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Ref Type Abstract
PMID
Authors Courtney D. DiNardo; Pau Montesinos; Lina Benajiba; Ana Triguero; Christian Recher; Andre C. Schuh; Maël Heiblig; Ashish Bajel; Arnaud Pigneux; Juan M. Alonso-Domiguez; Amir T. Fathi; Carolyn Grove; Hsin-An Hou; Michael Heuser; Sarit Assouline; Shaun Fleming; Dong-Yeop Shin; Kendra Sweet; Olatoyosi Odenike; Jessica Altman; Melissa Gaik Ming Ooi; Lao Zhentang; Nobert Vey; Joshua Zeidner; Amandeep Salhotra; Eunice Wang; Gary Schiller; Kimmo Porkka; Tsila Zuckerman; Violaine Havelange; Brian A. Jonas; Sujaatha Narayanan; Jun Ho Jang; Je-Hwan Lee; Anna M. Szpurka; Dana Heirich; Hsiao Rong Chen; Violet Hanft; Junjie Zhao; Ivelina Gueorguieva; Yin Zhang; Eytan M. Stein
Title Abstract CT026: A first-in-human phase 1 study of LY3410738, a covalent inhibitor of mutant IDH, in advanced myeloid malignancies
Journal Vol Issue Date Pages Journal Short Title
Cancer Research 83 8_Supplement April 15, 2023
URL https://aacrjournals.org/cancerres/article/83/8_Supplement/CT026/725302/Abstract-CT026-A-first-in-human-phase-1-study-of
Abstract Text Background: LY3410738 is a potent, selective, covalent, dual inhibitor of IDH1/2 mutations (IDH1/2m). LY3410738 binds covalently at a novel binding site, enabling continued potency in preclinical models in the setting of second site IDH resistance mutations. We present initial results from the first-in-human phase 1 dose escalation study of oral LY3410738 in patients (pts) with R/R IDH1/2m hematologic cancers. Methods: Dose escalation (3+3 design) evaluated LY3410738 monotherapy in IDH1/2m R/R AML (NCT04603001). Key objectives included determining the RP2D, safety, PK, PD (inhibition of plasma D-2-HG), and preliminary antitumor activity. Results: As of 28 July 2022, 114 pts including 108 R/R AML pts received LY3410738 dosed at 5-600 mg QD or 40-300 mg BID. Pts were median 73 years of age (range, 22-92) with a median of 2 prior therapies (range, 1-10); 29% received a prior IDH inhibitor and 58% a prior BCL2 inhibitor. Median time on treatment was 2.3 months (range, 0.1-15). No DLTs or treatment related deaths were observed. Treatment emergent adverse events ≥20% were diarrhea (22%), fatigue (21%), and anemia (20%). Differentiation syndrome was reported in 11 pts (10%); 4 grade 1/2 (4%), 7 grade 3 (6%). LY3410738 exposure was dose proportional. In pts with IDH1m cancers, LY3410738 achieved sustained D-2-HG inhibition at all dose levels including in pts who received prior IDH1 inhibitor. In pts with IDH2m cancers, a higher dose (≥150 mg daily dose) was required for D-2-HG inhibition. Responses were observed in both IDH1m and IDH2m AML (Table). Higher doses were required for IDH2m AML, especially IDH2 R140m pts. Efficacy appears higher in venetoclax naïve pts and limited in IDH inhibitor pre-treated pts. Conclusions: LY3410738 demonstrated a favorable safety profile with potent and sustained D-2-HG inhibition in pts with IDH1m R132, IDH2m R172, and IDH2m R140 mutations. Preliminary efficacy was also seen in all genotypes, in a dose dependent manner. RP2D evaluation is ongoing.

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Molecular Profile Treatment Approach
Gene Name Source Synonyms Protein Domains Gene Description Gene Role
Therapy Name Drugs Efficacy Evidence Clinical Trials
Drug Name Trade Name Synonyms Drug Classes Drug Description
Gene Variant Impact Protein Effect Variant Description Associated with drug Resistance
Molecular Profile Indication/Tumor Type Response Type Therapy Name Approval Status Evidence Type Efficacy Evidence References
IDH2 R140X acute myeloid leukemia predicted - sensitive LY3410738 Phase I Actionable In a Phase I trial, LY3410738 demonstrated safety and inhibited D-2-HG in patients with relapsed or refractory IDH-mutant acute myeloid leukemia, resulting in a composite complete remission (CRc) rate of 9% (2/23, 2 CR) in IDH inhibitor-naive patients harbor IDH2 R140 mutations (Cancer Res (2023) 83 (8_Supplement): CT026; NCT04603001). detail...
IDH1 R132X acute myeloid leukemia predicted - sensitive LY3410738 Phase I Actionable In a Phase I trial, LY3410738 demonstrated safety and inhibited D-2-HG in patients with relapsed or refractory IDH-mutant acute myeloid leukemia, resulting in a composite complete remission (CRc) rate of 38% (12/32, 5 CR, 2 CRh, 5 CRi/CRp) in IDH inhibitor-naive patients harbor IDH1 R132 mutations (Cancer Res (2023) 83 (8_Supplement): CT026; NCT04603001). detail...
IDH2 R172X acute myeloid leukemia predicted - sensitive LY3410738 Phase I Actionable In a Phase I trial, LY3410738 demonstrated safety and inhibited D-2-HG in patients with relapsed or refractory IDH-mutant acute myeloid leukemia, resulting in a composite complete remission (CRc) rate of 46% (6/13, 4 CR, 1 CRh, 1 CRi/CRp) in IDH inhibitor-naive patients harbor IDH2 R172 mutations (Cancer Res (2023) 83 (8_Supplement): CT026; NCT04603001). detail...