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Ref Type Journal Article
PMID (30108107)
Authors Lheureux S, Tinker A, Clarke B, Ghatage P, Welch S, Weberpals JI, Dhani NC, Butler MO, Tonkin K, Tan Q, Tan DSP, Brooks K, Ramsahai J, Wang L, Pham NA, Shaw PA, Tsao MS, Garg S, Stockley T, Oza AM
Title A Clinical and Molecular Phase II Trial of Oral ENMD-2076 in Ovarian Clear Cell Carcinoma (OCCC): A Study of the Princess Margaret Phase II Consortium.
Journal Clinical cancer research : an official journal of the American Association for Cancer Research
Vol 24
Issue 24
Date 2018 Dec 15
URL
Abstract Text Patients with recurrent ovarian clear cell carcinoma (OCCC) have limited effective options due to chemoresistance. A phase II study was designed to assess the activity of ENMD-2076, an oral multitarget kinase selective against Aurora A and VEGFR.This multicenter phase II study included patients with recurrent OCCC who received prior platinum-based chemotherapy. Primary endpoints were objective response and 6-month progression-free survival (PFS) rates. Correlative analyses include ARID1A and PTEN expression by IHC and gene sequencing with a targeted custom capture next-generation sequencing panel.Forty patients were enrolled with a median age of 54, of which 38 patients were evaluable. ENMD-2076 was well tolerated with main related grade 3 toxicities being hypertension (28%), proteinuria (10%), and diarrhea (10%). Best response was partial response for 3 patients (1 unconfirmed) and stable disease for 26 patients. The overall 6-month PFS rate was 22% and differed according to ARID1A expression (ARIDIA- vs. ARID1A+; 33% vs. 12%, P = 0.023). PTEN-positive expression was observed in 20 of 36 patients, and there was no correlation with outcome. Median PFS in patients with PI3KCA wild-type versus PI3KCA-mutated group was 5 versus 3.7 months (P = 0.049). Molecular profiling showed variants in PI3KCA (27%), ARID1A (26%), and TP53 (7%). The patient with the longest treatment duration (22 months) was PTEN wild-type, diploid PTEN with putative biallelic inactivation of ARID1A.Single-agent ENMD-2076 did not meet the preset bar for efficacy. Loss of ARID1A correlated with better PFS on ENMD-2076 and warrants further investigation as a potential predictive biomarker.

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Molecular Profile Treatment Approach
Gene Name Source Synonyms Protein Domains Gene Description Gene Role
Therapy Name Drugs Efficacy Evidence Clinical Trials
Drug Name Trade Name Synonyms Drug Classes Drug Description
Gene Variant Impact Protein Effect Variant Description Associated with drug Resistance
Molecular Profile Indication/Tumor Type Response Type Therapy Name Approval Status Evidence Type Efficacy Evidence References
ARID1A negative ovarian clear cell carcinoma predicted - sensitive ENMD-2076 Phase II Actionable In a Phase II trial, ENMD-2076 treatment resulted a median progression-free survival (PFS) of 4.4 months in patients with ARIDA1A-negative recurrent ovarian clear cell carcinoma and a median PFS of 3.6 months in ARID1A-positive patients, with a statistically significant difference in estimated 6-month PFS rate (0.33 vs 0.12, p=0.023) (PMID: 30108107). 30108107
Unknown unknown ovarian clear cell carcinoma no benefit ENMD-2076 Phase II Actionable In a Phase II trial, ENMD-2076 did not meet efficacy standard, resulted in partial response in 7.9% (3/38) and stable disease in 68.4% (26/38) of patients with recurrent ovarian clear cell carcinoma, with an overall 6-month progression-free survival rate of 22% (PMID: 30108107). 30108107