Yale School of Medicine, New Haven, CT.
University of Colorado Cancer Center, Aurora, CO.
J Clin Oncol. 2024 Oct 10;42(29):3421-3429. doi: 10.1200/JCO.23.02767. Epub 2024 Jul 31.
Patients with advanced endometrial cancer (EC) who progress on or after platinum-based therapy and immunotherapy have poor prognosis. We report efficacy and safety of sacituzumab govitecan (SG), a trophoblast cell-surface antigen 2 (Trop-2)-directed antibody-drug conjugate, in patients with advanced EC.
TROPiCS-03 (ClinicalTrials.gov identifier: NCT03964727) is a multicohort, open-label, phase II basket study in patients with metastatic solid tumors. Eligible patients in the EC cohort received SG 10 mg/kg once on days 1 and 8 every 3 weeks. Primary end point was objective response rate (ORR) by investigator's assessment per RECIST v1.1. Secondary end points included clinical benefit rate (CBR; complete and partial response, and stable disease ≥6 months), duration of response (DOR), and progression-free survival (PFS) per investigator assessment, overall survival, and safety. Trop-2 expression of archival or baseline tumor specimens was analyzed by immunohistochemistry.
At data extraction date, 41 patients were enrolled. Median follow-up was 5.8 months (range, 0.7-19.3); median previous therapies was three (range, 1-6); and 85% of patients received previous chemotherapy and immunotherapy. ORR was 22% (95% CI, 11 to 38); CBR was 32% (95% CI, 18 to 48). Median DOR was 8.8 months (95% CI, 2.8 to not estimable); median PFS was 4.8 months (95% CI, 2.8 to 9.8). Trop-2 exploratory analysis was conducted retrospectively for 39 patients. Tumor Trop-2 protein was highly expressed in EC, showing limited correlation with efficacy. Grade ≥3 treatment-related adverse events (TRAEs) occurred in 73% of patients. Study drug discontinuation due to TRAEs was 5%. Two deaths occurred, deemed unrelated to SG.
Findings from TROPiCS-03 showed encouraging efficacy of SG with a manageable toxicity profile in a heavily pretreated population with advanced EC. Safety findings were consistent with the known SG safety profile.
铂类药物治疗和免疫治疗后进展或不耐受的晚期子宫内膜癌(EC)患者预后较差。我们报告了 Trop-2 靶向抗体药物偶联物 sacituzumab govitecan(SG)在晚期 EC 患者中的疗效和安全性。
TROPiCS-03(临床试验标识符:NCT03964727)是一项多队列、开放标签、二期篮子研究,纳入转移性实体瘤患者。EC 队列的入组患者接受 SG 10mg/kg,每 3 周一次,第 1 天和第 8 天给药。主要终点为研究者评估的 RECIST v1.1 应答率(ORR)。次要终点包括临床获益率(CBR;完全和部分缓解以及稳定疾病≥6 个月)、缓解持续时间(DOR)、研究者评估的无进展生存期(PFS)、总生存期和安全性。通过免疫组化分析存档或基线肿瘤标本的 Trop-2 表达。
截至数据提取日,共入组 41 例患者。中位随访时间为 5.8 个月(范围,0.7-19.3);中位既往治疗方案数为 3 种(范围,1-6);85%的患者接受过化疗和免疫治疗。ORR 为 22%(95%CI,11%至 38%);CBR 为 32%(95%CI,18%至 48%)。中位 DOR 为 8.8 个月(95%CI,2.8 至无法评估);中位 PFS 为 4.8 个月(95%CI,2.8 至 9.8)。对 39 例患者进行了 Trop-2 探索性分析。EC 中肿瘤 Trop-2 蛋白表达较高,但与疗效相关性有限。73%的患者发生≥3 级治疗相关不良事件(TRAEs)。因 TRAEs 停药的比例为 5%。2 例死亡与 SG 无关。
TROPiCS-03 的研究结果显示,在铂类药物治疗和免疫治疗后进展或不耐受的晚期 EC 患者中,SG 具有令人鼓舞的疗效和可管理的毒性特征。安全性结果与已知的 SG 安全性特征一致。