Randomized phase 2 study of investigational aurora A kinase (AAK) inhibitor alisertib (MLN8237) + paclitaxel (P) vs placebo + P as second line therapy for small-cell lung cancer (SCLC)

Background

Alisertib, a selective AAK inhibitor, showed single-agent antitumor activity in preclinical in vivo SCLC models and was synergistic with P in this setting. We report the efficacy (PFS, OS, ORR) and safety from this study.

Methods

Pts ≥18 y with SCLC relapsed

Results

178 pts were randomized (89/89) Arm A/B; median age 62/62 y. The analysis of PFS using IVRS stratification favored Arm A (median 101 vs 66 d) with HR 0.77; 95% CI 0.557, 1.067; p = 0.113. The analysis for PFS using the corrected stratification factors again favored Arm A with HR 0.72; 95% CI 0.522, 1.004; p = 0.038. Median OS was 186 vs 165 d, with HR 0.93; 95% CI 0.652, 1.341; p = 0.714 and ORR was 22% vs 18%, disease control rate 58% vs 46%, stable disease 55% vs 49%, and progressive disease 15% vs 26%. Pts received a median of 3 (1–9) vs 2 (1–11) cycles. Rates of AEs were higher in Arm A.

Safety population

Conclusions

Alisertib + P shows favorable PFS over placebo + P with both corrected and IVRS stratification. A similar favorable trend was observed for OS and ORR. The alisertib + P arm showed higher rates of AEs and discontinuation due to AEs. Further analyses are pending.

Clinical trial identification

NCT02038647; EudraCT 2013-003713-18 (Clinical Trial Protocol C14018 Protocol Amend 2 2015-01-23)

Legal entity responsible for the study

Millennium Pharmaceuticals, Inc.

Funding

Millennium Pharmaceuticals Inc., a wholly owned subsidiary of Takeda Pharmaceutical Company Limited

Disclosure

T.K. Owonikoko: Consulting: Medivation, Novartis, Lilly, Amgen; Research funding: Novartis, Stemcentrix, BMS, Celgene, AstraZeneca, Takeda, Regeneron, G1 Therapeutics, Calithera, AbbVie. E. Sheldon-Waniga, D. Huebner: Employment (Millennium Pharmaceuticals, Inc., a wholly owned subsidiary of Takeda Pharmaceutical Company Limited). E.J. Leonard: Employment (Millennium Pharmaceuticals, Inc., a wholly owned subsidiary of Takeda Pharmaceutical Company Limited); stock ownership: Takeda Pharmaceutical Company Limited; Corporate-sponsored research: Takeda-sponsored clinical trial. All other authors have declared no conflicts of interest.