Trabectedin plus Durvalumab in Patients with Advanced Pretreated Soft Tissue Sarcoma and Ovarian Carcinoma (TRAMUNE): An Open-Label, Multicenter Phase Ib Study.


Journal

Clinical cancer research : an official journal of the American Association for Cancer Research
ISSN: 1557-3265
Titre abrégé: Clin Cancer Res
Pays: United States
ID NLM: 9502500

Informations de publication

Date de publication:
02 05 2022
Historique:
received: 20 06 2021
revised: 12 09 2021
accepted: 20 12 2021
pubmed: 31 12 2021
medline: 4 5 2022
entrez: 30 12 2021
Statut: ppublish

Résumé

Trabectedin has shown preclinical synergy with immune checkpoint inhibitors in preclinical models. TRAMUNE is a phase Ib study investigating the combination of trabectedin with durvalumab through a dose escalation phase and two expansion cohorts, soft tissue sarcoma (STS) and ovarian carcinoma. Trabectedin was given at three dose levels (1 mg/m2, 1.2 mg/m2, and 1.5 mg/m2) on day 1, in combination with durvalumab, 1,120 mg on day 2, every 3 weeks. The primary endpoints were the recommended phase II dose (RP2D) of trabectedin combined with durvalumab and the objective response rate (ORR) as per RECIST 1.1. The secondary endpoints included safety, 6-month progression-free rate (PFR), progression-free survival (PFS), overall survival, and biomarker analyses. A total of 40 patients were included (dose escalation, n = 9; STS cohort, n = 16; ovarian carcinoma cohort, n = 15, 80% platinum resistant/refractory). The most frequent toxicities were grade 1-2 fatigue, nausea, neutropenia, and alanine/aspartate aminotransferase increase. One patient experienced a dose-limiting toxicity at dose level 2. Trabectedin at 1.2 mg/m2 was selected as the RP2D. In the STS cohort, 43% of patients experienced tumor shrinkage, the ORR was 7% [95% confidence interval (CI), 0.2-33.9], and the 6-month PFR was 28.6% (95% CI, 8.4-58.1). In the ovarian carcinoma cohort, 43% of patients experienced tumor shrinkage, the ORR was 21.4% (95% CI, 4.7-50.8), and the 6-month PFR was 42.9% (95% CI, 17.7-71.1). Baseline levels of programmed death-ligand 1 expression and CD8-positive T-cell infiltrates were associated with PFS in patients with ovarian carcinoma. Combining trabectedin and durvalumab is manageable. Promising activity is observed in patients with platinum-refractory ovarian carcinoma. See related commentary by Digklia et al., p. 1745.

Identifiants

pubmed: 34965951
pii: 1078-0432.CCR-21-2258
doi: 10.1158/1078-0432.CCR-21-2258
doi:

Substances chimiques

Antibodies, Monoclonal 0
durvalumab 28X28X9OKV
Trabectedin ID0YZQ2TCP

Banques de données

ClinicalTrials.gov
['NCT03475953']

Types de publication

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

Langues

eng

Sous-ensembles de citation

IM

Pagination

1765-1772

Commentaires et corrections

Type : CommentIn
Type : CommentOn

Informations de copyright

©2021 American Association for Cancer Research.

Auteurs

Maud Toulmonde (M)

Department of Medicine, Institut Bergonié, Bordeaux, France.

Mehdi Brahmi (M)

Department of Medicine, Centre Léon Bérard, Lyon, France.

Antoine Giraud (A)

Clinical and Epidemiologic Research Unit, INSERM Clinical Investigation Centre, Institut Bergonié, Bordeaux, France.

Camille Chakiba (C)

Department of Medicine, Institut Bergonié, Bordeaux, France.

Alban Bessede (A)

Explicyte, Bordeaux, France.

Michèle Kind (M)

Department of Imaging, Institut Bergonié, Bordeaux, France.

Emilie Toulza (E)

Pharmacovigilance Unit, Institut Bergonié, Bordeaux, France.

Marina Pulido (M)

Clinical and Epidemiologic Research Unit, INSERM Clinical Investigation Centre, Institut Bergonié, Bordeaux, France.

Sabrina Albert (S)

Clinical and Epidemiologic Research Unit, INSERM Clinical Investigation Centre, Institut Bergonié, Bordeaux, France.

Jean-Philippe Guégan (JP)

Explicyte, Bordeaux, France.

Sophie Cousin (S)

Department of Medicine, Institut Bergonié, Bordeaux, France.

Simone Mathoulin-Pelissier (S)

Clinical and Epidemiologic Research Unit, INSERM Clinical Investigation Centre, Institut Bergonié, Bordeaux, France.

Raul Perret (R)

Department of Pathology, Institut Bergonié, Bordeaux, France.

Sabrina Croce (S)

Department of Pathology, Institut Bergonié, Bordeaux, France.

Jean-Yves Blay (JY)

Department of Medicine, Centre Léon Bérard, Lyon, France.

Isabelle Ray-Coquard (I)

Department of Medicine, Centre Léon Bérard, Lyon, France.

Anne Floquet (A)

Department of Medicine, Institut Bergonié, Bordeaux, France.

Antoine Italiano (A)

Department of Medicine, Institut Bergonié, Bordeaux, France.
Faculty of Medicine, University of Bordeaux, Bordeaux, France.

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