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Sonpavde GP, Sternberg CN, Loriot Y, Marabelle A, Lee JL, Fléchon A, Roubaud G, Pouessel D, Zagonel V, Calabro F, Banna GL, Shin SJ, Vera-Badillo FE, Powles T, Hellmis E, Miranda PAP, Lima AR, Emeribe U, Oh SM, Hotte SJ. Primary results of STRONG: An open-label, multicenter, phase 3b study of fixed-dose durvalumab monotherapy in previously treated patients with urinary tract carcinoma. Eur J Cancer 2022; 163:55-65. [PMID: 35042068 DOI: 10.1016/j.ejca.2021.12.012] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 12/03/2021] [Accepted: 12/06/2021] [Indexed: 11/03/2022]
Abstract
BACKGROUND Prior durvalumab (anti-PD-L1 agent) studies in platinum-refractory metastatic urothelial carcinoma evaluated a dose of 10 mg/kg administered every two weeks. The nonrandomised phase 3b STRONG study (NCT03084471) evaluated the safety and efficacy of fixed-dose durvalumab at a more convenient dosing schedule in a previously treated patient population, more similar to a real-world clinical setting. PATIENTS AND METHODS 867 patients with urothelial or nonurothelial urinary tract carcinoma (UTC) who progressed on or after platinum or nonplatinum chemotherapy were treated with durvalumab 1500 mg every four weeks; 87% had an Eastern Cooperative Oncology Group performance status (ECOG PS) of 0-1, and 13% had an ECOG PS of 2. The primary end-point was the incidence of adverse events of special interest (AESIs), including immune-mediated AEs (imAEs). Secondary and exploratory end-points included overall survival (OS), objective response rate (ORR) and disease control rate (at six and 12 months) (DCR). RESULTS AESIs of any grade were reported in 51% of patients (8% grade ≥ 3). The incidence of imAEs was 11% (2% grade ≥ 3). The median OS was 7.0 months (95% confidence interval [CI]: 6.4-8.2) and ORR was 18% (95% CI: 14.8-20.6), with complete responses in 5% of patients and a DCR at six months of 19% (95% CI: 16.1-22.1). CONCLUSION Fixed-dose durvalumab monotherapy every four weeks has an acceptable safety profile and yields durable clinical activity in previously chemotherapy-treated patients with UTC. Safety and efficacy are consistent with previous durvalumab studies and other anti-PD-1/PD-L1 agents in this setting. CLINICALTRIALS. GOV IDENTIFIER NCT03084471https://clinicaltrials.gov/ct2/show/NCT03084471.
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Affiliation(s)
- Guru P Sonpavde
- Medical Oncology, Dana Farber Cancer Institute, 450 Brookline Avenue, Boston, MA 02215, USA.
| | - Cora N Sternberg
- Englander Institute for Precision Medicine, Weill Cornell Medicine, Division of Hematology and Oncology, Sandra and Edward Meyer Cancer Center, Hematology/Oncology, 413 E 69th Street, Belfer Research Building, New York, NY 10021, USA; Presbyterian Hospital, 1305 York Avenue, New York, NY 10021, USA.
| | - Yohann Loriot
- Department of Cancer Medicine, Gustave Roussy, Université Paris-Saclay, Villejuif, France.
| | - Aurelien Marabelle
- Department of Cancer Medicine, Gustave Roussy, Université Paris-Saclay, Villejuif, France.
| | - Jae Lyun Lee
- Department of Oncology and Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-Ro 43-Gil, Songpa-Gu, Seoul 05505, South Korea.
| | - Aude Fléchon
- Department of Medical Oncology, Centre Léon-Bérard, 28 Rue Laennec, 69008 Lyon, France.
| | - Guilhem Roubaud
- Medical Oncology, Institut Bergonié, 229 Cours de l'Argonne, 33000 Bordeaux, France.
| | - Damien Pouessel
- Medical Oncology Department, Institut Claudius Régaud, IUCT Oncopole, 1 avenue Irène Joliot-Curie, 31059 Toulouse Cedex 9, Toulouse, France.
| | - Vittorina Zagonel
- Oncology Department, Oncology Unit 1, Veneto Institute of Oncology, IOV, IRCCS, Padua, Italy.
| | - Fabio Calabro
- Medical Oncology, San Camillo Forlanini Hospital, 75 Circonvallazione Gianicolense, 00152 Rome RM, Italy.
| | - Giuseppe L Banna
- (1)Department of Oncology, Ospedale Cannizzaro, 95126 Catania, Province of Catania, Italy.
| | - Sang Joon Shin
- Department of Internal Medicine, Yonsei University Health System, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, Republic of Korea.
| | | | - Thomas Powles
- Centre for Experimental Cancer Medicine, Barts Cancer Institute, Queen Mary University of London, Mile End Road, London E1 4NS, UK.
| | - Eva Hellmis
- Institut Urologicum Duisburg, Kometenplatz 29-33, 47179, Duisburg, Germany.
| | - Paulo A P Miranda
- Oncology Business Unit (OBU), Global Medical Affairs, AstraZeneca, 1 MedImmune Way, Gaithersburg, MD 20878, USA.
| | - Ana Rita Lima
- Oncology Business Unit (OBU), Global Medical Affairs, AstraZeneca, 1 MedImmune Way, Gaithersburg, MD 20878, USA.
| | - Ugochi Emeribe
- Statistical Science Immuno-Oncology, AstraZeneca, 1 MedImmune Way, Gaithersburg, MD 20878, USA.
| | - Sun Min Oh
- Oncology Business Unit (OBU), Global Medical Affairs, AstraZeneca, 1 MedImmune Way, Gaithersburg, MD 20878, USA.
| | - Sebastien J Hotte
- Department of Oncology, Juravinski Cancer Centre (JCC), Hamilton Health Sciences 699 Concession Street, Hamilton, ON, Canada.
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