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Avelumab or talazoparib in combination with binimetinib in metastatic pancreatic ductal adenocarcinoma: dose-finding results from phase Ib of the JAVELIN PARP MEKi trial

Combinations of avelumab [anti-programmed death-ligand 1 (anti-PD-L1)] or talazoparib [poly(adenosine diphosphate ribose) polymerase (PARP) inhibitor] with binimetinib (MEK inhibitor) were expected to result in additive or synergistic antitumor activity relative to each drug administered alone. Here...

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Published in:ESMO open 2023-08, Vol.8 (4), p.101584-101584, Article 101584
Main Authors: Rodon Ahnert, J., Tan, D.S.-W., Garrido-Laguna, I., Harb, W., Bessudo, A., Beck, J.T., Rottey, S., Bahary, N., Kotecki, N., Zhu, Z., Deng, S., Kowalski, K., Wei, C., Pathan, N., Laliberte, R.J., Messersmith, W.A.
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Language:English
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Summary:Combinations of avelumab [anti-programmed death-ligand 1 (anti-PD-L1)] or talazoparib [poly(adenosine diphosphate ribose) polymerase (PARP) inhibitor] with binimetinib (MEK inhibitor) were expected to result in additive or synergistic antitumor activity relative to each drug administered alone. Here, we report phase Ib results from JAVELIN PARP MEKi, which investigated avelumab or talazoparib combined with binimetinib in metastatic pancreatic ductal adenocarcinoma (mPDAC). Patients with mPDAC that had progressed with prior treatment received avelumab 800 mg every 2 weeks plus binimetinib 45 mg or 30 mg two times daily (continuous), or talazoparib 0.75 mg daily plus binimetinib 45 mg or 30 mg two times daily (7 days on/7 days off). The primary endpoint was dose-limiting toxicity (DLT). A total of 22 patients received avelumab plus binimetinib 45 mg (n = 12) or 30 mg (n = 10). Among DLT-evaluable patients, DLT occurred in five of 11 patients (45.5%) at the 45-mg dose, necessitating de-escalation to 30 mg; DLT occurred in three of 10 patients (30.0%) at the 30-mg dose. Among patients treated at the 45-mg dose, one (8.3%) had a best overall response of partial response. Thirteen patients received talazoparib plus binimetinib 45 mg (n = 6) or 30 mg (n = 7). Among DLT-evaluable patients, DLT occurred in two of five patients (40.0%) at the 45-mg dose, necessitating de-escalation to 30 mg; DLT occurred in two of six patients (33.3%) at the 30-mg dose. No objective responses were observed. Combinations of avelumab or talazoparib plus binimetinib resulted in higher-than-expected DLT rates. However, most DLTs were single occurrences, and the overall safety profiles were generally consistent with those reported for the single agents. ClinicalTrials.govNCT03637491; https://clinicaltrials.gov/ct2/show/NCT03637491 •Combining avelumab or talazoparib plus binimetinib was investigated in mPDAC.•Both combinations had higher-than-expected rates of DLT and limited clinical activity.•However, overall safety profiles were generally consistent with prior monotherapy studies.•One patient treated with avelumab plus binimetinib had a partial response.•The trial was terminated before a recommended phase II dose was established, and a triplet combination was not explored.
ISSN:2059-7029
2059-7029
DOI:10.1016/j.esmoop.2023.101584