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Phase II Study of Erdafitinib in Patients With Tumors With FGFR Amplifications: Results From the NCI-MATCH ECOG-ACRIN Trial (EAY131) Subprotocol K1.
Gong, Jun; Mita, Alain C; Wei, Zihan; Cheng, Heather H; Mitchell, Edith P; Wright, John J; Ivy, S Percy; Wang, Victoria; Gray, Robert C; McShane, Lisa M; Rubinstein, Larry V; Patton, David R; Williams, P Mickey; Hamilton, Stanley R; Alva, Ajjai S; Tricoli, James V; Conley, Barbara A; Arteaga, Carlos L; Harris, Lyndsay N; O'Dwyer, Peter J; Chen, Alice P; Flaherty, Keith T.
Afiliación
  • Gong J; Cedars-Sinai Medical Center, Los Angeles, CA.
  • Mita AC; Cedars-Sinai Medical Center, Los Angeles, CA.
  • Wei Z; Dana Farber Cancer Institute-ECOG-ACRIN Biostatistics Center, Boston, MA.
  • Cheng HH; University of Washington, Seattle, WA.
  • Mitchell EP; Sidney Kimmel Cancer Center at Thomas Jefferson University, Philadelphia, PA.
  • Wright JJ; Division of Cancer Treatment and Diagnosis, National Cancer Institute, Bethesda, MD.
  • Ivy SP; Division of Cancer Treatment and Diagnosis, National Cancer Institute, Bethesda, MD.
  • Wang V; Dana Farber Cancer Institute-ECOG-ACRIN Biostatistics Center, Boston, MA.
  • Gray RC; Dana Farber Cancer Institute-ECOG-ACRIN Biostatistics Center, Boston, MA.
  • McShane LM; Division of Cancer Treatment and Diagnosis, National Cancer Institute, Bethesda, MD.
  • Rubinstein LV; Division of Cancer Treatment and Diagnosis, National Cancer Institute, Bethesda, MD.
  • Patton DR; Division of Cancer Treatment and Diagnosis, National Cancer Institute, Bethesda, MD.
  • Williams PM; Frederick National Laboratory for Cancer Research, Bethesda, MD.
  • Hamilton SR; City of Hope Comprehensive Cancer Center, Duarte, CA.
  • Alva AS; University of Michigan Comprehensive Cancer Center, Ann Arbor, MI.
  • Tricoli JV; Division of Cancer Treatment and Diagnosis, National Cancer Institute, Bethesda, MD.
  • Conley BA; Division of Cancer Treatment and Diagnosis, National Cancer Institute, Bethesda, MD.
  • Arteaga CL; UT Southwestern Simmons Comprehensive Cancer Center, Dallas, TX.
  • Harris LN; Division of Cancer Treatment and Diagnosis, National Cancer Institute, Bethesda, MD.
  • O'Dwyer PJ; University of Pennsylvania, Philadelphia, PA.
  • Chen AP; Division of Cancer Treatment and Diagnosis, National Cancer Institute, Bethesda, MD.
  • Flaherty KT; Massachusetts General Hospital Cancer Center, Boston, MA.
JCO Precis Oncol ; 8: e2300406, 2024 Apr.
Article en En | MEDLINE | ID: mdl-38603651
ABSTRACT

PURPOSE:

Despite fibroblast growth factor receptor (FGFR) inhibitors being approved in tumor types with select FGFR rearrangements or gene mutations, amplifications of FGFR represent the most common FGFR alteration across malignancies. Subprotocol K1 (EAY131-K1) of the National Cancer Institute-MATCH platform trial was designed to evaluate the antitumor efficacy of the oral FGFR1-4 inhibitor, erdafitinib, in patients with tumors harboring FGFR1-4 amplification.

METHODS:

EAY131-K1 was an open-label, single-arm, phase II study with central confirmation of presence of FGFR1-4 amplification in tumors. Patients with urothelial carcinoma were excluded. Enrolled patients received oral erdafitinib at a starting dose of 8 mg once daily continuously with escalation to 9 mg once daily continuously, on the basis of predefined time point assessments of phosphate levels, until disease progression or intolerable toxicity. The primary end point was centrally assessed objective response rate (ORR), with key secondary end points being 6-month progression-free survival (PFS6), PFS, overall survival (OS), and safety.

RESULTS:

Thirty-five patients were enrolled into this study with 18 included in the prespecified primary efficacy analysis. The median age of the 18 patients was 60 years, and 78% had received ≥3 previous lines of therapy. There were no confirmed responses to erdafitinib; however, five patients experienced stable disease (SD) as best response. One patient with an FGFR1-amplified breast cancer had a prolonged PFS >168 days (5.5 months). The median PFS was 1.7 months (90% CI, 1.1 to 1.8 months) and the median OS was 4.2 months (90% CI, 2.3 to 9.3 months). The estimated PFS6 rate was 13.8% (90% CI, 3.3 to 31.6). The majority of toxicities were grade 1 to 2 in nature, although there was one grade 5 treatment-related adverse event.

CONCLUSION:

Erdafitinib did not meet its primary end point of efficacy as determined by ORR in treatment-refractory solid tumors harboring FGFR1-4 amplifications. Our findings support that rearrangements and gene mutations, but not amplifications, of FGFR remain the established FGFR alterations with approved indications for FGFR inhibition.
Asunto(s)

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Pirazoles / Quinoxalinas / Neoplasias Límite: Humans / Middle aged País/Región como asunto: America do norte Idioma: En Revista: JCO Precis Oncol Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Pirazoles / Quinoxalinas / Neoplasias Límite: Humans / Middle aged País/Región como asunto: America do norte Idioma: En Revista: JCO Precis Oncol Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos