Clinical Activity and Safety of Cediranib and Olaparib Combination in Patients with Metastatic Pancreatic Ductal Adenocarcinoma without BRCA Mutation.
LESSONS LEARNED
Cediranib and olaparib combination did not result in clinically meaningful activity in patients with metastatic pancreatic ductal adenocarcinoma without known BRCA mutation.


BACKGROUND
Cediranib, a vascular endothelial growth factor receptor inhibitor, suppresses expression of BRCA1/2 and RAD51 inducing homologous recombination DNA repair deficiency (HRD) in several cancer cell lines and xenograft models [1]. Olaparib provides a clinical benefit in patients with metastatic pancreatic adenocarcinoma (mPDAC) with germline BRCA mutation (gBRCAmt) [2]. We hypothesized that cediranib induces HRD in the absence of gBRCAmt and synergizes with olaparib, resulting in an objective response in patients with mPDAC.


METHODS
Patients with mPDAC with at least one prior systemic chemotherapy were enrolled. Patients with known gBRCAmt were excluded. Patients took cediranib 30 mg daily and olaparib 200 mg twice daily, orally. The primary endpoint was objective response (OR) rate.


RESULTS
Nineteen patients received the study drugs. Seven patients came off treatment before the first restaging scan: six because of clinical progression and one because of an adverse event. No OR was observed. Six patients had stable disease (SD) as a best overall response. The median duration of SD was 3.1 months. The median overall survival was 3.4 months. Common treatment-related adverse events were fatigue, hypertension, and diarrhea.


CONCLUSION
Cediranib and olaparib combination did not result in clinically meaningful activity in patients with mPDAC without gBRCAmt.
['Kim|Joseph W|JW|0000-0003-2222-3531', 'Cardin|Dana B|DB|', 'Vaishampayan|Ulka N|UN|', 'Kato|Shumei|S|', 'Grossman|Steven R|SR|', 'Glazer|Peter M|PM|', 'Shyr|Yu|Y|', 'Ivy|S Percy|SP|', 'LoRusso|Patricia M|PM|']
D000230:Adenocarcinoma D005260:Female D006801:Humans D009154:Mutation D010051:Ovarian Neoplasms D010190:Pancreatic Neoplasms D010793:Phthalazines D010879:Piperazines D011799:Quinazolines D042461:Vascular Endothelial Growth Factor A
Cediranib Olaparib Pancreatic ductal adenocarcinoma BRCA