Abstract 2586
Background
BTK is a key regulator in B-cell receptor-mediated signaling and its inhibition blocks several B-cell functions. Small molecule BTKi have been approved for the treatment of B-cell malignancies, such as resistant/refractory chronic lymphocytic leukemia (CLL), mantle cell lymphoma (MCL), and Waldenström’s macroglobulinemia (WM). M7583 is a potent, highly selective BTKi, under investigation in a two-part, phase I/II trial (NCT02825836) in patients (pts) with refractory/resistant B cell malignancies.
Methods
In Part 1 (dose escalation), pts with refractory/resistant B cell malignancies received 28-day cycles of once-daily (QD) M7583, starting at 80 mg for 3 days followed by 160 mg with doses increasing according to an adaptive Bayesian design. Part 2 (dose expansion) will be in pts with diffuse large B cell lymphoma (DLBCL; activated B-cell subtype) or MCL who have failed 1–3 lines of therapy. Safety and tumor response (investigator’s assessment according to Cheson/CLL/Owen criteria) are presented.
Results
As of 27/02/18, in Part 1, 14 pts have been enrolled into the first 4 dose levels (80/160 mg, 300 mg and 600 mg QD and 300 mg twice daily [BID]): 10 men, 4 women; age, 49–80 years; WM (n = 4), MCL (n = 6), marginal zone lymphoma (n = 2), CLL (n = 1), or DLBCL (n = 1). Treatment-emergent adverse events (TEAEs) were mainly mild to moderate in intensity with no dose-limiting toxicities reported. Six pts have had a total of 8 grade ≥3 TEAEs; only 1 TEAE was considered related to treatment (grade 4 neutropenia). One pt had 2 serious TEAEs (chest pain and fever) and 1 pt died (extensive progressive disease, cycle 1). Clinical benefit (stable disease [SD], complete [CR], minor [MR] or partial response [PR]) was observed in 12/14 pts: 6/6 pts who received 160 mg or 300 mg QD (3 PR, 1 MR, 2 SD), 3/5 pts treated with 600 mg QD (1 CR, 1 PR, 1 MR) and 3/3 pts on 300 mg BID (2 PR, 1 SD). Study is ongoing.
Conclusions
M7583 has been well tolerated with evidence of clinical benefit at all the doses investigated. M7583 appears to have a favorable benefit: risk profile.
Clinical trial identification
NCT02825836.
Legal entity responsible for the study
Merck KGaA, Darmstadt, Germany.
Funding
Merck KGaA, Darmstadt, Germany.
Editorial Acknowledgement
Provided by Helen Swainston of Bioscript Group, Macclesfield, UK.
Disclosure
W. Jurczak: Advisory board: Sandoz Novartis, Roche, Janssen, Acerta, Abbvie, TG Therapeutics, Teva, Takeda, Spectrum, NovoNordisk, Mundipharma; Research funding: Celgene, Abbvie, Gilead, TG Therapeutics, Janssen, Acerta, Merck, Begene, Pharmacyclics, Pfizer, Roche, Sandoz – Novartis, Takeda, Teva, Servier. S. Rule: Consultancy/honoraria: Janssen, Roche, Astra-Zeneca, Celgene, Pharmacyclics, Gilead, Sunesis, TG Therapeutics, Napp, Kite; Research funding: Janssen, Roche; Travel, accommodation and expenses: Janssen, Roche. W. Townsend: Consultancy/honoraria: Roche, Gilead. B. Sarholz, J. Scheele: Employment: Merck KGaA. J. Gribben: Honoraria: Genentech/Roche, Abbvie, Acerta, Janssen, Celgene, TG Therapeutics, Kite, Karyopharm, AstraZeneca, Gilead, Novartis. P.L. Zinzani: Honoraria: Roche, Celgene, Gilead, J and J, BMS, Karyopharma, Millenium Pharmaceuticals, Bayer, Verastem, Merck, Servier; Advisory committee/board: Roche, Celgene, Gilead, J and J, BMS, Karyopharma, Millenium Pharmaceuticals, Bayer, Verastem, Merck, Servier. All other authors have declared no conflicts of interest.