The University of Texas MD Anderson Cancer Center, Houston, TX.
City of Hope Comprehensive Cancer Center, Duarte, CA.
J Clin Oncol. 2023 Mar 20;41(9):1725-1734. doi: 10.1200/JCO.22.00830. Epub 2022 Dec 5.
Preclinical cancer models harboring amplification were more sensitive to adavosertib treatment, a WEE1 kinase inhibitor, than models without amplification. Thus, we conducted this phase II study to assess the antitumor activity of adavosertib in patients with -amplified, advanced refractory solid tumors.
Patients aged ≥ 18 years with measurable disease and refractory solid tumors harboring amplification, an Eastern Cooperative Oncology Group performance status of 0-1, and adequate organ function were studied. Patients received 300 mg of adavosertib once daily on days 1 through 5 and 8 through 12 of a 21-day cycle. The trial followed Bayesian optimal phase II design. The primary end point was objective response rate (ORR).
Thirty patients were enrolled. The median follow-up duration was 9.9 months. Eight patients had partial responses (PRs), and three had stable disease (SD) ≥ 6 months, with an ORR of 27% (95% CI, 12 to 46), a SD ≥ 6 months/PR rate of 37% (95% CI, 20 to 56), a median progression-free survival duration of 4.1 months (95% CI, 1.8 to 6.4), and a median overall survival duration of 9.9 months (95% CI, 4.8 to 15). Fourteen patients with epithelial ovarian cancer showed an ORR of 36% (95% CI, 13 to 65) and SD ≥ 6 months/PR of 57% (95% CI, 29 to 82), a median progression-free survival duration of 6.3 months (95% CI, 2.4 to 10.2), and a median overall survival duration of 14.9 months (95% CI, 8.9 to 20.9). Common treatment-related toxicities were GI, hematologic toxicities, and fatigue.
Adavosertib monotherapy demonstrates a manageable toxicity profile and promising clinical activity in refractory solid tumors harboring amplification, especially in epithelial ovarian cancer. Further study of adavosertib, alone or in combination with other therapeutic agents, in -amplified epithelial ovarian cancer is warranted.
携带扩增的临床前癌症模型对 WEE1 激酶抑制剂adavosertib 的治疗更为敏感,而没有扩增的模型则不然。因此,我们进行了这项 II 期研究,以评估 adavosertib 在携带扩增的晚期难治性实体瘤患者中的抗肿瘤活性。
纳入年龄≥18 岁、有可测量疾病且携带扩增的难治性实体瘤、东部合作肿瘤组体力状态 0-1 分和足够器官功能的患者。患者接受每日 300mg adavosertib 治疗,连续 5 天(第 1-5 天)和 12 天(第 8-12 天),每 21 天为一个周期。该试验遵循贝叶斯最优 II 期设计。主要终点为客观缓解率(ORR)。
共纳入 30 例患者。中位随访时间为 9.9 个月。8 例患者有部分缓解(PR),3 例有疾病稳定(SD)≥6 个月,ORR 为 27%(95%CI,12 至 46),SD≥6 个月/PR 率为 37%(95%CI,20 至 56),中位无进展生存期为 4.1 个月(95%CI,1.8 至 6.4),中位总生存期为 9.9 个月(95%CI,4.8 至 15)。14 例上皮性卵巢癌患者的 ORR 为 36%(95%CI,13 至 65),SD≥6 个月/PR 为 57%(95%CI,29 至 82),中位无进展生存期为 6.3 个月(95%CI,2.4 至 10.2),中位总生存期为 14.9 个月(95%CI,8.9 至 20.9)。常见的治疗相关毒性为胃肠道毒性、血液学毒性和疲劳。
adavosertib 单药治疗在携带扩增的难治性实体瘤中具有可管理的毒性特征和有前景的临床活性,特别是在上皮性卵巢癌中。进一步研究 adavosertib 单药或联合其他治疗药物在扩增的上皮性卵巢癌中的作用是合理的。