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演示文稿, 科學出版物 | 2020-04-27

AACR2020: 關於索凡替尼聯合特瑞普利單抗治療晚期實體瘤患者的I期臨床研究

標題: 關於索凡替尼聯合特瑞普利單抗治療晚期實體瘤患者的I期臨床研究
報告人: 曹彥碩
作者: 陸明1, 曹彥碩1, 龔繼芳1, 孫宇2, 李潔1, 沈琳1.

1北京大學腫瘤醫院惡性腫瘤發病機制及轉化研究教育部重點實驗室,消化道腫瘤科; 2北京大學腫瘤醫院惡性腫瘤發病機制及轉化研究教育部重點實驗室,病理科

報告環節: VPO.CT01
報告編號: CT142
報告編號:  查看摘要


Ming LuYanshuo CaoJifang GongYu SunJie LiLin Shen. Department of Gastrointestinal Oncology, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University Cancer Hospital & Institute, Beijing, China, Department of Pathology, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University Cancer Hospital & Institute, Beijing, China



M. Lu: None. Y. Cao: None. J. Gong: None. Y. Sun: None. J. Li: None. L. Shen: None.



Background: Surufatinib is a novel small-molecule inhibitor targeting vascular endothelial growth factor receptors 1, 2 and 3, fibroblast growth factor receptor 1 and colony stimulating factor 1 receptor. Toripalimab (JS001) is a monoclonal humanized IgG4 PD-1 antibody. The potential synergistic antitumor activity of surufatinib and anti-PD-L1 combination regimen had been demonstrated in preclinical study (presented at 2017 AACR). Here, we report the safety and preliminary efficacy results from a phase I trial of surufatinib plus toripalimab in patients with advanced solid tumor (NCT03879057).

Methods: This study is an open-label, dose escalation and expansion study in solid tumor patients who had failed standard therapies or had no effective treatment. In dose escalation stage, 3 dose levels of surufatinib (200, 300 and 250 mg once daily) were evaluated in combination with a fixed dose of toripalimab 240 mg every 3 weeks until the maximum tolerated dose (MTD) or recommended phase II dose (RP2D) was reached, which ever occurred first. Additional patients were enrolled at dose expansion phase to further assess the efficacy, safety and pharmacokinetic (PK) profile.

Results: As of 2020-1-20, a total of 30 patients were enrolled. Tumor types include neuroendocrine tumor (NET) Grade (G) 1/2 (4), NET G3 (4), neuroendocrine carcinoma (NEC) (13), colorectal carcinoma (CRC) (4), gastric adenocarcinoma (GC) (2), esophageal squamous cell carcinoma (ESCC) (2) and metastatic squamous cell carcinoma with unknown primary (1). The RP2D was determined at surufatinib 250 mg daily plus toripalimab. One patient at 300 mg experienced dose-limiting toxicity, grade 3 hyperthyroidism. The most common grade 3/4 treatment emergent adverse events (TEAE, ≥5%) were transaminase elevation, bilirubin elevation, fatigue, hyponatremia, and vomit, with higher frequencies in the 300 mg cohort compared with lower dose cohorts. There was no treatment-related fatal serious adverse event. Preliminary PK analysis showed surufatinib exposure at steady state increased dose-proportionally. Individual PK profiles was comparable to those of surufatinib or toripalimab from previous monotherapy trials. By 2020-1-10, 25/30 patients across 3 cohorts were evaluable for tumor response: 1 complete response, 6 partial response (ORR=28%); in NET G1/2 (3), NEC (2), ESCC (1), and CRC (1). Twelve patients experienced stable disease for at least 6 weeks (DCR=76%). Most patients with negative or low PD-L1 expression achieved PR or CR. Of 21 evaluable neuroendocrine neoplasms (NENs) patients, the ORR and DCR were 23.8% and 81.0%, respectively. Four of 8 evaluable patients at RP2D achieved PR, and the ORR and DCR were 50% and 100%, respectively.

Conclusions: Surufatinib plus toripalimab were well tolerated with no unexpected safety signals observed, and showed encouraging antitumor activity in patients with advanced solid tumor, especially in NENs patients. The phase II trial (NCT04169672) has been initiated.