Atezolizumab plus PEGPH20 versus chemotherapy in advanced pancreatic ductal adenocarcinoma and gastric cancer: MORPHEUS phase Ib/II umbrella randomized …
AH Ko, KP Kim, JT Siveke, CD Lopez, J Lacy… - The …, 2023 - academic.oup.com
AH Ko, KP Kim, JT Siveke, CD Lopez, J Lacy, EM O'Reilly, T Macarulla, GA Manji, J Lee…
The Oncologist, 2023•academic.oup.comBackground The MORPHEUS platform comprises multiple open-label, randomized, phase
Ib/II trials designed to identify early efficacy and safety signals of treatment combinations
across cancers. Atezolizumab (anti-programmed cell death 1 ligand 1 [PD-L1]) was
evaluated in combination with PEGylated recombinant human hyaluronidase (PEGPH20).
Methods In 2 randomized MORPHEUS trials, eligible patients with advanced, previously
treated pancreatic ductal adenocarcinoma (PDAC) or gastric cancer (GC) received …
Ib/II trials designed to identify early efficacy and safety signals of treatment combinations
across cancers. Atezolizumab (anti-programmed cell death 1 ligand 1 [PD-L1]) was
evaluated in combination with PEGylated recombinant human hyaluronidase (PEGPH20).
Methods In 2 randomized MORPHEUS trials, eligible patients with advanced, previously
treated pancreatic ductal adenocarcinoma (PDAC) or gastric cancer (GC) received …
Background
The MORPHEUS platform comprises multiple open-label, randomized, phase Ib/II trials designed to identify early efficacy and safety signals of treatment combinations across cancers. Atezolizumab (anti-programmed cell death 1 ligand 1 [PD-L1]) was evaluated in combination with PEGylated recombinant human hyaluronidase (PEGPH20).
Methods
In 2 randomized MORPHEUS trials, eligible patients with advanced, previously treated pancreatic ductal adenocarcinoma (PDAC) or gastric cancer (GC) received atezolizumab plus PEGPH20, or control treatment (mFOLFOX6 or gemcitabine plus nab-paclitaxel [MORPHEUS-PDAC]; ramucirumab plus paclitaxel [MORPHEUS-GC]). Primary endpoints were objective response rates (ORR) per RECIST 1.1 and safety.
Results
In MORPHEUS-PDAC, ORRs with atezolizumab plus PEGPH20 (n = 66) were 6.1% (95% CI, 1.68%-14.80%) vs. 2.4% (95% CI, 0.06%-12.57%) with chemotherapy (n = 42). In the respective arms, 65.2% and 61.9% had grade 3/4 adverse events (AEs); 4.5% and 2.4% had grade 5 AEs. In MORPHEUS-GC, confirmed ORRs with atezolizumab plus PEGPH20 (n = 13) were 0% (95% CI, 0%-24.7%) vs. 16.7% (95% CI, 2.1%-48.4%) with control (n = 12). Grade 3/4 AEs occurred in 30.8% and 75.0% of patients, respectively; no grade 5 AEs occurred.
Conclusion
Atezolizumab plus PEGPH20 showed limited clinical activity in patients with PDAC and none in patients with GC. The safety of atezolizumab plus PEGPH20 was consistent with each agent’s known safety profile. (ClinicalTrials.gov Identifier: NCT03193190 and NCT03281369).
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