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Attend this session at the
2019 ASCO Annual Meeting!


Session: Lung Cancer—Non-Small Cell Metastatic

Type: Poster Session

Time: Sunday June 2, 8:00 AM to 11:00 AM

Location: Hall A

Osimertinib (Osi) plus necitumumab (Neci) in EGFR-mutant NSCLC: An ETCTN California cancer consortium phase I study.

Sub-category:
Metastatic Non-Small Cell Lung Cancer

Category:
Lung Cancer—Non-Small Cell Metastatic

Meeting:
2019 ASCO Annual Meeting

Abstract No:
9057

Poster Board Number:
Poster Session (Board #380)

Citation:
J Clin Oncol 37, 2019 (suppl; abstr 9057)

Author(s): Jonathan W. Riess, Susan G. Groshen, Karen L. Reckamp, Heather A. Wakelee, Geoffrey R. Oxnard, Sukhmani Kaur Padda, Marianna Koczywas, Zofia Piotrowska, Lynette M. Sholl, Cloud P. Paweletz, Christie J. Lau, Jill Kolesar, Philip C. Mack, Jeffrey Moscow, Pasi A. Janne, Primo Lara, Edward M. Newman, David R. Gandara; UC Davis Comprehensive Cancer Center, Sacramento, CA; USC/Norris Comp Cancer Ctr, Los Angeles, CA; City of Hope Comprehensive Cancer Center, Duarte, CA; Stanford Cancer Institute, Stanford, CA; Dana-Farber Cancer Institute, Boston, MA; Massachusetts General Hospital Cancer Center, Boston, MA; Department of Pathology, Brigham and Women's Hospital, Boston, MA; University of Kentucky Markey Cancer Center, Lexington, KY; National Cancer Institute, Rockville, MD

Abstract Disclosures

Abstract:

Background: Osi (3rd gen EGFR TKI) has robust activity in 1st line EGFR mutant NSCLC and TKI resistant T790Mpos NSCLC but progressive disease (PD) occurs and outcomes with Osi alone are poor in T790Mneg, C797Xpos and EGFR exon 20 insertion (ins20) disease. This study examined the EGFR monoclonal antibody Neci with Osi in select settings of EGFR TKI resistance. Methods: Using a 3+3 design, Neci was examined in advanced EGFR mutant NSCLC at dose levels (DL) of 600 mg (DL1) & 800 mg (DL2) D1, D8 IV q21 days + Osi 80 mg qd. Four expansion cohorts (ExC; 18 each) included: A) T790Mneg PD on 1st/2nd gen TKI as last therapy, B) T790Mneg PD on 3rd gen TKI, C) T790Mpos PD on 3rd gen TKI, D) EGFR ex20ins PD on chemotherapy. Central T790M testing by ddPCR in ExC A-C. Additional studies performed include: NGS panel of > 400 genes, EGFR FISH, plasma for PK and serial EGFR ctDNA by ddPCR as exploratory analyses. Adverse events (AEs) graded (Gr) by CTCAEv5 with ORR and PFS by RECIST 1.1. Results: Dose escalation and ExC B completed accrual. In total 55 pts were evaluable (Table). 1 pt had DLT at DL2, Gr 3 sinus bradycardia. Drug related Gr 3 AEs were seen in 27% (15) of pts, mainly rash (7;13%). ctDNA showed decreased mutant allele frequency with therapy in all pts studied with detected EGFR at baseline, with complete plasma clearance in a pt with detectable C797S. Conclusions: The RP2D (Osi 80 mg qd and Neci 800 mg D1, D8 IV on q21d cycle) is feasible and tolerable. In ExC A,T790Mneg pts with 1st/2nd gen EGFR TKI as last treatment, using curtailed sampling, the pre-specified efficacy signal was reached for Osi + Neci comparing favorably to Osi alone in analogous pts from the AURA trial. Clinical activity was also seen in EGFR-dependent resistance (T790Mpos C797Spos) after PD on 3rd gen TKI and in EGFR ins 20. Clinical trial information: NCT02496663

ORR (N, %)Median PFS (95% CI) months
PD on 1st or 2nd gen TKI6/21 (29%)4.1 (2.5, 8.5)
    T790Mneg**1st or 2nd gen TKI as last therapy4/18 (22%)3.9 (1.3, 8.3)
    T790Mpos0/1 (0%)
    T790Munk2/2 (100%)
PD on 3rd gen TKI4/30 (13%)2.5 (1.3, 5.3)
    T790Mneg0/19 (0%)1.5 (1.1, 2.6)
    T790Mpos4/10 (40%)5.3 (2.3, 7.5)
    T790Munk0/1 (0%)
    T790Mpos/C797Spos2/4 (50%)6.4
EGFR ins 202/4 (50%)5.3

 
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Meeting: 2019 ASCO Annual Meeting Abstract No: 102 First Author: Ferdinandos Skoulidis
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2. Real-world outcomes of patients with advanced non-small cell lung cancer (aNSCLC) and autoimmune disease (AD) receiving immune checkpoint inhibitors (ICIs).

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Meeting: 2019 ASCO Annual Meeting Abstract No: 9000 First Author: Kazuhiko Nakagawa
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