Atezolizumab for Alveolar Soft Part Sarcoma: A Clinical Trial Update
Abstract
We previously reported initial results of the pivotal phase II trial of atezolizumab for patients with alveolar soft part sarcoma (ASPS; ClinicalTrials.gov identifier: NCT03141684 ). Here, we report on three additional years of observation. Fifty-three patients with ASPS received atezolizumab. Median duration of response increased to 37.0 months. Objective response rate (ORR) and median progression-free survival (mPFS) remained essentially as previously reported (35.8% [95% CI, 23.1 to 50.2] and 20.8 months [IQR, 7.6-not reached], respectively). ASPSCR1::TFE3 fusion type was determined for 47/53 patients; ORR and mPFS were higher among the 41 patients expressing type 1 (43.9% [95% CI, 28.5 to 60.2] and 28.3 months [IQR, 9.2-not reached], respectively) than the six patients expressing type 2 (0% [95% CI, 0 to 45.9] and 7.5 months [IQR, 3.9-not reached], respectively, PFS HR, 3.2 [95% CI, 1.01 to 10.2]). Eleven patients chose a per-protocol drug holiday (range, 3.5-26.4 months) after ≥2 years of treatment; two experienced disease progression during the holiday. Nine eligible patients elected to receive bevacizumab plus atezolizumab after progressing on monotherapy; ORR was 0% and mPFS was 18.5 months (IQR, 7.9-21.1) in this small cohort. Long-term results support using atezolizumab to treat ASPS, even for several years; a drug holiday with careful monitoring may be an option for some patients.
Article Details
Journal Info
Journal of Clinical Oncology
Lippincott Williams & Wilkins
Authors (28)
Alice P. Chen
Division of Cancer Treatment and Diagnosis, National Cancer Institute, Bethesda, MD
Christina L. Rosenberger
Division of Cancer Treatment and Diagnosis, National Cancer Institute, Bethesda, MD
Nancy Moore
Division of Cancer Treatment and Diagnosis, National Cancer Institute, Bethesda, MD
Jared C. Foster
Division of Cancer Treatment and Diagnosis, National Cancer Institute, Bethesda, MD
Abdul Rafeh Naqash
Elad Sharon
Geraldine O'Sullivan Coyne
Division of Cancer Treatment and Diagnosis, National Cancer Institute, Bethesda, MD
Gary K. Schwartz
Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH
Richard F. Riedel
avin Ratan, MD, MEd, Division of Cancer Medicine, Department of Sarcoma Medical Oncology, University of Texas, MD Anderson Cancer Center, Houston, TX; Bernd Kasper, MD, PhD, Sarcoma Unit, Mannheim University Medical Center, Mannheim Cancer Center, University of Heidelberg, Mannheim, Germany; Thierry Alcindor, MD, MS, Dana Farber Cancer Institute, Harvard Medical School, Boston, MA; Patrick Schöffski, MD, Department of General Medical Oncology, University Hospitals Leuven, Leuven Cancer Institute, KU Leuven, Leuven, Belgium; Winette T. van der Graaf, MD, PhD, Department of Medical Oncology, Netherlands Cancer Institute, Amsterdam, the Netherlands; Noah Federman, MD, Departments of Pediatrics and Orthopedics, UCLA Jonsson Comprehensive Cancer Center, UCLA David Geffen School of Medicine, Los Angeles, CA; Nam Q. Bui, MD, Division of Oncology, Department of Medicine, Stanford University, Stanford, CA; Gina D'Amato, MD, Sylvester Comprehensive Cancer Center, University of Miami Health System, Miami, FL; Richard...
John Glod
Center for Cancer Research, National Cancer Institute, Bethesda, MD
James S. Hu
Division of Oncology, University of Southern California Norris Comprehensive Cancer Center, Los Angeles, CA
Anthony P. Conley
The University of Texas MD Anderson Cancer Center, Houston, TX
William L. Read
Emory University, Atlanta, GA
Melissa A. Burgess
University of Pittsburgh Medical Center Hillman Cancer Center, Pittsburgh, PA
Elizabeth J. Davis
Division of Hematology/Oncology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN
Priscilla Merriam
Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA
Hari A. Deshpande
Department of Internal Medicine, Section of Medical Oncology, Yale University School of Medicine, New Haven, CT
Brian H. Ladle
Department of Oncology, Johns Hopkins University School of Medicine and Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD
Scott H. Okuno
Mayo Clinic, Rochester, MN
Jill C. Beck
Division of Pediatric Hematology-Oncology, University of Nebraska Medical Center, Omaha, NE
James L. Chen
Katherine V. Ferry-Galow
Clinical Pharmacodynamics Biomarker Program, Applied/Developmental Research Directorate, Frederick National Laboratory for Cancer Research, Frederick, MD
Kristin K. Fino
Clinical Pharmacodynamics Biomarker Program, Applied/Developmental Research Directorate, Frederick National Laboratory for Cancer Research, Frederick, MD
Brandon L. Miller
Clinical Pharmacodynamics Biomarker Program, Applied/Developmental Research Directorate, Frederick National Laboratory for Cancer Research, Frederick, MD
Deborah F. Wilsker
Clinical Pharmacodynamics Biomarker Program, Applied/Developmental Research Directorate, Frederick National Laboratory for Cancer Research, Frederick, MD
Asma Begum
Clinical Pharmacodynamics Biomarker Program, Applied/Developmental Research Directorate, Frederick National Laboratory for Cancer Research, Frederick, MD
Ralph E. Parchment
James H. Doroshow
Center for Cancer Research, National Cancer Institute, NIH