Abstract 1955
Background
Niraparib is a highly selective PARP-1/-2 inhibitor approved by FDA for the maintenance therapy of platinum-sensitive recurrent (PSR) ovarian cancer based on the significantly improved progression-free survival for niraparib-treated patients (pts) in the phase III NOVA study. A retrospective analysis of NOVA study suggests that pts with BW <77 kg or baseline plt count <150*109/L may have an improved safety profile from a starting dose of 200 mg once daily (QD) without compromising efficacy. A double-blinded, 2:1 randomized, placebo-controlled phase III study (NORA) is being conducted in China to investigate niraparib as maintenance therapy in Chinese pts with PSR ovarian cancer. The dosing regimen in the study was 300 mg QD but the study protocol was subsequently amended to have a starting dose of either 300 or 200 mg of niraparib/placebo QD based on baseline BW and plt counts. The trial has completed accrual and remains blinded for efficacy and safety. The current analysis was intended to evaluate niraparib tolerability for pts starting treatment with an individualized starting dose and compare with that in pts with the fixed starting dose of 300 mg QD.
Methods
The initial protocol adopted a fixed starting dose of 300 mg QD. After 16 patients were enrolled, the protocol was amended to start niraparib treatment at a dose of 200 mg QD in pts with BW <77 kg or plt count <150*109/L, and 300 mg for others. Blinded data were pooled from niraparib and placebo arms.
Results
A total of 265 pts had been enrolled, and 232 pts who have been followed up ≥ 90 days ending Mar 31, 2019 were included in this analysis. There were no major differences in key pts demographics or disease characteristics between both arms. Key safety data are presented in the table. More detailed safety data in all population will be disclosed.Table: 1004P
Pre-Amendment, Fixed starting dose (pooled niraparib and placebo arms) | Post-Amendment, Individualized starting dose (pooled niraparib and placebo arms ) | |||
---|---|---|---|---|
300 mg (N = 16) | 300 mg (N = 14) | 200 mg (N = 202) | Total (N = 216) | |
Median BW, kg (min, max) | 62 (40,76) | 83 (78,94) | 59 (37,82) | 61 (37,94) |
Median plt count,109/L (min, max) | 211 (124,336) | 187(153,325) | 184 (62,447) | 184 (62,447) |
Any ≥ grade 3 TEAE, n(%) | 9 (56.3) | 4 (28.6) | 56 (27.7) | 60 (27.8) |
≥Grade 3 thrombocytopenia, n(%) | 3 (13.8) | 1 (7.1) | 6 (3.0) | 7 (3.2) |
≥Grade 3 anemia, n(%) | 4 (25.0) | 2 (14.3) | 9 (4.5) | 11 (5.1) |
≥Grade 3 neutropenia, n(%) | 2 (12.5) | 0 | 25 (12.4) | 25 (11.6) |
Any serious TEAE, n(%) | 4 (25.0) | 1 (7.1) | 19 (9.4) | 20 (9.3) |
TEAE leading to end of treatment, n (%) | 1 (6.3) | 0 | 3 (1.5) | 3 (1.4) |
Conclusions
The results indicate that niraparib tolerability will be improved with a starting dose based on body weight or platelet count.
Clinical trial identification
NCT03705156.
Editorial acknowledgement
Jun Wan and John Zhang of Zai Lab Writing and coordinated by Sean Li and Wendy Zhang of Zai Lab, Inc, funded by Zai Lab, Inc. (Shanghai,China).
Legal entity responsible for the study
Zai Lab (Shanghai) Co., Ltd.
Funding
Zai Lab (Shanghai) Co., Ltd.
Disclosure
J. Hou: Full / Part-time employment: Zai Lab (Shanghai) Co., Ltd C. Zhang: Full / Part-time employment: Zai Lab (Shanghai) Co., Ltd Y. Hei: Full / Part-time employment: Zai Lab (Shanghai) Co., Ltd. All other authors have declared no conflicts of interest.
Resources from the same session
4546 - Efficacy and toxicity of weekly carboplatin and paclitaxel as induction or palliative treatment in advanced esophageal cancer patients
Presenter: Femke de Man
Session: Poster Display session 2
Resources:
Abstract
5908 - Perioperative chemotherapy with Docetaxel, Oxaliplatin, Fluorouracil and Leucovorin (FLOT) versus Epirubicin, Platinum and Capecitabine or Flourouracil (EOX/ECF) in Resectable Gastric or Gastroesophageal Junction Adenocarcinoma- Safety and response data from India.
Presenter: Tanuj Chawla
Session: Poster Display session 2
Resources:
Abstract
937 - Phase II Study of Preoperative Radiotherapy Combined with S-1 plus Cisplatin in Clinically Resectable Type 4 or Large Type 3 Gastric Cancer: OGSG1205
Presenter: Shunji Endo
Session: Poster Display session 2
Resources:
Abstract
1119 - Observational Study of the Peritoneal Washing Cytology Positive Gastric Cancer without Gross Peritoneal Metastasis Underwent Radical D2 Gastrectomy.
Presenter: Jun Eul Hwang
Session: Poster Display session 2
Resources:
Abstract
3744 - Primary results of multicenter phase II study of neoadjuvant chemotherapy with S-1 and oxaliplatin for locally advanced gastric cancer (Neo G-SOX PII)
Presenter: Akira Miki
Session: Poster Display session 2
Resources:
Abstract
5091 - Multicenter Phase I/II Feasibility Study of Adjuvant Treatment with S-1 in Patients after R0-Resection of Adenocarcinoma of the Stomach and Esophagogastric Junction (GMBH-STO-0114)
Presenter: Kathrin Heinrich
Session: Poster Display session 2
Resources:
Abstract
2891 - A phase I study of Docetaxel/Oxaliplatin/S-1 (DOS) combination neoadjuvant chemotherapy for patients with locally advanced adenocarcinoma of the esophagogastric junction
Presenter: Kei Hosoda
Session: Poster Display session 2
Resources:
Abstract
2994 - Apatinib combined with docetaxel in second-line treatment of advanced gastric cancer: a prospective clinical study (Data updated)
Presenter: Mudan Yang
Session: Poster Display session 2
Resources:
Abstract
3000 - A multicenter phase II study of TAS-114 in combination with S-1 in patients with pre-treated advanced gastric cancer (EPOC1604)
Presenter: Daisuke Takahari
Session: Poster Display session 2
Resources:
Abstract
4653 - Impact of Pembrolizumab (pembro) Versus Paclitaxel on Health-Related Quality of Life (HRQoL) in Patients With Advanced Gastric or Gastroesophageal Junction (GEJ) Cancer That Has Progressed After First-Line Chemotherapy (KEYNOTE-061)
Presenter: Eric Van Cutsem
Session: Poster Display session 2
Resources:
Abstract