PIK3CB抑制剂GSK2636771在PTEN突变/缺失或PTEN蛋白表达缺失的癌症中:来自NCI-MATCH ECOG-ACRIN试验(EAY131)亚协议的结果

IF 5.6 2区 医学 Q1 ONCOLOGY
JCO precision oncology Pub Date : 2025-08-01 Epub Date: 2025-08-27 DOI:10.1200/PO-25-00265
Filip Janku, Opeyemi A Jegede, Shannon L Puhalla, Panagiotis A Konstantinopoulos, Funda Meric-Bernstam, James A Zwiebel, Robert J Gray, Xin Victoria Wang, Lisa M McShane, Larry V Rubinstein, David R Patton, P Mickey Williams, Stanley R Hamilton, Naoko Takebe, Sofia Ghani, James V Tricoli, Barbara A Conley, Carlos L Arteaga, Lyndsay N Harris, Peter J O'Dwyer, Alice P Chen, Keith T Flaherty
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引用次数: 0

摘要

目的:PTEN缺失有助于磷脂酰肌醇3-激酶(PI3K)/蛋白激酶B/雷帕霉素途径的哺乳动物靶点的异常信号传导,并可能赋予针对PI3K途径的治疗敏感性。PIK3CB抑制剂GSK2636771对PIK3CB突变的肿瘤有效,对PTEN缺失的患者也可能同样有效。方法:在NCI-MATCH试验背景下,针对晚期复发/难治性实体瘤、淋巴瘤或骨髓瘤患者PTEN肿瘤改变的两个非随机、开放标签II期亚方案:PTEN突变/缺失(N组)或PTEN蛋白表达缺失(P组)。患者口服GSK2636771,剂量为400 mg,每天1次,28天为一个周期。主要终点为客观反应(OR);次要结局包括无进展生存期(PFS)≥6个月、PFS和总生存期。结果:在两个亚方案的59例患者中(N = 24, P = 35), 54例符合条件并接受GSK2636771治疗。在24例肿瘤发生PTEN突变/缺失但保留PTEN表达的患者(N组)中,7例(32%)患者达到疾病稳定(SD), 2例(9%)患者SD≥6个月(子宫平滑肌肉瘤和子宫内膜癌);中位PFS为1.8个月。在32例PTEN蛋白表达缺失的肿瘤患者(P组)中,7例(22%)患者达到SD, 2例(6%)患者SD≥6个月(前列腺癌、鳞状膀胱癌);中位PFS为1.8个月。最常见的≥3级治疗相关不良事件包括n组的疲劳(n = 4)和贫血(n = 2), p组的低钙血症(n = 3)、贫血、疲劳、腹泻和低钾血症(各n = 2)。结论:尽管未达到OR的主要终点,但GSK2636771在PTEN突变/缺失、PTEN表达或PTEN蛋白丢失的复发/难治性癌症患者中显示出中度单药活性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
PIK3CB Inhibitor GSK2636771 in Cancers With PTEN Mutation/Deletion or Loss of PTEN Protein Expression: Results From the NCI-MATCH ECOG-ACRIN Trial (EAY131) Subprotocols N and P.

Purpose: PTEN loss contributes to aberrant signaling of the phosphatidylinositol 3-kinase (PI3K)/protein kinase B/mammalian target of rapamycin pathway and may confer sensitivity to therapies targeting the PI3K pathway. The PIK3CB inhibitor GSK2636771 demonstrated efficacy in tumors with PIK3CB mutations and may similarly show efficacy in patients with PTEN loss.

Methods: Two nonrandomized, open-label phase II subprotocols within the context of the NCI-MATCH trial targeted PTEN tumor alterations in patients with advanced relapsed/refractory solid tumors, lymphoma, or myeloma: PTEN mutation/deletion (arm N) or loss of PTEN protein expression (arm P). Patients were treated with oral GSK2636771 at 400 mg once per day on 28-day cycles. The primary outcome was objective response (OR); secondary outcomes included progression-free survival (PFS) ≥ 6 months, PFS, and overall survival.

Results: Of the 59 patients enrolled across both subprotocols (arm N = 24, arm P = 35), 54 were eligible and treated with GSK2636771. Among 24 patients whose tumors had PTEN mutation/deletion but retained PTEN expression (arm N), seven patients (32%) achieved stable disease (SD), with two (9%) experiencing SD ≥ 6 months (uterine leiomyosarcoma and uterine endometrial carcinoma); the median PFS was 1.8 months. Of the 32 patients whose tumors had loss of PTEN protein expression (arm P), seven patients (22%) achieved SD, with two (6%) experiencing SD ≥ 6 months (prostate cancer; squamous bladder cancer); the median PFS was 1.8 months. Most frequent ≥grade 3 treatment-related adverse events included fatigue (n = 4) and anemia (n = 2) in arm N and hypocalcemia (n = 3), anemia, fatigue, diarrhea, and hypokalemia (each n = 2) in arm P.

Conclusion: Although the primary end point of OR was not met, GSK2636771 demonstrated modest single-agent activity among patients with relapsed/refractory cancer having PTEN mutation/deletion with PTEN expression or PTEN protein loss.

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