CXCR2 antagonist navarixin in combination with pembrolizumab in select advanced solid tumors: a phase 2 randomized trial
- Author(s)
- Armstrong, AJ; Geva, R; Chung, HC; Lemech, C; Miller, WH, Jr; Hansen, AR; Lee, JS; Tsai, F; Solomon, BJ; Kim, TM; Rolfo, C; Giranda, V; Ren, Y; Liu, F; Kandala, B; Freshwater, T; Wang, JS;
- Journal Title
- Investigational New Drugs
- Publication Type
- Research article
- Abstract
- C-X-C motif chemokine receptor 2 (CXCR2) has a role in tumor progression, lineage plasticity, and reduction of immune checkpoint inhibitor efficacy. Preclinical evidence suggests potential benefit of CXCR2 inhibition in multiple solid tumors. In this phase 2 study (NCT03473925), adults with previously treated advanced or metastatic castration-resistant prostate cancer (CRPC), microsatellite-stable colorectal cancer (MSS CRC), or non-small-cell lung cancer (NSCLC) were randomized 1:1 to the CXCR2 antagonist navarixin 30 or 100 mg orally once daily plus pembrolizumab 200 mg intravenously every 3 weeks up to 35 cycles. Primary endpoints were investigator-assessed objective response rate (RECIST v1.1) and safety. Of 105 patients (CRPC, n=40; MSS CRC, n=40; NSCLC, n=25), 3 had a partial response (2 CRPC, 1 MSS CRC) for ORRs of 5%, 2.5%, and 0%, respectively. Median progression-free survival was 1.8-2.4 months without evidence of a dose-response relationship, and the study was closed at a prespecified interim analysis for lack of efficacy. Dose-limiting toxicities occurred in 2/48 patients (4%) receiving navarixin 30 mg and 3/48 (6%) receiving navarixin 100 mg; events included grade 4 neutropenia and grade 3 transaminase elevation, hepatitis, and pneumonitis. Treatment-related adverse events occurred in 70/105 patients (67%) and led to treatment discontinuation in 7/105 (7%). Maximal reductions from baseline in absolute neutrophil count were 44.5%-48.2% (cycle 1) and 37.5%-44.2% (cycle 2) and occurred within 6-12 hours postdose in both groups. Navarixin plus pembrolizumab did not demonstrate sufficient efficacy in this study. Safety and tolerability of the combination were manageable. (Trial registration: ClinicalTrials.gov , NCT03473925).
- Publisher
- Springer Nature
- Keywords
- C-X-C chemokine; Clinical trial; Navarixin; Pembrolizumab; Solid tumors
- Department(s)
- Medical Oncology
- Publisher's Version
- https://doi.org/10.1007/s10637-023-01410-2
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- Refer to copyright notice on published article.
Creation Date: 2024-02-29 12:18:03
Last Modified: 2024-02-29 12:27:09