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Ref Type | Abstract | ||||||||||||
PMID | |||||||||||||
Authors | T.A. Yap S.A. Piha-Paul D. Karp E.E. Dumbrava D.S. Hong S. Fu V. Subbiah A.M. Tsimberidou J. Rodon J. Rhudy C. Valladolid Y. Yuan B. Jana P. Spiliopoulou L. Randall A. Poklepovic K. Sehgal G.I. Shapiro R. Said F. Meric-Bernstam | ||||||||||||
Title | 701P NCI10221: Phase II multicenter biomarker driven combination trial of copanlisib and nivolumab in patients with molecularly-selected advanced solid tumors (BaCoN) | ||||||||||||
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URL | https://www.annalsofoncology.org/article/S0923-7534(23)02724-2/fulltext | ||||||||||||
Abstract Text | Background Preclinical data showed antitumor efficacy with PI3K and PD-1 combined blockade. We hypothesized that efficacy will be enriched in tumors with PIK3CA hotspot and PTEN mutations vs those without. This provided rationale for this 3-arm trial of copanlisib (pan-PI3K inhibitor) and nivolumab (PD-1 inhibitor) in patients (pts) with: (1) activating PIK3CA hotspot mutations, (2) inactivating PTEN mutations or (3) wildtype (WT) for PIK3CA/PTEN mutations (NCT04317105). Methods Copanlisib was started as monotherapy in cycle 1 at 60 mg IV D1, 8, 15, before nivolumab was added from cycle 2 at 480 mg IV every 28 days. Fresh tumor biopsies and ctDNA were mandated in all pts at baseline, copanlisib monotherapy, on combo and at progression. Prior PD-1/L1 or PI3K inhibitors (PD-1/L1i or PI3Ki) were allowed. Objectives were safety, antitumor activity and analyses of sequential tumors (WES; RNA-Seq; RPPA) and ctDNA. Results 50 pts (M:F 17:33; ECOG PS 0:1 18:32; mean age 58 years (27-79) with ovarian (n=12), breast (n=10), HNSCC (n=4), bile duct (n=3), NSCLC (n=3), prostate (n=3), colon (n=3), gallbladder (n=2), leiomyosarcoma (n=2), salivary gland (2), bladder, cervical, endometrial, liposarcoma, sarcoma, skin (n=1) cancers enrolled. Pts with PIK3CA hotspot (n=16), PTEN (n=18), and WT (n=16) tumors enrolled. 31/50 pts had ≥3 lines of prior therapy; 23 (46%)/50 pts had prior PD-1/L1i and 3 (6%)/50 prior mTOR inhibitors. Common toxicities: G1/2 nausea (35%), rash (24%), diarrhea (24%), mucositis (20%), anemia (20%), fatigue (18%), hyperglycemia (18%); ≥ G3 transient hypertension (24%). RECISTv1.1 CR/PR in PIK3CA and PTEN cohorts were achieved in 4 (27%)/15 (1 cPR; 3 uCR/PR) pts and 3 (20%)/15 (3 cPR) pts, vs 0/15 (0%) pts in WT cohort. Responses were deep (up to -100%) and durable (up to 15+ months). Clinical benefit rate (SD>4 months/CR/PR) was 29% across cohorts; 40% in PIK3CA hotspot cohort, 33% in PTEN cohort and 13% in WT cohort. Conclusions The combination of copanlisib and nivolumab is well tolerated with antitumor activity in pts with PIK3CA hotspot and PTEN mutations including PD-1/L1i-exposed pts. Translational analyses are ongoing. Clinical trial identification NCT04317105. |
Molecular Profile | Treatment Approach |
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Molecular Profile | Indication/Tumor Type | Response Type | Therapy Name | Approval Status | Evidence Type | Efficacy Evidence | References |
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PIK3CA act mut | Advanced Solid Tumor | predicted - sensitive | Copanlisib + Nivolumab | Phase II | Actionable | In a Phase II trial (BaCoN), treatment with the combination of Aliqopa (copanlisib) and Opdivo (nivolumab) was well tolerated in patients with advanced solid tumors harboring an activating mutation in PIK3CA, and resulted in a complete response/partial response (CR/PR) in 27% (4/15, 1 cPR, 3 uCR/PR) and a clinical benefit rate (CR or PR or stable disease > 4 months) of 40% (Ann Oncol 34 (2023): S487-S488; NCT04317105). | detail... |
PTEN inact mut | Advanced Solid Tumor | predicted - sensitive | Copanlisib + Nivolumab | Phase II | Actionable | In a Phase II trial (BaCoN), treatment with the combination of Aliqopa (copanlisib) and Opdivo (nivolumab) was well tolerated in patients with advanced solid tumors harboring an inactivating mutation in PTEN, and resulted in a complete response/partial response (CR/PR) in 20% (3/15, 3 cPR) and a clinical benefit rate (CR or PR or stable disease > 4 months) of 33% (Ann Oncol 34 (2023): S487-S488; NCT04317105). | detail... |