Cedars-Sinai Medical Center, Los Angeles, CA.
Dana Farber Cancer Institute-ECOG-ACRIN Biostatistics Center, Boston, MA.
JCO Precis Oncol. 2024 Apr;8:e2300407. doi: 10.1200/PO.23.00407.
Subprotocol K2 (EAY131-K2) of the NCI-MATCH platform trial was an open-label, single-arm, phase II study designed to evaluate the antitumor efficacy of the oral FGFR1-4 inhibitor, erdafitinib, in patients with tumors harboring FGFR1-4 mutations or fusions.
Central confirmation of tumor FGFR1-4 mutations or fusions was required for outcome analysis. Patients with urothelial carcinoma were excluded. Enrolled subjects received oral erdafitinib at a starting dose of 8 mg daily continuously until intolerable toxicity or disease progression. The primary end point was objective response rate (ORR) with key secondary end points of safety, progression-free survival (PFS), and overall survival (OS).
Thirty-five patients were enrolled, and 25 patients were included in the primary efficacy analysis as prespecified in the protocol. The median age was 61 years, and 52% of subjects had received ≥3 previous lines of therapy. The confirmed ORR was 16% (4 of 25 [90% CI, 5.7 to 33.0], = .034 against the null rate of 5%). An additional seven patients experienced stable disease as best-confirmed response. Four patients had a prolonged PFS including two with recurrent WHO grade IV, IDH1-/2-wildtype glioblastoma. The median PFS and OS were 3.6 months and 11.0 months, respectively. Erdafitinib was manageable with no new safety signals.
This study met its primary end point in patients with several pretreated solid tumor types harboring FGFR1-3 mutations or fusions. These findings support advancement of erdafitinib for patients with fibroblast growth factor receptor-altered tumors outside of currently approved indications in a potentially tumor-agnostic manner.
NCI-MATCH 平台试验的子协议 K2(EAY131-K2)是一项开放标签、单臂、二期研究,旨在评估口服 FGFR1-4 抑制剂 erdafitinib 对携带 FGFR1-4 突变或融合的肿瘤患者的抗肿瘤疗效。
需要对肿瘤 FGFR1-4 突变或融合进行中心确认,以便进行结果分析。不包括尿路上皮癌患者。入组患者接受起始剂量为 8mg/天的口服 erdafitinib,持续用药,直至出现不可耐受毒性或疾病进展。主要终点是客观缓解率(ORR),关键次要终点为安全性、无进展生存期(PFS)和总生存期(OS)。
共入组 35 例患者,根据方案预设,25 例患者纳入主要疗效分析。中位年龄为 61 岁,52%的患者接受了≥3 线治疗。确认的 ORR 为 16%(25 例中有 4 例[90%CI,5.7 至 33.0],.034 与预期的 5%的无反应率相比)。另外 7 例患者的最佳确认缓解为疾病稳定。4 例患者有延长的 PFS,包括 2 例复发性、WHO 分级 IV、IDH1-/2-野生型胶质母细胞瘤。中位 PFS 和 OS 分别为 3.6 个月和 11.0 个月。erdafitinib 可管理,无新的安全性信号。
本研究在几种经预处理的、携带 FGFR1-3 突变或融合的实体瘤患者中达到了主要终点。这些发现支持以潜在的肿瘤不可知的方式,将 erdafitinib 推进到目前批准适应症之外的纤维母细胞生长因子受体改变的肿瘤患者中。