Ontology highlight
ABSTRACT: Purpose
Targeting focal adhesion kinase (FAK) renders checkpoint immunotherapy effective in pancreatic ductal adenocarcinoma (PDAC) mouse model. Defactinib is a highly potent oral FAK inhibitor that has a tolerable safety profile.Patients and methods
We conducted a multicenter, open-label, phase I study with dose escalation and expansion phases. In dose escalation, patients with refractory solid tumors were treated at five escalating dose levels of defactinib and gemcitabine to identify a recommended phase II dose (RP2D). In expansion phase, patients with metastatic PDAC who progressed on frontline treatment (refractory cohort) or had stable disease (SD) after at least 4 months of standard gemcitabine/nab-paclitaxel (maintenance cohort) were treated at RP2D. Pre- and posttreatment tumor biopsies were performed to evaluate tumor immunity.Results
The triple drug combination was well-tolerated, with no dose-limiting toxicities. Among 20 treated patients with refractory PDAC, the disease control rate (DCR) was 80%, with one partial response (PR) and 15 SDs, and the median progression-free survival (PFS) and overall survival (OS) were 3.6 and 7.8 months, respectively. Among 10 evaluable patients in the maintenance cohort, DCR was 70% with one PR and six SDs. Three patients with SD came off study due to treatment- or disease-related complications. The median PFS and OS on study treatment were 5.0 and 8.3 months, respectively.Conclusions
The combination of defactinib, pembrolizumab, and gemcitabine was well-tolerated and safe, had promising preliminary efficacy, and showed biomarker activity in infiltrative T lymphocytes. Efficacy of this strategy may require incorporation of more potent chemotherapy in future studies.
SUBMITTER: Wang-Gillam A
PROVIDER: S-EPMC9772237 | biostudies-literature | 2022 Dec
REPOSITORIES: biostudies-literature
Wang-Gillam Andrea A Lim Kian-Huat KH McWilliams Robert R Suresh Rama R Lockhart Albert C AC Brown Amberly A Breden Marcus M Belle Jad I JI Herndon John J Bogner Savannah J SJ Pedersen Katrina K Tan Benjamin B Boice Nicholas N Acharya Abhi A Abdiannia Mina M Gao Feng F Yoon Harry H HH Zhu Mojun M Trikalinos Nikolaos A NA Ratner Lee L Aranha Olivia O Hawkins William G WG Herzog Brett H BH DeNardo David G DG
Clinical cancer research : an official journal of the American Association for Cancer Research 20221201 24
<h4>Purpose</h4>Targeting focal adhesion kinase (FAK) renders checkpoint immunotherapy effective in pancreatic ductal adenocarcinoma (PDAC) mouse model. Defactinib is a highly potent oral FAK inhibitor that has a tolerable safety profile.<h4>Patients and methods</h4>We conducted a multicenter, open-label, phase I study with dose escalation and expansion phases. In dose escalation, patients with refractory solid tumors were treated at five escalating dose levels of defactinib and gemcitabine to i ...[more]