Details

Autor(en) / Beteiligte

• O'Reilly, Eileen M
• Lee, Jonathan W
• Zalupski, Mark
• Capanu, Marinela
• Park, Jennifer
• Golan, Talia
• Tahover, Esther
• Lowery, Maeve A
• Chou, Joanne F
• Sahai, Vaibhav
• Brenner, Robin
• Kindler, Hedy L
• Yu, Kenneth H
• Zervoudakis, Alice
• Vemuri, Shreya
• Stadler, Zsofia K
• Do, Richard K G
• Dhani, Neesha
• Chen, Alice P
• Kelsen, David P

Titel

Randomized, Multicenter, Phase II Trial of Gemcitabine and Cisplatin With or Without Veliparib in Patients With Pancreas Adenocarcinoma and a Germline BRCA/PALB2 Mutation

Ist Teil von

• Journal of clinical oncology, 2020-05, Vol.38 (13), p.1378-1388

Ort / Verlag

United States: American Society of Clinical Oncology

Erscheinungsjahr

2020

Quelle

MEDLINE

Beschreibungen/Notizen

• Five percent to 9% of pancreatic ductal adenocarcinomas (PDACs) develop in patients with a germline or (g +) mutation. Phase IB data from a trial that used cisplatin, gemcitabine, and veliparib treatment demonstrated a high response rate (RR), disease control rate (DCR), and overall survival (OS) in this population. We designed an open-label, randomized, multicenter, two-arm phase II trial to investigate cisplatin and gemcitabine with or without veliparib in g + PDAC. Eligible patients had untreated g PDAC with measurable stage III to IV disease and Eastern Cooperative Oncology Group performance status of 0 to 1. Treatment for patients in arm A consisted of cisplatin 25 mg/m and gemcitabine 600 mg/m intravenously on days 3 and 10; treatment for patients in arm B was the same as that for patients in arm A, and arm A also received veliparib 80 mg orally twice per day on days 1 to 12 cycled every 3 weeks. The primary end point was RRs of arm A and arm B evaluated separately using a Simon two-stage design. Secondary end points were progression-free survival, DCR, OS, safety, and correlative analyses. Fifty patients were evaluated by modified intention-to-treat analysis. The RR for arm A was 74.1% and 65.2% for arm B ( = .55); both arms exceeded the prespecified activity threshold. DCR was 100% for arm A and 78.3% for arm B ( = .02). Median progression-free survival was 10.1 months for arm A (95% CI, 6.7 to 11.5 months) and 9.7 months for arm B (95% CI, 4.2 to 13.6 months; = .73). Median OS for arm A was 15.5 months (95% CI, 12.2 to 24.3 months) and 16.4 months for arm B (95% CI, 11.7 to 23.4 months; = .6). Two-year OS rate for the entire cohort was 30.6% (95% CI, 17.8% to 44.4%), and 3-year OS rate was 17.8% (95% CI, 8.1% to 30.7%). Grade 3 to 4 hematologic toxicities for arm A versus arm B were 13 (48%) versus seven (30%) for neutropenia, 15 (55%) versus two (9%) for thrombocytopenia, and 14 (52%) versus eight (35%) for anemia. Cisplatin and gemcitabine is an effective regimen in advanced g + PDAC. Concurrent veliparib did not improve RR. These data establish cisplatin and gemcitabine as a standard approach in g / + PDAC.