Phase II Trial of Cabozantinib in Recurrent/Metastatic Endometrial Cancer: A Study of the Princess Margaret, Chicago, and California Consortia (NCI9322/PHL86)

Neesha C. Dhani, Hal W. Hirte, Lisa Wang, Julia V. Burnier, Angela Jain, Marcus O. Butler, Stephen Welch, Gini F. Fleming, Jean Hurteau, Koji Matsuo, Daniela Matei, Waldo Jimenez, Carolyn Johnston, Mihaela Cristea, Katia Tonkin, Prafull Ghatage, Stephanie Lheureux, Anjali Mehta, Judy Quintos, Qian TanSuzanne Kamel-Reid, Olga Ludkovski, Ming Sound Tsao, John J. Wright, Amit M. Oza

Research output: Contribution to journalArticle

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Abstract

Purpose: The relevance of the MET/hepatocyte growth factor pathway in endometrial cancer tumor biology supports the clinical evaluation of cabozantinib in this disease. Patients and Methods: PHL86/NCI#9322 (NCT01935934) is a single arm study that evaluated cabozantinib (60 mg once daily) in women with endometrial cancer with progression after chemotherapy. Coprimary endpoints were response rate and 12-week progression-free-survival (PFS). Patients with uncommon histology endometrial cancer (eg, carcinosarcoma and clear cell) were enrolled in a parallel exploratory cohort. Results: A total of 102 patients were accrued. Among 36 endometrioid histology patients, response rate was 14%, 12-week PFS rate was 67%, and median PFS was 4.8 months. In serous cohort of 34 patients, response rate was 12%, 12-week PFS was 56%, and median PFS was 4.0 months. In a separate cohort of 32 patients with uncommon histology endometrial cancer (including carcinosarcoma), response rate was 6% and 12-week PFS was 47%. Six patients were on treatment for >12 months, including two for >30 months. Common cabozantinib-related toxicities (>30% patients) included hypertension, fatigue, diarrhea, nausea, and hand–foot syndrome. Gastrointestinal fistula/perforation occurred in four of 70 (6%) patients with serous/endometrioid cancer and five of 32 (16%) patients in exploratory cohort. We observed increased frequency of responses with somatic CTNNB1 mutation [four partial responses (PRs) in 10 patients, median PFS 7.6 months] and concurrent KRAS and PTEN/PIK3CA mutations (three PRs in 12 patients, median PFS 5.9 months). Conclusions: Cabozantinib has activity in serous and endometrioid histology endometrial cancer. These results support further evaluation in genomically characterized patient cohorts.

Original languageEnglish (US)
Pages (from-to)2477-2486
Number of pages10
JournalClinical Cancer Research
Volume26
Issue number11
DOIs
StatePublished - Jun 1 2020

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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    Dhani, N. C., Hirte, H. W., Wang, L., Burnier, J. V., Jain, A., Butler, M. O., Welch, S., Fleming, G. F., Hurteau, J., Matsuo, K., Matei, D., Jimenez, W., Johnston, C., Cristea, M., Tonkin, K., Ghatage, P., Lheureux, S., Mehta, A., Quintos, J., ... Oza, A. M. (2020). Phase II Trial of Cabozantinib in Recurrent/Metastatic Endometrial Cancer: A Study of the Princess Margaret, Chicago, and California Consortia (NCI9322/PHL86). Clinical Cancer Research, 26(11), 2477-2486. https://doi.org/10.1158/1078-0432.CCR-19-2576