Abstract
Osimertinib plus necitumumab in EGFR-mutant NSCLC: Final results from an ETCTN California Cancer Consortium phase I study
Journal of clinical oncology, Vol.40(16_suppl), pp.9014-9014
06/01/2022
DOI: 10.1200/JCO.2022.40.16_suppl.9014
Abstract
9014
Background: Osimertinib (Osi) is standard of care in 1
st
line (1L) EGFR mut NSCLC and TKI resistant T790M
pos
NSCLC but acquired resistance emerges; outcomes are less robust in T790M
neg
, C797X
pos
and EGFR exon 20 insertion (ex20ins) disease. We examined Osi with the EGFR monoclonal antibody Necitumumab (Neci) in select settings of EGFR TKI resistance. Methods: Pts were accrued to 5 expansion cohorts (ExC) at recommended phase 2 dose (RP2D) of Osi 80 mg daily and Neci 800 mg D1 + D8 of q21d cycle. ExC (18 pts/cohort): A) T790M
neg
progressive disease (PD) on 1
st
/2
nd
gen TKI as last therapy, B) T790M
neg
PD on 1
st
/2
nd
gen TKI and PD on 3
rd
gen TKI, C) T790M
pos
PD on 1
st
/2
nd
gen TKI and PD on 3
rd
gen TKI, D) EGFR ex20ins PD on chemotherapy, E) PD on 1L osi. In ExC A-C, T790M was confirmed centrally (tissue) by ddPCR. Additional correlative studies include: tissue NGS (> 400 gene panel), EGFR FISH, plasma for PK and serial EGFR ctDNA by ddPCR. Adverse events were graded (Gr) by CTCAEv5; ORR, PFS by RECIST 1.1. Primary pre-specified efficacy endpoint ≥3/18 pts responding per cohort. Results: 101 patients accrued (100 evaluable). Efficacy is summarized in the Table. Drug related Gr 3 AEs were seen in 38% of pts, mainly rash (21%). ORR among all pts was 19% (95% CI 12-28%) that varied across cohorts (Table). In ExC A-C, 69% pts had detectable EGFR activating mutations in ctDNA, with decline in mutant allele frequency (AF) on treatment in 80% and ctDNA clearance in 33%. Conclusions: Osi/Neci is feasible and tolerable at the RP2D. EGFR ctDNA was detectable at baseline in the majority of pts with decrease in AF on treatment. Osi/Neci was active in select settings of EGFR-TKI resistance, meeting its prespecified efficacy endpoint in T790M
neg
PD on 1
st
/2
nd
gen TKI as last therapy (ExC A), EGFR ex20ins post-chemo (ExC D) and PD on 1L osimertinib (ExC E). mPFS in the EGFR ex20ins cohort was within the range of current EGFR Exon 20 ins agents in development. EGFR monoclonal antibodies with osimertinib warrant further study in settings of de novo and acquired EGFR dependent resistance to EGFR-TKI. Clinical trial information: NCT02496663. [Table: see text]
Details
- Title: Subtitle
- Osimertinib plus necitumumab in EGFR-mutant NSCLC: Final results from an ETCTN California Cancer Consortium phase I study
- Creators
- Jonathan W. Riess - University of California, DavisMark D. Krailo - Children's Oncology GroupSukhmani Kaur Padda - Cedars-Sinai Medical CenterSusan G. Groshen - Keck Hospital of USCHeather A. Wakelee - Cancer Prevention Institute of CaliforniaKaren L. Reckamp - Cedars-Sinai Medical CenterMarianna Koczywas - City Of Hope National Medical CenterZofia Piotrowska - Massachusetts General HospitalConor Ernst Steuer - Emory UniversityChul Kim - Room 417 (Pod B, Second Floor), Washington, DCCloud P. Paweletz - Dana-Farber Cancer InstituteLynette M. Sholl - Brigham and Women's HospitalGrace Heavey - Dana-Farber Cancer InstituteJill Kolesar - University of KentuckyJeffrey Moscow - National Cancer InstitutePasi A. Janne - Dana-Farber Cancer InstitutePrimo "Lucky" N. Lara - University of California, Sacramento, CAEdward M. Newman - City Of Hope National Medical CenterDavid R. Gandara - University of California, Davis
- Resource Type
- Abstract
- Publication Details
- Journal of clinical oncology, Vol.40(16_suppl), pp.9014-9014
- DOI
- 10.1200/JCO.2022.40.16_suppl.9014
- ISSN
- 0732-183X
- eISSN
- 1527-7755
- Language
- English
- Date published
- 06/01/2022
- Academic Unit
- Pharmacy; Pharmaceutical Sciences and Experimental Therapeutics
- Record Identifier
- 9984696555702771
Metrics
1 Record Views