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Liao, Chih‐Yi

https://orcid.org/0000-0002-5114-3162

Mayo Clinic

University of Chicago Medical Center

Citations 15

Cohort-level safety and efficacy results for [ 212 Pb]VMT-α-NET in advanced somatostatin receptor subtype 2 (SSTR2+)–expressing neuroendocrine tumors (NETs): Cohorts 1–3.
Halfdanarson, Thorvardur Ragnar, Sukrithan, Vineeth, Mancini, Brandon Robert, Mosallaie, Seyed Ali, Balaraman, Savitha, Sibley, Gregory, Starr, Jason S., Anthony, Lowell , Liao, Chih-Yi, Mehr, Samuel, Weiss, J., Ramirez, Robert A., Iravani, Amir Iravani, Baratto, Lucia, Yang, Wenjing, Hanna, Alaa , Keefe, Stephen Michael, Puhlmann, Markus , Prasad, Vikas, Hálfdánarson, Þorvarður R. , Wahl, Richard L. , Sukrithan, Vineeth , Sibley, Gregory S., Starr, Jason S. , Liao, Chih‐Yi , Mehr, Samuel H., Weiss, Jared, Ramirez, Robert A., Keefe, MD Stephen, Prasad, Vikas

Journal of Clinical Oncology | May 27, 2026 | Volume: 44 | Issue: 16_suppl | Pages: 4173-4173

10.1200/jco.2026.44.16_suppl.4173 Get It

4173 Background: [ 212 Pb]VMT-α-NET is an alpha-particle radiation-delivering agent targeted to somatostatin receptor type 2 (SSTR2)-expressing tumors. Here, we present safety and efficacy results from the dose-finding phase 1/2a clinical trial (NCT05636618). Methods: This phase 1/2a dose-escalation study uses a Bayesian algorithm to identify an optimal dose of [ 212 Pb]VMT-α-NET for participants with advanced, well-differentiated NETs expressing SSTR2. Eligible participants must have unresectable or metastatic disease, documented radiologic progression following at least one prior systemic treatment, and evidence of SSTR2 expression (Krenning Score ³2) in ≥1 lesion confirmed on an FDA-approved somatostatin receptor PET scan. Patients previously treated with systemic peptide receptor radionuclide therapy (PRRT) are excluded from enrollment. During the dose-finding phase, participants may receive up to four administrations of [ 212 Pb]VMT-α-NET at their assigned dose level, and they are monitored for dose-limiting toxicities (DLTs) for 42 days and safety throughout the study. Efficacy is evaluated by investigators according to RECIST criteria v1.1. Dosimetry is included as a supportive analysis. Results: As of the 10-Dec-2025 data cut-off (DCO), 56 participants had been enrolled across Cohorts 1, 2, and 3 and received at least one dose of [ 212 Pb]VMT-α-NET: 2 participants in Cohort 1 (2.5 mCi), 46 in Cohort 2 (5 mCi), and 8 in Cohort 3 (6 mCi). No dose-limiting toxicities, grade 5 adverse events, treatment-related discontinuations, serious renal events, dysphagia, or clinically meaningful treatment-related myelosuppression were observed. The median follow-up for all treated participants was 40 weeks (range 6–97). Efficacy has been summarized in this abstract for 25 participants (2 in Cohort 1 and 23 in Cohort 2). Nineteen of these 25 participants remained progression-free at the time of the DCO, with a median efficacy follow-up of 49 weeks (range 6–97). In Cohort 2, investigators observed RECIST v1.1 objective responses in 9 of 23 participants (39%), including 8 confirmed responses. Both participants in Cohort 1 continued to exhibit stable disease after two years of follow-up. Updated safety for all participants and updated efficacy for participants with sufficient maturity beyond the 25 summarized here will be presented at the congress. Conclusions: Treatment with [ 212 Pb]VMT-α-NET continues to demonstrate a favorable safety profile across all treated participants (n = 56) and shows signs of sustained efficacy at the 2.5 mCi and 5 mCi dose levels. The therapy has been well-tolerated with no observed dose-limiting toxicities or serious treatment-related adverse outcomes. Based on these encouraging safety and efficacy findings, the study is ongoing, and enrollment into Cohort 3 (6 mCi) remains active. Clinical trial information: NCT05636618 .
Safety and preliminary efficacy results of [ 212 Pb]VMT-a-NET in advanced somatostatin receptor subtype 2 (SSTR2)-expressing neuroendocrine tumors (NETs).
Sólnes, Lilja B. , Balaraman, Savitha, Mancini, Brandon Robert, Sibley, Gregory S., Anthony, Lowell , Starr, Jason S., Liao, Chih‐Yi , Mehr, Samuel, Weiss, J., Baratto, Lucia , Yang, Wenjing, Hanna, Alaa , Puhlmann, Markus , Prasad, Vikas , Hálfdánarson, Þorvarður R. , Wahl, Richard L. , Sukrithan, Vineeth , Starr, Jason S. , Mehr, Samuel H., Weiss, Jared, Yang, Wenjing, O’Keefe, Stephen J.

Journal of Clinical Oncology | January 12, 2026 | Volume: 44 | Issue: 2_suppl | Pages: 635-635

10.1200/jco.2026.44.2_suppl.635 Get It

635 Background: [ 212 Pb]VMT-a-NET is an alpha therapy agent targeting somatostatin receptor subtype 2 (SSTR2)-expressing tumors. Here, we report the results of a prospective, open-label, Phase I/IIa trial (NCT05636618), assessing safety, tolerability, pharmacokinetics, and preliminary efficacy of [ 212 Pb]VMT-a-NET in patients with advanced neuroendocrine tumors (NETs). Methods: Adults with well-differentiated unresectable or metastatic SSTR2-expressing NETs, who are peptide receptor radionuclide therapy (PRRT) naïve, and who progressed on at least one prior line of systemic therapy, are eligible. Participants can receive up to four cycles of [ 212 Pb]VMT-a-NET at the assigned dose level. Participants are followed for dose-limiting toxicity (DLT) observation up to 42 days after the first dose. Efficacy is evaluated by investigators according to RECIST criteria v1.1. Results: As of 16-Aug-2025 (data cut-off [DCO]) a total of 48 participants were enrolled into cohorts 1 and 2 and received at least one dose of [ 212 Pb]VMT-a-NET (n=2 in Cohort 1, and n=46 in Cohort 2 at a dose level of 92.5 MBq and 185 MBq, respectively). Among all participants treated with at least one dose of [ 212 Pb]VMT-a-NET (n=48), no DLTs, no grade 4 or 5 adverse events (AEs), and no treatment-related discontinuations, were observed. Median follow-up time was 28 weeks (range: 6-93). Nine participants were followed for DLT observation (n=2 in cohort 1 and n=7 in cohort 2).Seven of these patients were with no progression as of the DCO. Three out of the seven participants enrolled at the dose level of 185 MBq achieved a confirmed partial response (PR). Median follow-up time for participants included in the efficacy group was 72 weeks (range: 6-93). Cohort 3, at a dose level of 222 MBq, has recently been opened for enrollment. At the DCO, 4 participants were enrolled in this cohort. Updated safety outcome for all participants along with updated efficacy findings for participants in Cohort 1 and 2 with sufficient maturity, will be presented during the congress. Conclusions: [ 212 Pb]VMT-a-NET showed a favorable safety profile and promising clinical benefit for patients with advanced SSTR2-expressing NETs treated at the dose levels of 92.5 MBq and 185 MBq. The study is ongoing with Cohort 3 (222 MBq) currently open for enrollment. Clinical trial information: NCT05636618 .
Phase II study of tinengotinib in advanced cholangiocarcinoma: Analysis of molecular response and resistance mechanisms.
Lamarca, Angela, Javle, Milind M., Fountzilas, C., Liao, Chih-Yi, Pelster, Meredith , Deming, Dustin A. , Sahai, Vaibhav , Fonkoua, Lionel Aurelien Kankeu, Cohn, Allen Lee, Mantry, Parvez , Richards, D., Kingsley, Ed, Mahipal, A., Hennessy, Katie , Wang, Hui , Sun, Caixia , Sahai, Vaibhav , Lamarca, Angela , Javle, Milind , Fountzilas, Christos , Liao, Chih‐Yi , Li, Daneng , Fonkoua, Lionel Aurelien Kankeu , Mahipal, Amit , Fan, Jean

Journal of Clinical Oncology | January 12, 2026 | Volume: 44 | Issue: 2_suppl | Pages: 566-566

10.1200/jco.2026.44.2_suppl.566 Get It

566 Background: FGFR inhibitors (FGFRi) have an established role in treating FGFR2-altered (alt) cholangiocarcinoma (CCA). Tinengotinib, a novel FGFRi, has shown promising activity overcoming acquired resistance to prior FGFRi. We present biomarker analyses evaluating tinengotinib’s ability to overcome prior FGFRi resistance and to elucidate mechanism of resistance to tinengotinib. Methods: Eligible patients (pts) with advanced/metastatic CCA who had received ≥ 1 prior systemic chemotherapy were treated with tinengotinib 10 mg daily across 4 Cohorts: A1: FGFR2 fusion (fus) with primary progressive disease (PD) on prior FGFRi; A2: FGFR2 fus with PD after prior response to FGFRi; B: FGFR alt without FGFR2 fus; C: FGFR wild-type. Efficacy was assessed by RECIST v1.1. All pts underwent liquid biopsy for circulating tumor DNA (ctDNA) at baseline; additional timepoints include cycle 3 day 1 (C3D1), time of PD, and end of treatment (EOT). Samples were analyzed using FoundationOne Liquid panel. Results: 27 out of 55 enrolled pts had biomarker samples collected at baseline and C3D1. Among them, pts in A1 (n=10, 107 mutations (mut)), B (n=8, 90 mut) and C (n=5, 74 mut) showed a significant decrease in short variant allele frequencies (VAF) from baseline to C3D1 by a median relative VAF reduction of 100% (p<0.0001) for each of the three cohorts. Although a median relative VAF reduction of 33.3% was seen in A2 (n=4, 15 mut), this was not significant (p=0.6093) likely due to low baseline mutation burden. A ≥50% reduction in ctDNA was associated with improved progression free survival (p<0.0014). Additionally, 100% of median relative reductions in FGFR2 kinase domain (KD) mut were seen in A1 and B (p<0.0001, 95% CI 100-100% and p=0.0156, 95% CI 83.6-100%, respectively), with 92% and 57% clearance of initial FGFR2 KD mut by C3D1. In a subgroup of 10 pts with biomarker sampling at baseline and EOT, 3 pts in A1 with acquired resistance showed emergence of novel FGFR2 mut, loss of FGFR-sensitive mut and new mut in alternate pathways (e.g., AKT, EGFR, RAS/MAPK) while retaining the original FGFR2 fus. 1 pt from B developed resistance due to new FGFR2 rearrangements and FGFR2 mut. 4 FGFR wild-type pts from C developed resistance involving mut in TP53, KRAS, and other oncogenic drivers. Conclusions: These findings provide genomic evidence that tinengotinib may overcome resistance to prior FGFRi treatment in FGFR2 fus-positive CCA, as reflected by significantly reductions in ctDNA VAFs and frequent clearance of FGFR2 KD mutations. The emergence of resistance alterations including de novo FGFR2 mutations and bypass pathways activations indicates acquired resistance that may limit long-term benefit. These results support further investigation with expanded biomarker sampling to better characterize resistance evolution and guide therapy optimization in an ongoing Phase 3 trial. Clinical trial information: NCT04919642 .
Abstract C095: [212Pb]VMT-a-NET for somatostatin receptor subtype 2 (SSTR2)-expressing tumors: safety and preliminary efficacy results in patients with advanced neuroendocrine tumors (NETs)
Prasad, Vikas, Sólnes, Lilja B. , Balaraman, Savitha, Sibley, Gregory S., Anthony, Lowell , Mancini, B.R. , Starr, Jason S. , Liao, Chih‐Yi , Baratto, Lucia , Yang, Wenjing , Hanna, Alaa , Puhlmann, Markus , Halfdanarson, Thorvadur, Wahl, Richard L. , Sukrithan, Vineeth , Mehr, Samuel, O’Keefe, Stephen J. , Hálfdánarson, Þorvarður R.

Molecular Cancer Therapeutics | October 22, 2025 | Volume: 24 | Issue: 10_Supplement | Pages: C095-C095

10.1158/1535-7163.targ-25-c095 Get It

Abstract Background: [212Pb]VMT-a-NET is an alpha therapy agent targeting somatostatin receptor subtype 2 (SSTR2)-expressing tumors. Neuroendocrine tumors (NETs) generally express SSTR2 on their cell surface. Here, we report the results of a prospective, open-label, Phase I/IIa clinical trial evaluating the safety, tolerability, pharmacokinetics, and preliminary efficacy of [212Pb]VMT-a-NET [NCT05636618]. Methods: The study design follows a Bayesian dose-finding algorithm. Main inclusion criteria include histologically proven well-differentiated unresectable or metastatic NETs, radiological evidence of progression on at least one prior line of systemic therapy, demonstration of lesional SSTR2 expression on an FDA-approved SSTR PET. Main exclusion criteria include: prior treatment with systemic PRRT-based therapies. In the dose finding phase, participants can receive up to four cycles of [212Pb]VMT-a-NET at the assigned dose level. Participants are followed for dose-limiting toxicity (DLT) observation up to 42 days after the first cycle. Efficacy is evaluated by investigators according to RECIST criteria v1.1. Here we report safety and preliminary efficacy data of participants enrolled in cohorts 1 and 2 at 92.5 MBq [2.5 mCi] and 185 MBq [5 mCi], respectively. Results: As of 30-Apr-2025 (data cut-off – DCO), a total of 42 participants were enrolled into the study. Nine of them were followed for DLT observation; thirty-three (33) additional participants were subsequently enrolled into cohort 2 to further evaluate safety and efficacy at the selected dose. For data analysis purposes, participants were divided into two different groups: a safety group and an efficacy group. The safety group included all participants enrolled by the DCO (n=42), while the efficacy group included only nine participants enrolled in cohort 1 (n=2) and cohort 2 (n=7) for DLT observation. Median follow up time for participants included in the safety group was 14 weeks (range:0,77); median follow up time for participants included in the efficacy group was 56 weeks (range: 6,77). In the safety group (n=42) we did not observe any DLTs, any grade 4 or 5 adverse events (AEs), any treatment-related discontinuations, any serious renal complications or myelosuppression, or any dysphagia. In the efficacy group (n=9) seven out of nine participants were with no progression as of the DCO, and four out of the seven participants enrolled in cohort 2 achieved a partial response (PR). Three PRs were confirmed, while one was pending confirmation at the time of DCO. Cohort 3, at a dose level of 222 MBq [6 mCi], has recently been opened for enrollment. Safety data for all treated participants and efficacy results for a mature subset will be presented at the congress. Conclusions: [212Pb]VMT-a-NET showed a favorable safety profile and promising clinical benefit for patients with advanced SSTR2-expressing NETs treated at the dose level of 185 MBq (5 mCi). The study is ongoing with cohort 3 currently open for enrollment. Citation Format: Vikas Prasad, Richard Wahl, Lilja Solnes, Savitha Balaraman, Gregory Sibley, Lowell Anthony, Brandon Mancini, Jason Starr, Vineeth Sukrithan, Chih-Yi Liao, Samuel Mehr, Lucia Baratto, Wenjing Yang, Alaa Hanna, Stephen Keefe, Markus Puhlmann, Thorvadur Halfdanarson. [212Pb]VMT-a-NET for somatostatin receptor subtype 2 (SSTR2)-expressing tumors: safety and preliminary efficacy results in patients with advanced neuroendocrine tumors (NETs) [abstract]. In: Proceedings of the AACR-NCI-EORTC International Conference on Molecular Targets and Cancer Therapeutics; 2025 Oct 22-26; Boston, MA. Philadelphia (PA): AACR; Mol Cancer Ther 2025;24(10 Suppl):Abstract nr C095 .
Final Results from a First-in-Human Phase I Study of the Dual Isocitrate Dehydrogenase (IDH) 1/2 Inhibitor, LY3410738, in Advanced Solid Tumors Harboring IDH1 or IDH2
Harding, James J. , Oh, Do‐Youn , Macarulla, Teresa , Goyal, Lipika , Varkaris, Andreas , Palmieri, Lola‐Jade , Ikeda, Masafumi , Kondo, Shunsuke , Bai, Li‐Yuan , Ueno, Makoto , Papadopoulos, Kyriakos P. , Shroff, Rachna T. , Kizilbash, Sani H. , Liao, Chih‐Yi , Azad, Nilofer S. , Jaeckle, Kurt A. , Bender, Mark H. , Varughese, Sunoj Chacko , Sachdeva, Deepa , Radtke, David B. , Gueorguieva, Ivelina , Chen, Hsiao-Rong , Liu, Hui , Xu, Xiangyuan , Macarulla, Teresa , Chen, Li-Tzong , Papadopoulos, Kyriakos P , Shroff, Rachna T , Kizilbash, Sani H , Hollebecque, Antoine , Adeva, Jorge , Cosman, Rasha , Yokota, Tomoya , Park, Joon Oh , Turk, Anita , Liao, Chih-Yi , Satoh, Taroh , Borad, Mitesh J , El-Khouiery, Anthony B , Azad, Nilofer , Jaeckle, Kurt A , Loong, Herbert H , Yong, Wei-Peng , Bender, Mark H , Varughese, Sunoj Chacko , Sachdeva, Deepa , Radtke, David B , Gueorguieva, Ivelina , Szpurka, Anna M , Chen, Hsiao-Rong , Liu, Hui , Xu, Xiaojian , Rodon, Jordi , Ikeda, Masafumi , Goyal, Lipika , Harding, James J , Chen, Li‐Tzong , Adeva, Jorge , Yokota, Tomoya , Borad, Mitesh J. , El-Khoueiry, Anthony B. , Loong, Herbert H. , Yong, Wei Peng

Clinical Cancer Research | September 30, 2025 | Volume: 31 | Issue: 23 | Pages: 4920-4932

10.1158/1078-0432.ccr-25-0174 Get It

Abstract Purpose: Isocitrate dehydrogenase (IDH) 1/2–isoform inhibitors have clinical efficacy in IDH1/IDH2-mutated neoplasms. However, primary resistance and secondary resistance limit their therapeutic potential. LY3410738, an oral, brain-penetrant, dual IDH1/IDH2-mutated isoform-selective inhibitor, was designed to overcome resistance. Patients and Methods: This global, multicenter, open-label, phase I study of patients with IDH-mutant solid tumors evaluated LY3410738 as monotherapy (dose escalation) for advanced solid tumors in combination with cisplatin–gemcitabine (CISGEM) for newly diagnosed cholangiocarcinoma or with durvalumab for relapsed/refractory cholangiocarcinoma (dose expansion; NCT04521686). Primary objectives were the maximum tolerated dose, recommended phase II dose, and preliminary antitumor activity. Safety, pharmacokinetics, inhibition of D-2-hydroxyglutarate, and ctDNA were assessed. Results: Overall, 119 patients received LY3410738 alone (N = 94) or in combination with CISGEM (N = 19) or durvalumab (N = 6). No dose-limiting toxicities were observed; the maximum tolerated dose was not determined. Common adverse events included nausea, vomiting, and decreased appetite. Overall response rates of 5.2% and 11.1% and disease control rates of 56.9% and 63.0% were observed for patients with relapsed/refractory IDH1- or IDH2-mutant cholangiocarcinoma or IDH1-mutant glioma, respectively. D-2-hydroxyglutarate normalization was rapid and durable. In dose-expansion cohorts, combination treatments were tolerable, with one dose-limiting toxicity in the durvalumab cohort. LY3410738 plus CISGEM demonstrated a response rate of 42.1%, a median duration of response of 8.1 months, and a median progression-free survival of 10.2 months for patients with newly diagnosed IDH-mutant cholangiocarcinoma. Conclusions: LY3410738 demonstrated largely cytostatic antitumor activity in IDH1- or IDH2-mutated cholangiocarcinoma and IDH1-mutated gliomas. LY3410738 plus CISGEM exhibited favorable antitumor activity in patients with treatment-naïve IDH-mutated cholangiocarcinoma, warranting further exploration as a treatment strategy.
[ 212 Pb]VMT-α-NET therapy in somatostatin receptor 2 (SSTR2) expressing neuroendocrine tumors (NETs): Dose-limiting toxicity (DLT) observation participants after 1 year follow-up and preliminary report for expansion part
Sólnes, Lilja B. , Mancini, Brandon Robert, Sibley, Gregory S., Anthony, Lowell , Liao, Chih‐Yi , Starr, Jason S. , Balaraman, Savitha, Prasad, Vikas, Baratto, Lucia , Hanna, Alaa , Yang, Wenjing , Puhlmann, Markus , Hálfdánarson, Þorvarður R. , O’Keefe, Stephen J. , Wahl, Richard L.

Journal of Clinical Oncology | May 28, 2025 | Volume: 43 | Issue: 16_suppl | Pages: 3005-3005

10.1200/jco.2025.43.16_suppl.3005 Get It

3005 Background: [ 212 Pb]VMT-α-NET, a next generation 212 Pb-based, SSTR2-targeted alpha-particle radiopharmaceutical therapy (RPT), was designed to achieve superior biodistribution via optimized tumor uptake and retention and rapid renal clearance. Results reported here are from the Phase 1/2a first-in-human study [NCT05636618]. Methods: Safety, pharmacokinetics, dosimetry and efficacy using RECIST v1.1 were investigated in the treatment of participants with [ 212 Pb]VMT-α-NET who had SSTR2-expressing, well-differentiated adult NETs of any grade. Participants received ≥1 prior therapy. No prior peptide receptor radionuclide therapy was allowed. The trial has multiple dose cohorts including 92.5 MBq (2.5 mCi, cohort 1) and 185 MBq (5 mCi, cohort 2) of administered activity based on a Bayesian modified toxicity probability interval (mTPI-2) design. Up to 8 participants per cohort were treated with 4 doses of [ 212 Pb]VMT-α-NET for DLT observation. Cohort 2 enrollment was expanded to further define the safety and efficacy profile at this dose level. Results: Nine (9) gastroenteropancreatic NET participants were enrolled into cohorts 1 and 2 for DLT observation. The ninth of these participants was enrolled more than 1 year prior to presentation of these data. Among these participants at the time of abstract submission, no DLTs were observed, and there were no grade 4, 5 or serious adverse events (SAEs). Specifically, no renal insufficiency or dysphagia were observed. Hematologic AEs were low grade and few in number. No treatment discontinuations due to AE occurred. Three (3) of the 7 cohort 2 participants enrolled for DLT observation achieved investigator-assessed partial responses (PRs). Two PRs were unconfirmed at the time of abstract submission. Durable progression-free survival (PFS) was consistently observed. More than 15 additional participants were enrolled in the cohort 2 expansion. Preliminary data for these patients will be reported at the congress. Conclusions: [ 212 Pb]VMT-α-NET is a well-tolerated, next generation RPT showing signs of clinical activity at early dose-levels in this phase 1/2a study. Based on these clinical data, further dose-escalation and development of this promising therapy are warranted. Clinical trial information: NCT05636618 .
Tinengotinib in patients with advanced, metastatic cholangiocarcinoma: Overall survival results and biomarker correlative analysis from a phase 2 clinical trial.
Liao, Chih‐Yi , Pelster, Meredith S. , Deming, Dustin A. , Sahai, Vaibhav , Fonkoua, Lionel Aurelien Kankeu , Cohn, Allen Lee, Mantry, Parvez , Richards, Donald , Kingsley, Ed, Wu, Frank , Peng, Peng , Hennessy, Katie , Wang, Hui , Shan, Yujun, Sun, Caixia, Javle, Milind , Sahai, Vaibhav , Fountzilas, Christos , Li, Daneng , Shan, Yujun, Fan, Jean , Mahipal, Amit

Journal of Clinical Oncology | January 27, 2025 | Volume: 43 | Issue: 4_suppl | Pages: 608-608

10.1200/jco.2025.43.4_suppl.608 Get It

608 Background: Tinengotinib, a spectrum-selective multi-kinase inhibitor with unique binding properties to FGFR , potently inhibited FGFR2 fusion/rearrangement and acquired resistant/gatekeeper mutations in pre-clinical models and exhibited antitumor activity in cholangiocarcinoma (CCA) patients (pts) in phase 1/2 trials. Here we present the overall survival (OS) data and biomarker correlative analysis from a phase 2 clinical trial of tinengotinib in CCA. Methods: Eligible pts with advanced/metastatic CCA who had received ≥ 1 prior systemic chemotherapy with ECOG PS 0-1 were treated with tinengotinib 10 mg QD across four Cohorts: A1: FGFR2 fusion(s) with primary progression on previous FGFR inhibitor ( FGFR i); A2: FGFR2 fusion(s) with progression after prior response to FGFR i; B: FGFR alteration(s) without FGFR2 fusion(s); C: FGFR wild-type. Efficacy was evaluated per RECIST v1.1 and safety was assessed by CTCAE v5.0. Genomic alterations in circulating tumor DNA (ctDNA) were assessed by Foundation Medicine NGS panel at baseline, C3D1 and EOT. Planned correlative analyses of response (PR+SD>6 months) and PFS in pt subgroups based on ctDNA mutational status were performed. Results: 55 eligible pts were enrolled (18 in A1, 11 in A2, 13 in B, 13 in C) with median age 61.0 [range 24-81] years, ECOG PS 0 in 50.9% pts, 56.4% female, and 60.0% with ≥ 3 lines of prior therapy. Among 42 pts with FGFR alterations, 78.4% had ≥ 1 prior FGFR i, and 97.6% had prior chemotherapy. Median follow up time was 8.6 months (0.4-30.5). The median OS (months) was 17.1 (95%CI 7.5-19.5) in A1; not reached (95%CI 9.6, -) in A2; 18.0 (95%CI 9.6, -) in A1+A2; not reached (95%CI 8.0, -) in B; 6.5 (95%CI 4.8-16.4) in C. The OS rate in A, B and C was 100%, 91.7% and 75% at month 3; 83.7%, 83.3% and 66.7% at month 6, and 65.8%, 55.6% and 23.8% at month 12. Partial response was observed in 26% (10/39) of evaluable FGFR-altered pts (A1+A2+B). The safety profile was consistent with previous reports. The most common any-grade treatment-related AEs were hypertension (63.6%) and diarrhea (47.3%). Baseline ctDNA results were available in 46 pts, 35 in cohorts A+B and 11 in C. A positive correlation was shown in MED12 mutation vs response (P=0.03476). BCOR and ARID1A mutation were found to be negatively associated with PFS (P=0.01366 and P=0.0437). Acquired/secondary mutations at baseline were observed in cohort A, including V564F/I (3/24 and 5/24) and N549K/H (5/24 and 5/24); favorable anti-tumor activity was noted despite these resistant mutations, consistent with preclinical data. Conclusions: Tinengotinib has shown promising anti-tumor efficacy in CCA pts with FGFR fusion after prior FGFR i and in those with primary FGFR mutations. An ongoing randomized phase III study will investigate tinengotinib vs. chemotherapy in FGFR inhibitor refractory CCA (NCT05948475). Clinical trial information: NCT04919642 .
Alliance EAY191-A6: FOLFOX in combination with binimetinib as second-line therapy for patients with advanced biliary tract cancers (BTCs) with MAPK pathway alterations: A ComboMATCH treatment trial.
Shergill, Ardaman , Liao, Chih-Yi, Baghdadi, Tareq Al, Feldman, Diane, Shroff, Rachna T. , Baghdadi, Tareq Al , Liao, Chih‐Yi , Elsaid, Mohamed I , Ji, Yan , Feldman, Diane, George, Suzanne , O’Reilly, Eileen M. , Meyerhardt, Jeffrey A. , Berg, Stephanie , Schwartz, Gary K. , Münster, Pamela N. , Bekaii‐Saab, Tanios , Abou‐Alfa, Ghassan K. , Shapiro, Geoffrey I.

Journal of Clinical Oncology | July 3, 2024 | Volume: 42 | Issue: 16_suppl | Pages: TPS4196-TPS4196

10.1200/jco.2024.42.16_suppl.tps4196 Get It

TPS4196 Background: Advanced BTC patients have poor prognosis. Up to 40% of BTCs have KRAS mutations and are associated with worse overall survival (OS). With a median OS of 7.7 months in KRAS wild-type compared to 1.7 months in KRAS mutated disease, these alterations are independent poor prognostic factors in BTC. Gemcitabine and cisplatin (GC) with or without immunotherapy are often used as 1st-line therapies. However, there is a lack of data on best 2nd-line regimens. mFOLFOX6 (5-fluorouracil [5-FU], leucovorin [LV], oxaliplatin) or liposomal irinotecan+5-FU+LV are options when no biomarkers are found (e.g., MSI-H, BRAFV600E, FGFR-fusions, IDH1-mutation, HER2-overexpression). Prior studies do not demonstrate benefit with MEK inhibitors (MEKi), but none of the studies had biomarker selection. Pre-clinical studies in BTC cell lines suggest synergy between MEKi and 5-FU. Thymidylate synthase (TS )levels induced by 5-FU are downregulated by addition of binimetinib. Early clinical studies show safety and tolerance of this combination. In this study, we will evaluate if the combination of mFOLFOX6+binimetinib improves OS for patients with BTC and MAPK mutations compared to mFOLFOX6 alone in 2nd-line therapy. Methods: EAY191-A6 is a treatment study arm of the NCI ComboMATCH master registration trial EAY191. The A6 trial has a randomized phase II design, enrolling a maximum of 66 patients. Patients with any MAPK pathway mutations except those with available therapies will be eligible. Patient must first enroll to the EAY191 master trial. Local molecular results may be used for enrollment. Submission of tissue at baseline is mandatory. Eligible patients will be randomized 1:1 to mFOLFOX6 vs mFOLFOX6 + binimetinib (45 mg oral twice a day every 14 days). Stratification factors include location and stage of disease. Primary efficacy analysis will compare OS in the intent-to-treat population. If the observed hazard ratio (HR) of experimental arm vs standard of care is < 0.545 (corresponding to an observed increase in OS by 5 months or longer), experimental treatment will be considered superior. An interim futility analysis at 50% of expected events will be conducted. If the observed HR is ≥ 1, experimental treatment will not be considered superior, and accrual maybe suspended. Secondary endpoints include progression-free survival, objective response rate, duration of response, disease control rate and toxicity of treatments. Exploratory objectives include prognostic modeling, correlations of genomic alterations with response or resistance and use of machine learning for outcome prediction. This study is active and open to accrual. Clinical trial information: NCT05564403 .
Abstract CT133: A phase 1b multicenter study of anti-TIM3 (S095018/Sym023) in combination with anti-PD1 (Sym021) in patients with advanced/metastatic recurrent biliary tract cancer
Razak, Albiruni Ryan Abdul, Liao, Chih‐Yi , Raimbourg, Judith , Geromini, Julia, Harouki, Najah , Rodrigues, Christelle , Darcel, Pauline, Skartved, Niels Jørgen Østergaard, Hald, Rikke , Lopez-Ravnborg, Daleen, He, Peng , Ianopoulos, Xenophon, Askoxylakis, Vasileios , Davis, S. Lindsey , Ghiringhelli, François , Kim, Richard D. , Macarulla, Teresa , Moreno, Irene Gala , Rodon, Jordi , Marron, Thomas , Kaplon, Hélène , Lakhani, Nehal J. , Mahipal, Amit

Cancer Research | April 5, 2024 | Volume: 84 | Issue: 7_Supplement | Pages: CT133-CT133

10.1158/1538-7445.am2024-ct133 Get It

Abstract Background: TIM3 is an inhibitory immunoreceptor linked to decreased activity of immune cells in the tumor microenvironment. S095018 is a human anti-TIM3 IgG2 antibody which blocks binding of phosphatidyl serine to TIM3 promoting the stimulation of T-cells, dendritic cells (DCs) and macrophages. Sym021 is a humanized IgG1 antibody that inhibits binding of PD-1 with its ligands PD-L1 and PD-L2. Preclinical data demonstrated that Sym021 combined with S095018 results in enhanced immunostimulatory antitumor activity. Methods: S095018 in combination with Sym021 was tested in patients with advanced/metastatic biliary tract cancer whose disease progressed under treatment with at least one line of systemic therapy and who had not received prior treatment with PD-1/-L1 inhibitors (NCT04641871). The dose/schedule of Sym021 and S095018 was 3mg/kg IV Q2W and 10mg/kg IV Q2W, respectively. Primary endpoints included overall response rate (ORR) using RECIST v1.1 and incidence/severity of adverse events. Key secondary endpoints included PK parameters, disease control rate (DCR), progression free survival (PFS) and overall survival (OS). Results As of 31-Oct-2023, 35 patients with stage IV biliary tract cancer (34 cholangiocarcinoma, 1 gallbladder adenocarcinoma) received S095018 in combination with Sym021. All patients were naïve to prior immune checkpoint inhibitor treatment. Twenty-two patients (62.9%) had received 1 prior antineoplastic systemic treatment for advanced/metastatic disease, 34.3% had received ≥2 prior treatments for advanced/metastatic disease. Overall, 34 patients (97.1%) discontinued treatment, 85.7% due to disease progression. Best overall response was 2 PR (5.7%), 11 SD (31.4%), 18 PD (51.4%) and 4 not evaluable. Median PFS and OS were 1.9 months (90% CI 1.8-3.7) and 13.4 months (90% CI 8.2-27.1) respectively. Disease control rate (CR+PR+SD) with SD≥16 weeks, ≥24 weeks and ≥12 months was 28.6%, 22.9% and 8.6% respectively. Treatment emergent adverse events of any grade occurring in &gt;5% of patients included fatigue, pruritus, alkaline phosphatase increase, amylase increase, IRR (each 8.6%) and hypothyroidism, hyperthyroidism, AST increase, lipase increase and myalgia (each 5.7%). Exploratory biomarker analyses in paired tumor biopsies (N=18) showed an intratumoral increase in CD8 T-cell density, as well as upregulation of gene signatures related to IFNg signaling, antigen presentation, T-cell activation and cytotoxicity upon treatment. Baseline tumor biopsies from the two patients who achieved confirmed PR showed high PD-L1 expression. Conclusions: S095018 in combination with Sym021 exhibited antitumor activity in patients with advanced/metastatic recurrent biliary tract cancer who had not received prior treatment with PD-1/-L1 inhibitors. The combination was well tolerated without new safety signals. Further biomarker analysis is ongoing. Citation Format: Francois Ghiringhelli, Richard Kim, Teresa Macarulla, Irene Moreno, Albiruni Razak, Jordi Rodon, Chih-Yi Liao, Thomas Marron, Judith Raimbourg, Helene Kaplon, Julia Geromini, Najah Harouki, Christelle Rodrigues, Pauline Darcel, Niels Jorgen Skartved, Rikke Hald, Daleen Lopez-Ravnborg, Peng He, Xenophon Ianopoulos, Vasileios Askoxylakis, Nehal J. Lakhani, Sarah Davis, Amit Mahipal. A phase 1b multicenter study of anti-TIM3 (S095018/Sym023) in combination with anti-PD1 (Sym021) in patients with advanced/metastatic recurrent biliary tract cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 2 (Late-Breaking, Clinical Trial, and Invited Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(7_Suppl):Abstract nr CT133.