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Proffered paper session - NETs and endocrine tumours

3442 - Activity & Safety of Spartalizumab (PDR001) in Patients (pts) With Advanced Neuroendocrine Tumors (NET) of Pancreatic (Pan), Gastrointestinal (GI), or Thoracic (T) Origin, & Gastroenteropancreatic Neuroendocrine Carcinoma (GEP NEC) Who Have Progressed on Prior Treatment (Tx)

Date

22 Oct 2018

Session

Proffered paper session - NETs and endocrine tumours

Presenters

James Yao

Citation

Annals of Oncology (2018) 29 (suppl_8): viii467-viii478. 10.1093/annonc/mdy293

Authors

J.C. Yao1, J. Strosberg2, N. Fazio3, M.E. Pavel4, P. Ruszniewski5, E. Bergsland6, D. Li7, S. Tafuto8, N. Raj9, D. Campana10, S. Hijioka11, M. Raderer12, R. Guimbaud13, P. Gajate14, S. Pusceddu15, A. Reising16, E. Degtyarev17, B. Mookerjee18, P. Aimone19, S. Singh20

Author affiliations

  • 1 Department Of Gastrointestinal Medical Oncology, University of Texas/MD Anderson Cancer Center, 77030-4095 - Houston/US
  • 2 Department Of Medicine, Moffitt Cancer Center, Tampa, 33612 - Florida/US
  • 3 Unit Of Gastrointestinal Medical Oncology And Neuroendocrine Tumors, European Institute of Oncology, 20141 - Milan/IT
  • 4 Department Of Endocrinology, University of Erlangen-Nuremberg, 91054 - Erlangen/DE
  • 5 Gastroenterology And Pancreatology Department, Beaujon Hospital, 92110 - Clichy/FR
  • 6 Division Of Hematology/oncology, UCSF Helen Diller Family Comprehensive Cancer Center, San Francisco/US
  • 7 Department Of Medical Oncology & Therapeutics Research, City of Hope Comprehensive Cancer Center and Beckman Research Institute, 91009-91010 - Duarte/US
  • 8 Dipartimento Di Oncologia Addominale, Istituto Nazionale Tumori, IRCCS Fondazione G. Pascale, ENETS Center of Excellence, 80131 - Naples/IT
  • 9 Medical Oncology, Memorial Sloan Kettering Cancer Center, New York, 10065 - New York/US
  • 10 Department Of Medical And Surgical Sciences, Policlinico Sant'Orsola-Malpighi, 40138 - Bologna/IT
  • 11 Department Of Gastroenterology, Aichi Cancer Center Hospital, 464-8681 - Nagoya/JP
  • 12 Clinical Division Of Oncology, Medical University of Vienna, 1090 - Vienna/AT
  • 13 Department Of Digestive Medical Oncology, CHU de Toulouse, Toulouse/FR
  • 14 Clinical Oncology Department, Hospital Universitário Ramón y Cajal, 28001 - Madrid/ES
  • 15 Department Of Medical Oncology, Fondazione IRCCS Istituto Naz, 20133 - Milan/IT
  • 16 Opm Translational Precision Oncology, Novartis Pharmaceuticals Corporation, East Hanover, 07936 - New Jersey/US
  • 17 Oncology Biostatistics, Novartis Pharma AG, Basel/CH
  • 18 Global Drug Development, Novartis Pharmaceuticals Corporation, East Hanover/US
  • 19 Global Drug Development, Novartis Pharma AG, 4056 - Basel/CH
  • 20 Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto/CA
More

Resources

Abstract 3442

Background

PDR001 is a high-affinity, humanized, anti-PD-1 IgG4 antibody that blocks PD-L1 & PD-L2 binding to PD-1. A phase 2, multi-center study assessed the efficacy & safety of PDR001 in pts with nonfunctional well- & poorly-differentiated (diff) neuroendocrine neoplasms.

Methods

Pts with advanced NET (GI, Pan, or T origin) who have progressed on prior Tx (including everolimus), & GEP NEC pts who have progressed on 1 line of chemoTx, were enrolled, regardless of PD-L1 expression. Primary endpoint was overall response rate (central; ORR). Secondary endpoints were duration of response, biomarker analyses & safety.

Results

Total 116 pts enrolled (33 panNET, 32 GI NET, 30 T NET, & 21 GEP NEC). Pts received PDR001 (400 mg, q4w) via 30 min IV infusion until disease progression/unacceptable toxicity. At data snapshot cut-off (Feb 09, 2018) with median follow-up of 7.6 mo in NET and 6 mo in GEP NEC, ORR was 7.4% in well-diff NET (pooled) & 4.8% in poorly-diff GEP NEC. Pts with T NET had higher ORR, while, clinical activity was marginal in other cohorts (Table). Most common grade 3/4 adverse events (>2.5%) regardless of causality were abdominal & back pain, anemia, dyspnea, & hypertension. PD-L1 expression was generally low; GEP NEC pts had a higher proportion of PD-L1 expression in immune cells >1% (43% vs T NET: 19%; panNET: 23%; GI NET: 10%). Biomarker results suggest a potential link between TIM-3 expression & lack of Tx response. Additional biomarker data will be presented.Table: 1308O

T*PGIOverall NET (T+P+GI)GEP NEC
Partial response, %20.03.007.44.8
Stable disease, %53.354.559.455.814.3
Unknown, %10.03.06.36.314.3
Disease control rate, %73.357.659.463.219.0
*

All responses were observed in atypical carcinoid cohort.

Conclusions

These preliminary results suggest clinical activity of spartalizumab in pts with well-diff nonfunctional NET of T origin. Further studies are needed to explore the role of immunotherapy combinations, identifying predictive biomarkers for immunoncology (IO) response or strategies to increase response to IO in this pt population.

Clinical trial identification

NCT02955069.

Legal entity responsible for the study

Novartis Pharmaceuticals Corporation.

Funding

Novartis Pharmaceuticals Corporation.

Editorial Acknowledgement

Disclosure

J.C. Yao: Grants: Novartis, during the conduct of the study; Personal fees: Novartis; Personal fees: Ipsen, outside the submitted work. J. Strosberg: Personal fees: Novartis, Ipsen, Lexicon, outside the submitted work. N. Fazio: Consultation fees: Novartis, Ipsen, Pfizer, AAA, Merck Serono. M.E. Pavel: Personal fees: Novartis, Ipsen, Pfizer, Lexicon, during the conduct of the study. P. Ruszniewski: Personal fees: Ipsen, Novartis, AAA, outside the submitted work. E. Bergsland: Other: Novartis and Merck, during the conduct of the study. D. Li: Personal fees: Novartis, Ipsen, Lexicon, Exelixis, outside the submitted work. M. Raderer: Travel, accommodations, meeting expenses: Roche, Novartis, Ipsen, Jansse Cilag, Amgen. S. Pusceddu: Travel grant, Honoraria, Personal fees: Novartis, Ipsen, Italfarmaco, Pfizer, AAA. A. Reising, P. Aimone: Employee: Novartis. E. Degtyarev: Employee, Personal fee: Novartis, during the conduct of the study. B. Mookerjee: Employee, Stock options: Novartis S. Singh: Honoraria, Travel funding: Ipsen, Pfizer, Novartis; Research funding: EMD Serono, Novartis. All other authors have declared no conflicts of interest.

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