0或1,IV期乳腺腺癌,既往未接受转移性疾病的全身治疗。1Adams等,J clinical Oncol 2016;34(Suppl): abstract 1009引用格式:Schmid P, Nunes AT, Lall R, D9Cruz C, Grinsted L, Lanasa MC. BEGONIA: durvalumab、紫杉醇等新型肿瘤治疗药物作为转移性三阴性乳腺癌(mTNBC)患者第1线(1L)治疗的Ib/II期开放标签、平台研究[摘要]。2018年圣安东尼奥乳腺癌研讨会论文集;2018年12月4-8日;费城(PA): AACR;中国癌症杂志,2019;79(4增刊):OT3-01-01。
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引用次数: 3
Abstract OT3-05-02: ALEXANDRA/IMpassion030: A phase III study of standard adjuvant chemotherapy with or without atezolizumab in early triple negative breast cancer OT3-05-02: ALEXANDRA/IMpassion030:早期三阴性乳腺癌标准辅助化疗加或不加atezolizumab的III期研究
Pub Date : 2019-02-15 DOI: 10.1158/1538-7445.SABCS18-OT3-05-02
M. Ignatiadis, H. McArthur, A. Bailey, J-L Martinez, E. Azambuja, O. Metzger, C. Lai, N. Pondé, T. Goulioti, F. Daly, A. Bouhlel, V. Balta, V. V. Dooren, G. Viale, M. Maetens, C. Dufrane, A. Duc, E. Winer, R. Gelber, M. Piccart
Background: Triple negative breast cancer (TNBC) is a subtype with a high risk of relapse in the early disease setting. Because TNBC does not currently have specific targeted agents approved for use in the early setting it is treated primarily with chemotherapy. A growing body of evidence indicates that TNBC is more immunogenic than other subtypes of breast cancer and promising clinical activity has been reported with atezolizumab (an anti–PD-L1 antibody) in Phase 1/1b metastatic TNBC trials. Furthermore, the anti-tumor activity of PD-1/PD-L1 targeting drugs is hypothesized to be enhanced when co-administered with chemotherapy. ALEXANDRA/IMpassion030 will evaluate the efficacy and safety of atezolizumab in combination with standard adjuvant chemotherapy in early TNBC. Methods: ALEXANDRA/IMpassion030 is a global, prospective, randomised, open-label Phase 3 trial investigating the efficacy, safety and pharmacokinetic (PK) profile of adjuvant atezolizumab plus standard chemotherapy versus chemotherapy alone in early TNBC. In total, 2300 patients diagnosed with non-metastatic operable stage II or III TNBC confirmed by central pathology review will be randomised. TumorPD-L1evaluationwill be performed centrally. Patients will be stratified by type of surgery, nodal status, and PD-L1 status. The adjuvant treatment will consist of weekly paclitaxel 80 mg/m2 for 12 weeks followed by dose dense anthracycline (epirubicin 90 mg/m2 or doxorubicin 60 mg/m2) and cyclophosphamide 600 mg/m2 for 4 doses every 2 weeks or the same chemotherapy regimen (T-EC/AC) given concomitantly with atezolizumab 840 mg every 2 weeks followed by maintenance atezolizumab 1200 mg every 3 weeks until completion of 1 year of atezolizumab. Primary end-point is invasive disease-free survival (iDFS) and secondary end-points include iDFS by PD-L1 and lymph node status, overall survival, safety, patient functioning and health related quality of life (HRQoL). Tumour tissue and blood samples will be collected for biomarker research. The first site was activated in May 4th, and approximately 430 sites are expected to be open globally in 30 countries. This trial is sponsored by Roche and conducted in partnership with the Breast International Group, Frontier Science and Technology Research Foundation, Institute Jules Bordet and Alliance Foundation Trials. Clinicaltrials.gov NCT03498716. Citation Format: Ignatiadis M, McArthur H, Bailey A, Martinez J-L, De Azambuja E, Metzger O, Lai C, Ponde N, Goulioti T, Daly F, Bouhlel A, Balta V, Van Dooren V, Viale G, Maetens M, Dufrane C, Nguyen Duc A, Winer E, Gelber R, Piccart M. ALEXANDRA/IMpassion030: A phase III study of standard adjuvant chemotherapy with or without atezolizumab in early triple negative breast cancer [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr OT3-05-02.
背景:三阴性乳腺癌(TNBC)是一种在疾病早期复发风险很高的亚型。由于TNBC目前没有被批准用于早期治疗的特异性靶向药物,因此主要采用化疗治疗。越来越多的证据表明,TNBC比其他亚型乳腺癌具有更强的免疫原性,并且在1/1b期转移性TNBC试验中,atezolizumab(一种抗pd - l1抗体)有很好的临床活性。此外,假设PD-1/PD-L1靶向药物与化疗联合使用时抗肿瘤活性增强。ALEXANDRA/IMpassion030将评估atezolizumab联合标准辅助化疗治疗早期TNBC的疗效和安全性。方法:ALEXANDRA/IMpassion030是一项全球性、前瞻性、随机、开放标签的3期临床试验,旨在研究atezolizumab联合标准化疗与单独化疗治疗早期TNBC的疗效、安全性和药代动力学(PK)特征。总共有2300名经中心病理检查证实为非转移性可手术的II期或III期TNBC患者将被随机分组。集中进行肿瘤pd - l1评估。患者将根据手术类型、淋巴结状态和PD-L1状态进行分层。辅助治疗将包括每周紫杉醇80mg /m2,持续12周,随后是剂量密集的蒽环类药物(表柔比星90mg /m2或阿霉素60mg /m2)和环磷酰胺600mg /m2,每2周4次,或相同的化疗方案(T-EC/AC),与阿特佐利珠单抗840mg,每2周,随后维持阿特佐利珠单抗1200mg,每3周,直到阿特佐利珠单抗1年完成。主要终点是侵袭性无病生存期(iDFS),次要终点包括PD-L1和淋巴结状态、总生存期、安全性、患者功能和健康相关生活质量(HRQoL)的iDFS。将收集肿瘤组织和血液样本用于生物标志物研究。第一个站点已于5月4日启动,预计将在全球30个国家开设约430个站点。该试验由罗氏赞助,并与Breast国际集团、前沿科学技术研究基金会、Jules bordt研究所和联盟基金会试验合作进行。Clinicaltrials.gov NCT03498716。引用格式:Ignatiadis M, McArthur H, Bailey A, Martinez J-L, De Azambuja E, Metzger O, Lai C, Ponde N, Goulioti T, Daly F, Bouhlel A, Balta V, Van Dooren V, Viale G, Maetens M, Dufrane C, Nguyen Duc A, Winer E, Gelber R, Piccart M. ALEXANDRA/IMpassion030:早期三阴性乳腺癌标准辅助化疗的III期研究[摘要]。2018年圣安东尼奥乳腺癌研讨会论文集;2018年12月4-8日;费城(PA): AACR;中国癌症杂志,2019;79(4增刊):OT3-05-02。
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引用次数: 0
Abstract OT2-07-08: Withdrawn 摘要OT2-07-08:撤回
Pub Date : 2019-02-15 DOI: 10.1158/1538-7445.sabcs18-ot2-07-08
E. Paplomata, Virginia F. Borges, S. Loi, V. Abramson, E. Hamilton, S. Hurvitz, Nan Lin, L. Walker, R. Murthy
{"title":"Abstract OT2-07-08: Withdrawn","authors":"E. Paplomata, Virginia F. Borges, S. Loi, V. Abramson, E. Hamilton, S. Hurvitz, Nan Lin, L. Walker, R. Murthy","doi":"10.1158/1538-7445.sabcs18-ot2-07-08","DOIUrl":"https://doi.org/10.1158/1538-7445.sabcs18-ot2-07-08","url":null,"abstract":"","PeriodicalId":19476,"journal":{"name":"Ongoing Clinical Trials","volume":"117 6 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88467502","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Abstract OT3-04-03: KEYNOTE-756: A randomized, double-blind, phase III study of pembrolizumab versus placebo in combination with neoadjuvant chemotherapy and adjuvant endocrine therapy for high-risk early-stage ER+/HER2–breast cancer OT3-04-03: KEYNOTE-756:一项随机、双盲、III期研究:派姆单抗与安慰剂联合新辅助化疗和辅助内分泌治疗高危早期ER+/ her2乳腺癌
Pub Date : 2019-02-15 DOI: 10.1158/1538-7445.SABCS18-OT3-04-03
F. Cardoso, A. Bardia, F. André, D. Cescon, H. McArthur, M. Telli, S. Loi, J. Cortes, P. Schmid, N. Harbeck, C. Denkert, C. Jackisch, L. Jia, K. Tryfonidis, V. Karantza
Background:Although ER+/HER2– breast cancer has a better overall prognosis than other breast cancer subtypes, there is a high-risk subpopulation characterized by high-grade tumors and decreased sensitivity to endocrine therapy, higher responsiveness to chemotherapy and worse prognosis. A large meta-analysis of prospective studies focusing on neoadjuvant chemotherapy (NAC) for treatment of stage I-III breast cancer demonstrated that increased pathologic complete response (pCR) rates at surgery were associated with improved survival. This correlation was observed across triple-negative breast cancer (TNBC), HER2+ breast cancer, and high-grade HR+/HER2- breast cancer. Specifically, patients with a pCR after NAC had a 5-year event-free survival (EFS) rate of 90%, whereas patients who did not achieve a pCR had a 5-year EFS rate of 60%.Therefore, increasing pCR rates after NAC may have a substantial impact for patients with high-risk early-stage HR+/HER2– breast cancer. KEYNOTE-756 is a global, randomized, double-blind, phase III study of pembrolizumab (vs placebo) + chemotherapy as neoadjuvant treatment, followed by pembrolizumab (vs placebo) plus endocrine therapy as adjuvant treatment for patients with high-risk, early-stage ER+/HER2– breast cancer. Methods: Patients with T1c-2 cN1-2 or T3-4 cN0-2 grade 3 or grade 2 with Ki-67 ≥30%, invasive, ductal ER+/HER2– breast cancerwill be stratified by lymph node involvement (positive vs negative), tumor PD-L1 status (positive vs negative), ER positivity (≥10% vs Citation Format: Cardoso F, Bardia A, Andre F, Cescon DW, McArthur H, Telli M, Loi S, Cortes J, Schmid P, Harbeck N, Denkert C, Jackisch C, Jia L, Tryfonidis K, Karantza V. KEYNOTE-756: A randomized, double-blind, phase III study of pembrolizumab versus placebo in combination with neoadjuvant chemotherapy and adjuvant endocrine therapy for high-risk early-stage ER+/HER2– breast cancer [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr OT3-04-03.
背景:虽然ER+/HER2 -乳腺癌总体预后优于其他乳腺癌亚型,但存在肿瘤级别高、对内分泌治疗敏感性降低、化疗反应性高、预后较差的高危亚群。一项针对新辅助化疗(NAC)治疗I-III期乳腺癌的前瞻性研究的大型荟萃分析表明,手术时病理完全缓解(pCR)率的增加与生存率的提高有关。在三阴性乳腺癌(TNBC)、HER2+乳腺癌和高级别HR+/HER2-乳腺癌中均观察到这种相关性。具体而言,NAC后pCR患者的5年无事件生存率(EFS)为90%,而未实现pCR的患者的5年EFS率为60%。因此,NAC后增加pCR率可能对高危早期HR+/HER2 -乳腺癌患者有实质性影响。KEYNOTE-756是一项全球性、随机、双盲、III期研究,将派姆单抗(vs安慰剂)+化疗作为新辅助治疗,随后派姆单抗(vs安慰剂)+内分泌治疗作为高风险、早期ER+/HER2 -乳腺癌患者的辅助治疗。方法:Ki-67≥30%、浸润性、导管性ER+/HER2 -乳腺癌的T1c-2 cN1-2或T3-4 cN0-2 3级或2级患者将根据淋巴结受累(阳性与阴性)、肿瘤PD-L1状态(阳性与阴性)、ER阳性(≥10%)进行分层。引用格式:Cardoso F, Bardia A, Andre F, Cescon DW, McArthur H, Telli M, Loi S, Cortes J, Schmid P, Harbeck N, Denkert C, Jackisch C, Jia L, Tryfonidis K, Karantza v。一项随机、双盲、III期研究:派姆单抗与安慰剂联合新辅助化疗和辅助内分泌治疗高危早期ER+/HER2 -乳腺癌[摘要]2018年圣安东尼奥乳腺癌研讨会论文集;2018年12月4-8日;费城(PA): AACR;中国癌症杂志,2019;79(4增刊):OT3-04-03。
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引用次数: 1
Abstract OT3-02-01: RIBANNA — Real-world evidence of ribociclib plus aromatase inhibitor, or endocrine monotherapy, or chemotherapy as first-line therapy for postmenopausal women with HR+, HER2– advanced breast cancer (aBC) 摘要:RIBANNA -真实世界的证据表明,RIBANNA联合芳香化酶抑制剂,或内分泌单药治疗,或化疗作为绝经后妇女HR+, HER2 -晚期乳腺癌(aBC)的一线治疗
Pub Date : 2019-02-15 DOI: 10.1158/1538-7445.SABCS18-OT3-02-01
A. Wöckel, P. Fasching, G. Guderian, J. Heim, C. Jackisch, H. Lück, D. Lüftner, F. Marmé, T. Reimer, T. Decker
Background: In the pivotal phase 3 MONALEESA-2 trial, ribociclib, a highly selective oral CDK4/6 inhibitor in combination with letrozole significantly prolonged progression-free survival (PFS) compared to letrozole alone. In the year 2017, based on the results of MONALEESA-2, ribociclib in combination with an aromatase inhibitor (AI) was approved for the treatment of HR+, HER2– aBC in postmenopausal women with no prior therapy for their advanced disease (first-line treatment). Beyond phase 3 trials, further data for ribociclib are now becoming available from the phase 3b trials, RIBECCA and COMPLEEMENT-1, involving approximately 500 and 3000 patients with aBC, respectively. However, real-world evidence for the effectiveness, safety, and tolerability of ribociclib + AI in the routine clinical practice is needed to further support the use of this combination in the first-line therapy. Methods: RIBANNA is a non-interventional study, which started in October 2017 and plans to enroll 3020 patients across ˜400 sites in Germany. Postmenopausal women diagnosed with aBC will be enrolled into 3 cohorts (cohort 1: ribociclib + AI; cohort 2: endocrine monotherapy; and cohort 3: chemotherapy). Across all cohorts, patients will be treated in accordance with the respective German-prescribing guidelines. Data related to efficacy (with PFS as the primary efficacy criterion), safety, tolerability, duration of therapy, and impact on quality of life (QoL) will be collected. QoL will be assessed using the validated patient questionnaires. This study was especially designed to analyze the patient data from sequential lines of therapy in all three cohorts over a period of up to 7 years. For this purpose, RIBANNA will collect the data on each line of treatment and the reason for changing treatment in all 3 cohorts. The same accounts for QoL, which will also be assessed periodically, regardless of disease progression and initiation of subsequent therapies. RIBANNA is the first study to provide the real-world evidence regarding treatment of HR+, HER2− aBC with the CDK4/6 inhibitor, ribociclib. This study includes 3 treatment cohorts (ribociclib + AI, endocrine monotherapy, and chemotherapy) with subsequent treatment algorithms and assessment of QoL over the entire study period. Citation Format: Wockel A, Fasching PA, Guderian G, Heim J, Jackisch C, Luck H-J, Luftner D, Marme F, Reimer T, Decker T. RIBANNA — Real-world evidence of ribociclib plus aromatase inhibitor, or endocrine monotherapy, or chemotherapy as first-line therapy for postmenopausal women with HR+, HER2– advanced breast cancer (aBC) [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr OT3-02-01.
背景:在关键的3期MONALEESA-2试验中,与单独来曲唑相比,高选择性口服CDK4/6抑制剂ribociclib联合来曲唑可显著延长无进展生存期(PFS)。2017年,基于MONALEESA-2的结果,ribociclib联合芳香化酶抑制剂(AI)被批准用于治疗HR+, HER2 - aBC的绝经后晚期妇女(一线治疗)。除了3期临床试验,RIBECCA和complement -1的3b期临床试验也提供了更多关于ribociclib的数据,分别涉及约500例和3000例aBC患者。然而,需要在常规临床实践中对ribociclib + AI的有效性、安全性和耐受性的真实证据来进一步支持在一线治疗中使用该组合。方法:RIBANNA是一项非介入性研究,于2017年10月开始,计划在德国约400个地点招募3020名患者。诊断为aBC的绝经后妇女将被纳入3个队列(队列1:ribociclib + AI;队列2:内分泌单一疗法;队列3:化疗)。在所有队列中,患者将按照各自的德国处方指南进行治疗。将收集与疗效(以PFS为主要疗效标准)、安全性、耐受性、治疗持续时间和对生活质量(QoL)的影响相关的数据。生活质量将使用经过验证的患者问卷进行评估。本研究特别设计用于分析所有三个队列在长达7年的时间内连续治疗的患者数据。为此,RIBANNA将收集所有3个队列中每条治疗线的数据和改变治疗的原因。生活质量也将定期评估,无论疾病进展和后续治疗是否开始。RIBANNA是首个用CDK4/6抑制剂ribociclib治疗HR+, HER2−aBC的研究。本研究包括3个治疗队列(核糖环尼+人工智能、内分泌单药治疗和化疗),并对整个研究期间的治疗算法和生活质量进行了评估。引用格式:Wockel A, Fasching PA, Guderian G, Heim J, Jackisch C, Luck H-J, Luftner D, Marme F, Reimer T, Decker T. RIBANNA -实际证据表明,ribociclib联合芳香化酶抑制剂,或内分泌单一疗法,或化疗可作为绝经后妇女HR+, HER2 -晚期乳腺癌(aBC)的一线治疗[摘要]。2018年圣安东尼奥乳腺癌研讨会论文集;2018年12月4-8日;费城(PA): AACR;中国癌症杂志,2019;79(4增刊):OT3-02-01。
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引用次数: 1
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Ongoing Clinical Trials
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