ESMO 2024: Optimising the personalisation of prostate cancer treatment
Dr Yahann Loriot speaks to ecancer about the interim analysis of a phase 2 study, RAGNAR, into tumour agnostic efficacy and safety of erdafitinib in patients (pts) with advanced solid tumours with pre-specified fibroblast growth factor receptor alterations (FGFRalt).
The results of the study showed evidence of efficacy and safety of erdafitinib in patients with advanced FGFR+ malignancies including glioblastoma, pancreatic, and salivary gland cancers.
A wide range of cancers exhibit some EGFR mutation and fusion but at varying frequency; so, for
example, in breast cancer it’s less than 1%, in lung cancer less than 1%. So the idea of this trial is to
conduct a tumour agnostic trial where patients with solid tumours and EGFR alterations, so mutations
and fusions, are treated with an EGFR inhibitor erdafitinib. This drug is approved in metastatic bladder
cancer. Why? Because we have the phase II trials that show that erdafitinib produces an objective
response rate of 40% so, based on this data, we’ve conducted a tumour agnostic trial just to have an
idea of the activity and safety of this drug across tumour histologies.
It’s an open label, single-arm, tumour agnostic phase II trial where patients with solid tumours and
EGFR1, 2, 3, 4 mutation and fusion are treated with erdafitinib. The primary endpoint is the objective
response rate. We need 200 assessable patients and today we report the third interim analysis, so
178 patients are included in this analysis.
The objective response rate is 29.2%; the disease control rate is 75.2% so it’s quite striking across
tumour histologies. We have a median PFS of 5.2 months and a duration of response 7 months.
Clinical activity was observed across tumour histologies in hard to treat cancers - pancreatic cancer,
salivary gland tumour, high grade glioma. Regarding safety, it’s generally manageable with a safety
profile very consistent as has been reported in metastatic bladder cancer in the past.
What are the next steps for this study?
We need the primary analysis; as I said before, it’s an interim analysis today. So we need to do the
primary analysis. It will be conducted late this year and we hope to confirm, of course, this interim
analysis. If so, what we want to do is to provide the drug in daily practice in the US, in Europe,
worldwide, for the patients with solid tumours and prespecified tumours, prespecified EGFR
alterations.
ESMO 2024: Optimising the personalisation of prostate cancer treatment
Durvalumab, gemcitabine and cisplatin continue to show clinically meaningful long-term survival in biliary tract cancer patients
Preoperative endocrine therapy in premenopausal women leads to sparing chemotherapy in additional patients
Potential benefit to response rates from trastuzumab added to perioperative chemotherapy for patients with HER-2+ GC
First-line NALIRIFOX shows improvement in OS and PFS in metastatic pancreatic cancer
Olaparib plus ceralasertib might benefit paediatric cancer patients with DNA repair-deficient tumours
Amivantamab shows robust efficacy in post-platinum therapy patients with EGFR Ex20ins NSCLC
Four chemo cycles given with durvalumab and tremelimumab optimise response and tumour shrinkage in patients with mNSCLC
CodeBreaK 200 shows sotorasib to be a more tolerable treatment option for patients with pretreated, KRASG12C-mutated advanced NSCLC