2019 ASCO Annual Meeting!
Session: Gastrointestinal (Noncolorectal) Cancer
Type: Poster Session
Time: Monday June 3, 8:00 AM to 11:00 AM
Location: Hall A
A phase Ib dose-escalation and cohort-expansion study of safety and activity of the transforming growth factor (TGF) β receptor I kinase inhibitor galunisertib plus the anti-PD-L1 antibody durvalumab in metastatic pancreatic cancer.
Gastrointestinal (Noncolorectal) Cancer
2019 ASCO Annual Meeting
Poster Board Number:
Poster Session (Board #229)
J Clin Oncol 37, 2019 (suppl; abstr 4124)
Author(s): Davide Melisi, Antoine Hollebecque, Do-Youn Oh, Emiliano Calvo, Anna M. Varghese, Erkut Hasan Borazanci, Teresa Macarulla Mercade, Francesca Simionato, Joon Oh Park, Johanna C. Bendell, Sandrine J. Faivre, Yumin Zhao, Ivelina Gueorguieva, Michael Man, Shawn Estrem, Karim Adnane Benhadji, Mark Lanasa, Susan C. Guba, Rocio Garcia-Carbonero; University of Verona, Verona, Italy; Gustave Roussy, Villejuif, France; Seoul National University Hospital, Seoul, South Korea; START Madrid, Centro Integral Oncológico Clara Campal, Madrid, Spain; Memorial Sloan Kettering Cancer Center, New York, NY; HonorHealth Research Institute, Scottsdale, AZ; Vall d'Hebron University Hospital and Vall d'Hebron Institute of Oncology, Barcelona, Spain; University of Verona, Tonezza Del Cimone, Italy; Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea; Sarah Cannon Research Institute/Tennessee Oncology, Nashville, TN; Service d'Oncologie Médicale, Clichy, France; Eli Lilly and Company, Indianapolis, IN; Eli Lilly and Company, Erl Wood, United Kingdom; Eli Lilly, Indianapolis, IN; Eli Lilly and Company, New York, NY; AstraZeneca, Gaithersburg, MD; Hospital Universitario 12 de Octubre, IIS imas12, UCM, CNIO, CIBERONC, Madrid, Spain
Background: Pancreatic cancer (PC) is characterized by a highly immunosuppressive microenvironment, and immune checkpoint inhibitors as monotherapy have been ineffective to date. TGFβ is commonly viewed as a powerful immunosuppressive cytokine, and inhibition of its signaling reverses this suppression and activates adaptive immune responses. A combination of TGFβ and PD-L1 inhibition may act synergistically to induce immune restoration and to improve antitumor responses. This Phase 1b study (NCT02734160) evaluated the combination of galunisertib plus durvalumab in recurrent or refractory metastatic PC. Methods: Eligible patients (pts) were ≥18 years old, had ECOG status ≤1, and had not received treatment with anti-PD-1, anti-PD-L1, or TGFβ R1 kinase inhibitors. The primary objective was to assess the safety and the recommended dose of galunisertib given 14 days on/14 days off in combination with durvalumab 1500 mg every 4 weeks. Four dose levels of galunisertib were tested in the dose escalation portion of the study: 50 mg QD, 50 mg BID, 80 mg BID and 150 mg BID, followed by the cohort expansion portion of the study at the recommended Phase 2 dose (RP2D). Secondary objectives included preliminary assessment of activity by response rate, (RECIST v1.1), median PFS (mPFS), and OS (mOS). Results: 42 pts (25F/17M) were treated in the study (median age 56.5 y; 71.4% had received ≥2 prior systemic regimens). There was no dose limiting toxicity and galunisertib 150 mg BID was chosen as the RP2D. In the 32 pts treated at this dose, Grade ≥3 related AEs included AST and GGT elevations (2 pts each), and ALT and alkaline phosphatase elevations, and neutropenia (1 pt each). One partial response and 7/32 stable diseases were observed (disease control rate 25%); mPFS was 1.9 months (95% CI: 1.5, 2.2) and mOS was NR (95% CI: 3.6, NR). Biomarker data will be presented at the meeting. Conclusions: The combination of galunisertib plus durvalumab had an acceptable tolerability and safety profile. The activity of this combination in second and third line PC patients warrants further consideration. Clinical trial information: NCT02734160