P3.06-002 ATLANTIS Trial: Phase III Study of PM01183/Doxorubicin vs. CAV or Topotecan in SCLC after One Platinum-Containing Line: Topic: Clinical Studies

Abstract

PM01183 (lurbinectedin) is a new anticancer drug that blocks trans-activated transcription, induces DNA double-strand breaks and modulates the tumor microenvironment. Synergism in combination with doxorubicin with compelling overall response rates (∼67%, including approximately 10% complete responses) was reported in a phase I expansion cohort in 21 second-line SCLC patients (pts) (ASCO 2015, abstract 7509). The most common toxicity observed was hematologic. Multinational, multicenter (>150 sites), open-label, randomized, phase III study of PM01183/doxorubicin vs. a control arm with investigator choice of either standard CAV or topotecan (1.5 mg/m2, D1-5 q3wk). A total of 600 pts will be randomized (1:1) and stratified according to ECOG performance status (PS), chemotherapy-free interval (CTFI), known CNS involvement, prior PD-1/PD-L1 based immunotherapy and potential investigator’s control preference. Patients with clinical benefit after 10 cycles of doxorubicin containing-combination will continue on single agent PM01183 or CV, until PD or unacceptable toxicity. Interim safety analysis will be performed after 150 pts by an independent data monitoring committee. The most relevant inclusion criteria are: pts ≥18 years old; confirmed diagnosis of SCLC (small-cell carcinomas from unknown site are eligible provided ≥50% Ki-67 expression). One prior platinum containing regimen is mandatory (additional immunotherapy is allowed provided that it was not given in combination with CT); PS: 0-2 and adequate major organ function, including normal LVEF ≥50% at baseline. Pts are excluded if pre-treated with PM01183, doxorubicin or topotecan; symptomatic or steroid requiring CNS involvement or any serious medical condition that might preclude safe compliance with study treatment. The primary objective is to determine a difference in progression-free survival by an independent review committee. Secondary endpoints are overall survival, survival rates at 12/18/24 months, antitumor response (RECIST v1.1), duration of response, QoL, safety, subgroup analyses and pharmacokinetics (PK) of PM01183/doxorubicin arm. First patient is planned in JUL2016. Enrollment is expected to be completed by 4Q17. Section not applicable. Section not applicable.