Abstract 4390
Background
Advanced BTC is an aggressive neoplasm with median overall survival (OS) of less than a year with current therapy. There is no approved second line therapy. TAS-102, a combination of the thymidine analog trifluridine, and tipiracil an inhibitor of trifluridine degradation, has shown activity in both fluoropyrimidine sensitive and resistant tumours. We conducted a single arm phase 2 trial to evaluate safety and efficacy of TAS-102 in pts with advanced, refractory BTC.
Methods
Pts of advanced BTC with ECOG PS 0-1 and adequate major organ function, who had progressed on at least one gemcitabine based chemotherapy, were enrolled and treated with TAS-102 at a dose of 35 mg/m2 BID on days 1-5 and 8-12 of a 28-day cycle until disease progression or unacceptable toxicity. The primary endpoint was 16-week progression-free survival (PFS) rate, defined as number of pts who are progression-free and alive at 16 weeks since registration (success) divided by the number of evaluable pts. Using a single stage binomial design, this study required 25 evaluable pts to compare a PFS rate at 16 weeks of 10% (null) versus 30% (alternative) with one-sided alpha of 0.05 and 80% power. Among the first 25 evaluable pts, 6 or more successes were needed for the regimen to be considered for further investigation. Secondary objectives included assessment of safety and tolerability, OS, response rate, and PFS.
Results
From 10/2017 to 8/2018, 28 pts were enrolled, of which 53.6 % pts were male and median age was 61.5 years (range: 46-77). 27 pts were evaluable for endpoint (1 patient did not start any treatment). PFS rate at 16 weeks was 9/27 [33.3%; 95% confidence interval (95% CI): 16.5-54.0 %]. Median (95% CI) PFS and OS were 3.9 (2.0 – 6.7) and 6.8 (5.8 – 12.3) months, respectively. The median number of treatment cycles was 3 (range: 1-8). Best response seen in this cohort was stable disease (13/27 pts). The most common grade 3 or worse adverse events were neutrophil count decreased (44.4%), anemia (22.2%), alkaline phosphate increased (22.2%), blood bilirubin increased (18.5%), and white blood cell decreased (18.5%) without any unexpected safety signals.
Conclusions
Treatment of advanced refractory BTC pts with TAS-102 demonstrated antitumor activity with acceptable toxicity.
Clinical trial identification
NCT03278106.
Editorial acknowledgement
Legal entity responsible for the study
Amit Mahipal.
Funding
Eisai.
Disclosure
All authors have declared no conflicts of interest.
Resources from the same session
1452 - RBP-Jκ in colon cancer cells facilitates tumor associated macrophages (TAMs)-induced cell metastasis by secreting CXCL11
Presenter: Meng jie Liu
Session: Poster Display session 2
Resources:
Abstract
2786 - Development of a living organoid biobank derived from colorectal cancer patients: towards personalized medicine
Presenter: Federica Papaccio
Session: Poster Display session 2
Resources:
Abstract
3351 - Microsatellite Instability Detection in Colorectal Cancer: 44-Center Comparison between the Idylla MSI Assay and Routine Molecular and Immunohistochemistry Tests on Formalin-Fixed Paraffin-Embedded Tissue
Presenter: Xavier Matias-guiu
Session: Poster Display session 2
Resources:
Abstract
4901 - Expression profile of EPHB3 and its prognostic significance in colorectal cancer progression (Running head: Prognostic value of EPHB3 in colorectal cancers)
Presenter: Bogun Jang
Session: Poster Display session 2
Resources:
Abstract
5030 - A pan-ErbB family inhibitor, AF8c, promotes apoptosis by DR5/Nrf2 activation via ROS in colorectal cancer cells
Presenter: Soyeon Jeong
Session: Poster Display session 2
Resources:
Abstract
5053 - Frequent BRAF, GNAS and SMAD4 mutations identified in Colorectal Mucinous Carcinomas
Presenter: Sun Mi Lee
Session: Poster Display session 2
Resources:
Abstract
5220 - Impact of CCL4 knockout using CRISPR Cas-9 technology on colorectal tumor progression
Presenter: Roba Barakat
Session: Poster Display session 2
Resources:
Abstract
5330 - Independent clinical validation of a gene expression profile to predict benefit of 5-FU in metastatic colorectal cancer
Presenter: Ida Buhl
Session: Poster Display session 2
Resources:
Abstract
5515 - WRN mutated Colorectal Cancer (CRC) is characterized by a distinct molecular and immunological profile
Presenter: Andreas Seeber
Session: Poster Display session 2
Resources:
Abstract
5716 - Mutation analysis of B2M gene in colorectal cancer patients with microsatellite instability
Presenter: Ivana Kašubová
Session: Poster Display session 2
Resources:
Abstract