1481PD - Efficacy and Safety of Palbociclib in Patients With Advanced Gastrointestinal Stromal Tumors Refractory to Imatinib and Sunitinib

Date 11 September 2017
Event ESMO 2017 Congress
Session Sarcoma
Topics Anti-Cancer Agents & Biologic Therapy
Cancer in Adolescents
GIST
Sarcoma
Presenter Antoine Italiano
Citation Annals of Oncology (2017) 28 (suppl_5): v521-v538. 10.1093/annonc/mdx387
Authors A. Italiano1, A. Adenis2, J. Blay3, F. Duffaud4, M. Rios5, E. Bompas6, O. Bouche7, M. Pulido8, A. Le Cesne9
  • 1Medical Oncology, Institute Bergonié, 33076 - Bordeaux/FR
  • 2Medical Oncology, Centre Oscar Lambret, 59020 - Lille/FR
  • 3Medical Oncology, Centre Leon Berard, 69008 - Lyon/FR
  • 4Oncology, CHU La Timone Adultes, 13385 - Marseille/FR
  • 5Med, Institut de Cancérologie de Lorraine - Alexis Vautrin, 54519 - Vandoeuvre les Nancy/FR
  • 6Medical Oncology, ICO Institut de Cancerologie de l'Ouest René Gauducheau, 44805 - Saint-Herblain/FR
  • 7Oncology, CHU de Reims - Hôpital Robert Debré, 51092 - Reims/FR
  • 8Biostatistics, Institute Bergonié, 33076 - Bordeaux/FR
  • 9Department Of Medical Oncology, Gustave Roussy Cancer Campus, 94805 - Villejuif/FR

Abstract

Background

p16/CDKN2A loss play a crucial role in GIST progression. Therapeutic options after progression to imatinib and sunitinib are limited. Palbociclib, an oral small-molecule inhibitor of cyclin-dependent kinases 4 and 6, was recently approved for postmenopausal women with advanced hormone receptor–positive, her2-negative breast cancer. Preclinical studies show that palbociclib inhibits the cell cycle and growth in cells with decreased p16.

Methods

This is a multicenter single-arm phase 2 clinical trial based on 2-stage Simon’s design which assesses safety and efficacy of palbociclib in patients (pts) with advanced GIST having failed at least on imatinib and sunitinib and with CDKN2A loss assessed by CGH array. All pts had to have documented progressive disease (PD) as per RECIST 1.1 before study entry. Pts receive palbocilcib 150mg day 1-day 21 (oral route), daily until PD or unacceptable toxicity. The primary endpoint is the 4-month non-PD rate according to RECIST 1.1. Based on the following hypotheses: 25% 4-month non-PD rate (H0), 45% acceptable 4-month non-PD rate (H1), 5% type I error rate, 90% power, a total of 57 assessable pts are necessary (22 for the first stage + 25 for the second stage). Following the inclusion of the first 22 pts, if ≥ 7 pts are progression-free at 4 months, the accrual will continue. In order to account for not assessable pts (+/- 10%), 63 pts will be of the French Sarcoma Group.

Results

As of May 2017, 72 pts (52 males, 20 females) have been included in the study. Median age is 66.0 years out of the first 22 first evaluable patients had progressive disease at 4 months indicating that palbocicilib had not reached the primary endpoint to justify continuing accrual after the 1st step of the study.

Conclusions

Palbociclib has no significant activity as a single agent in advanced GIST with p16/CDKN2A loss. Prognostic value of CDKN2A loss in the whole population will be presented at the meeting.

Clinical trial identification

NCT01907607

Legal entity responsible for the study

Institut Bergonié

Funding

INCA

Disclosure

All authors have declared no conflicts of interest.