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Outcome of BRCA 1/2-Mutated (BRCA+) and triple-negative, BRCA wild type (BRCA-wt) breast cancer patients in a phase I study of single-agent veliparib (V).
General Poster Session B: Risk Assessment, Prevention, Early Detection, Screening, and Systemic Therapy
Background: Veliparib (V) (ABT-888) is an oral, potent inhibitor of PARP 1/2. PARP inhibitors have preclinical and clinical efficacy in BRCA+ malignancies. There are genotypic and phenotypic similarities between BRCA+ cancers, serous ovarian cancer and basal-like breast cancer and we postulated that these tumors types may be similarly sensitive to single-agent PARP inhibition. This study sought to establish the maximum tolerated dose (MTD), dose -limiting toxicities (DLT), pharmacokinetic and pharmocodynamic properties, and preliminary efficacy of chronically-dosed V in 2 cohorts of patients, BRCA+ and BRCA-wt (consisting of serous ovarian cancer and triple-negative breast cancer (TNBC). Methods: A 3+3 dose escalation phase I trial was performed. Nine dose levels (DL) were planned, and dose escalation started at 50 mg BID to a maximum of 500 mg BID to determine a maximum tolerated dose (MTD) and recommended phase II dose (RP2D). V was administered orally continuously on a 28 day cycle. BRCA+ and BRCA-wt patients were enrolled in 2 separate cohorts with 2 separate escalations. Results: 98 (70 BRCA+ and 28 BRCA-wt) pts have been enrolled. The maximum administered dose (MAD) was 500mg BID and the MTD/RP2D is 400mg BID for both cohorts. 59 BRCA+ pts and 24 BRCA-wt pts (21 TNBC and 3 ovary) were evaluable for response. ORR was defined as CR+PR and clinical benefit rate (CBR) as CR+PR+SD > 6 months. Results are summarized in the table. Conclusions: There is evidence of anti-tumor activity with V comparable to that of other PARP inhibitors in the BRCA+ population. There was indication of dose responsiveness with greater activity in this population at higher doses. There is less activity in the mostly TNBC, BRCA-wt population, although there was evidence of benefit in a small number of patients. Ongoing tissue correlative studies will help to identify potential mechanisms of sensitivity and resistance. Clinical trial information: NCT00892736.
|Total ORR||RP2D/MAD ORR||Total CBR||RP2D/MAD CBR|
|All tumor types: BRCA+||14/59 = 24%||13/35 = 37%||33/59 = 56%||22/35 = 63%|
|BRCA+ breast cancer||4/14 = 29%||3/5 = 60%||8/14 = 57%||4/5 = 80%|
|All tumor types: BRCA-wt||1/24 = 4%||0/5 = 0%||4/24 = 17%||0/5 = 0%|
|BRCA-wt breast cancer||1/21 = 5%||0/4 = 0%||4/21 = 19%||0/4 = 0%|
Abstracts by Shalu Pahuja:
Preliminary activity of veliparib (V) in BRCA2-mutated metastatic castration-resistant prostate cancer (mCRPC).Meeting: 2015 Genitourinary Cancers Symposium | Abstract No: 170
A phase I study of veliparib (ABT-888) in combination with weekly carboplatin and paclitaxel in advanced solid malignancies and enriched for triple-negative breast cancer (TNBC).Meeting: 2015 ASCO Annual Meeting | Abstract No: 1015
- Meeting: 2015 ASCO Annual Meeting | Abstract No: e17626