Safety and activity of the TGFβ receptor I kinase inhibitor galunisertib plus the anti-PD-L1 antibody durvalumab in metastatic pancreatic cancer
Year: 2021
Type: article
Study design: Clinical Trial
Abstract: BACKGROUND: We assessed the safety, efficacy, and pharmacokinetics of the transforming growth factor beta (TGFβ) receptor inhibitor galunisertib co-administered with the anti-programmed death-ligand 1 (PD-L1) antibody durvalumab in recurrent/refractory metastatic pancreatic cancer previously treated with ≤2 systemic regimens. METHODS: This was a two-part, single-arm, multinational, phase Ib study. In a dose-finding phase, escalating oral doses of galunisertib were co-administered on days 1-14 with fixed-dose intravenous durvalumab 1500 mg on day 1 every 4 weeks (Q4W), followed by an expansion cohort phase. RESULTS: The galunisertib recommended phase II dose (RP2D) when co-administered with durvalumab 1500 mg Q4W was 150 mg two times per day. No dose-limiting toxicities were recorded. Among 32 patients treated with galunisertib RP2D, 1 patient had partial response, 7 had stable disease, 15 had objective progressive disease, and 9 were not evaluable. Disease control rate was 25.0%. Median overall survival and progression-free survival were 5.72 months (95% CI: 4.01 to 8.38) and 1.87 months (95% CI: 1.58 to 3.09), respectively. Pharmacokinetic profiles for combination therapy were comparable to those published for each drug. There was no association between potential biomarkers and treatment outcomes. CONCLUSION: Galunisertib 150 mg two times per day co-administered with durvalumab 1500 mg Q4W was tolerable. Clinical activity was limited. Studying this combination in patients in an earlier line of treatment or selected for predictive biomarkers of TGFβ inhibition might be a more suitable approach. TRIAL REGISTRATION NUMBER: ClinicalTrials.gov identifier: NCT02734160.
Authors: Davide Melisi, Do-Youn Oh, Antoine Hollebecque, Emiliano Calvo, Anna Varghese, Erkut Borazanci, Teresa Macarulla, Valeria Merz, Camilla Zecchetto, Yumin Zhao, Ivelina Gueorguieva, Michael Man, Leena Gandhi, Shawn T Estrem, Karim A Benhadji, Mark C Lanasa, Emin Avsar, Susan C Guba, Rocio Garcia-Carbonero
Institutions: University of Verona, Seoul National University, Seoul National University Hospital, Institut Gustave Roussy, Memorial Sloan Kettering Cancer Center, Translational Genomics Research Institute, HonorHealth, Vall d'Hebron Hospital Universitari, Vall d'Hebron Institute of Oncology, Ospedale Santa Chiara, Eli Lilly (United States), Eli Lilly (United Kingdom), Eli Lilly (Australia), AstraZeneca (United States), Universidad Complutense de Madrid, Hospital Universitario 12 De Octubre, Centro de Investigación Biomédica en Red de Cáncer
Language: English
Subfield: Oncology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,490
OpenAlex ID: W3134477587
