Preliminary results of niraparib and brivanib dual therapy evaluation in recurrent, metastatic and persistent cervical cancer (CQGOG0101): An open-label, phase II clinical trial.

Abstract

e17506 Background: Early-stage cervical cancer (CC) has a good long-term prognosis, with 5-year survival rate more than 90% for localized disease. However, once the CC relapsed, patients lack effective solutions and usually die in less than one year. In this study (CQGOG0101), we aimed to assess the efficacy and safety of niraparib combined with brivanib or toripalimab in patients with recurrent CC. Herein, we report the cohort 1 portion of the study (patients recieving Niraparib 200mg and Brivanib 400mg orally).Findings for the cohort 2 of patients receiving niraparib and toripalimab will be reported separately. Methods: The cohort 1 of CQGOG0101 trial was to evaluate the safety and activity of Niraparib combined with Brivanib in patients with recurrent, metastatic, or persistent cervical cancer. 10 patients were planned to be enrolled (Actually nine patients). Eligible patients were aged 18–70 years with measurable lesions and had an ECOG performance status of 0-2. Patients received oral niraparib 200 mg and brivanib 400 mg once daily until disease progression, intolerable toxicity, or withdrawal of consent. Primary endpoint was the objective response rate (ORR) assessed by RECIST version 1.1. Secondary endpoints included disease control rate (DCR), duration of response (DOR) and safety. Results: Between May 8th, 2020 and Jan 22nd, 2021, 9 patients (median age, 50 years old [28-73]) were enrolled. Patients had received a median of two (1-3) previous lines of platinum-based therapy. All of nine patients had distant metastatic lesions and had underwent at least one post-baseline tumor assessment (To deadline for submission), including 1 confirmed partial response, 4 with stable disease, 4 with progressive disease. Median duration of treatment was 3.8 months (3-8.2), three patients were still on treatment. No drug-related grade 3 or worse treatment-emergent adverse events were detected, the most common grade 1-2 adverse events (AEs) included: neutropenia (4 of 9 patients), anemia (2 of 9 patients), thrombocytopenia (1 of 9 patients), hypertension (2 of 9 patients), proteinuria(1 of 9 patients), fatigue (1 of 9 patients), and increased ALT/AST (1 of 9 patients). Conclusions: This combo seems to show a similar efficacy compared to other recurrent cervical cancer late-line therapies. We are planning to initiate the cohort 2 to explore niraparib combined with anti-PD-1 antibody (Toripalimab) in recurrent CC in our trial later. Clinical trial information: NCT04395612.