Vemurafenib in non-small-cell lung cancer patients with BRAF


Journal

Annals of oncology : official journal of the European Society for Medical Oncology
ISSN: 1569-8041
Titre abrégé: Ann Oncol
Pays: England
ID NLM: 9007735

Informations de publication

Date de publication:
02 2020
Historique:
received: 17 06 2019
revised: 08 10 2019
accepted: 20 10 2019
entrez: 22 1 2020
pubmed: 22 1 2020
medline: 7 1 2021
Statut: ppublish

Résumé

BRAF mutations occurring in 1%-5% of patients with non-small-cell lung cancer (NSCLC) are therapeutic targets for these cancers but the impact of the exact mutation on clinical activity is unclear. The French National Cancer Institute (INCA) launched the AcSé vemurafenib trial to assess the efficacy and safety of vemurafenib in cancers with various BRAF mutations. We herein report the results of the NSCLC cohort. Tumour samples were screened for BRAF mutations in INCA-certified molecular genetic centres. Patients with BRAF-mutated tumours progressing after ≥1 line of treatment were proposed vemurafenib 960 mg twice daily. Between October 2014 and July 2018, 118 patients were enrolled in the NSCLC cohort. The primary outcome was the objective response rate (ORR) assessed every 8 weeks (RECIST v1.1). A sequential Bayesian approach was planned with an inefficacy bound of 10% for ORR. If no early stopping occurred, the treatment was of interest if the estimated ORR was ≥30% with a 90% probability. Secondary outcomes were tolerance, response duration, progression-free survival (PFS), and overall survival (OS). Of the 118 patients enrolled, 101 presented with a BRAF Routine biomarker screening of NSCLC should include BRAF ClinicalTrials.gov identifier: NCT02304809.

Sections du résumé

BACKGROUND
BRAF mutations occurring in 1%-5% of patients with non-small-cell lung cancer (NSCLC) are therapeutic targets for these cancers but the impact of the exact mutation on clinical activity is unclear. The French National Cancer Institute (INCA) launched the AcSé vemurafenib trial to assess the efficacy and safety of vemurafenib in cancers with various BRAF mutations. We herein report the results of the NSCLC cohort.
PATIENTS AND METHODS
Tumour samples were screened for BRAF mutations in INCA-certified molecular genetic centres. Patients with BRAF-mutated tumours progressing after ≥1 line of treatment were proposed vemurafenib 960 mg twice daily. Between October 2014 and July 2018, 118 patients were enrolled in the NSCLC cohort. The primary outcome was the objective response rate (ORR) assessed every 8 weeks (RECIST v1.1). A sequential Bayesian approach was planned with an inefficacy bound of 10% for ORR. If no early stopping occurred, the treatment was of interest if the estimated ORR was ≥30% with a 90% probability. Secondary outcomes were tolerance, response duration, progression-free survival (PFS), and overall survival (OS).
RESULTS
Of the 118 patients enrolled, 101 presented with a BRAF
CONCLUSION
Routine biomarker screening of NSCLC should include BRAF
TRIAL REGISTRATION
ClinicalTrials.gov identifier: NCT02304809.

Identifiants

pubmed: 31959346
pii: S0923-7534(19)36079-X
doi: 10.1016/j.annonc.2019.10.022
pii:
doi:

Substances chimiques

Vemurafenib 207SMY3FQT
BRAF protein, human EC 2.7.11.1
Proto-Oncogene Proteins B-raf EC 2.7.11.1

Banques de données

ClinicalTrials.gov
['NCT02304809']

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

289-294

Informations de copyright

Copyright © 2019 The Authors. Published by Elsevier Ltd.. All rights reserved.

Auteurs

J Mazieres (J)

Thoracic Oncology Unit, IFCT (Intergroupe Français de Cancérologie Thoracique), Respiratory Disease Department, Larrey Hospital, CHU Toulouse, Université Paul Sabatier, Toulouse, France. Electronic address: mazieres.j@chu-toulouse.fr.

C Cropet (C)

Direction of Clinical Research and Innovation, Biostatistics Department, Centre Léon Bérard, Lyon, France.

L Montané (L)

Direction of Clinical Research and Innovation, Biostatistics Department, Centre Léon Bérard, Lyon, France.

F Barlesi (F)

Multidisciplinary Oncology & Therapeutic Innovations Department, IFCT, Aix-Marseille University, CNRS, INSERM, CRCM, APHM, Marseille, France.

P J Souquet (PJ)

Thoracic Oncology Department, IFCT, Hospices Civils de Lyon, CH Lyon Sud, Pierre Bénite, France.

X Quantin (X)

Respiratory Diseases Department, Hôpital Arnaud de Villeneuve, Montpellier, France.

C Dubos-Arvis (C)

Pneumology Department, Centre François Baclesse, Caen, France.

J Otto (J)

Department of Medicine, Centre Antoine Lacassagne, Nice, France.

L Favier (L)

Oncology Department, Centre Georges François Leclerc, Dijon, France.

V Avrillon (V)

Centre Léon Bérard & Centre de Recherche en Cancérologie de Lyon & Université Claude Bernard Lyon I, Lyon, France.

J Cadranel (J)

Pneumology Department, IFCT, Hôpital Tenon APHP and GRC #4 Theranoscan, Sorbonne Université, Paris, France.

D Moro-Sibilot (D)

IFCT, University Pneumology Clinic, Pôle Thorax et Vaisseaux, CHU Grenoble Alpes, Grenoble, France.

I Monnet (I)

Pneumology Department, Centre Hospitalier Intercommunal, Créteil, France.

V Westeel (V)

Pneumology Department, IFCT, Hôpital Jean Minjoz, CHU Besançon, Besançon, France.

J Le Treut (J)

Respiratory Diseases Department, Centre Hospitalier Intercommunal Aix Pertuis, Aix en Provence, France.

E Brain (E)

Department of Medical Oncology, Institut Curie/Saint-Cloud, Saint-Cloud, France.

J Trédaniel (J)

Groupe Hospitalier Paris Saint Joseph, Université Paris Descartes, Sorbonne Paris Cité Unité INSERM UMR-S 1124, Paris, France.

M Jaffro (M)

Radiology and Medical Imagery Department, Hôpital Rangueil-Larrey, CHU Toulouse, Toulouse, France.

S Collot (S)

Radiology and Medical Imagery Department, Hôpital Rangueil-Larrey, CHU Toulouse, Toulouse, France.

G R Ferretti (GR)

Radiology and Medical Imagery Department, CHU Grenoble Alpes & Université Grenoble Alpes, Grenoble, France.

C Tiffon (C)

French National Cancer Institute, Boulogne-Billancourt, France.

C Mahier-Ait Oukhatar (C)

Research and Development UNICANCER, Paris, France.

J Y Blay (JY)

Centre Léon Bérard, Centre de Recherche en Cancérologie de Lyon, LYRICAN (NCa_INSERM_DGOS_12563), Université Claude Bernard Lyon I, Lyon, France.

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Classifications MeSH