GU Cancers 2022 | ATLANTIS rucaparib arm: maintenance PARPi following chemotherapy for mUC
Simon Crabb, PhD, MBBS, Southampton Experimental Cancer Medicine Centre, University of Southampton, Southampton, UK, talks on the Phase II ATLANTIS screening trial for the maintenance treatment in biomarker-defined subgroups of patients with advanced urothelial cancer (UC). Biomarker analysis was carried out on tumor samples of patients who were undergoing palliative chemotherapy to determine patient allocation to randomized placebo-controlled Phase II trials exploring different maintenance targeted treatment options. The first trial investigating maintenance rucaparib following platinum-based chemotherapy was presented at the American Society of Clinical Oncology (ASCO) Genitourinary Cancers Symposium 2022 in patients with a DNA repair deficiency biomarker. An extended progression-free survival (PFS) was shown, with patients receiving rucaparib demonstrating a 35 week PFS compared to 15 weeks for patients receiving placebo, justifying further investigation of PARP inhibition in selected patients with mUC. This interview took place at the American Society of Clinical Oncology (ASCO) Genitourinary Cancers Symposium 2022 in San Francisco, CA.
Transcript (edited for clarity)
ATLANTIS is a clinical trial platform. It’s a multicenter investigator led study that’s been running in the UK. And it takes patients with advanced urothelial carcinoma, who are having palliative first-line chemotherapy. And during that period, we have undertaken biomarker analysis on their archival tumor samples. And then on the basis of those results, patients were able to enter a number of randomized placebo controlled Phase II trials that were running in parallel, as maintenance treatment options following on from chemotherapy...
ATLANTIS is a clinical trial platform. It’s a multicenter investigator led study that’s been running in the UK. And it takes patients with advanced urothelial carcinoma, who are having palliative first-line chemotherapy. And during that period, we have undertaken biomarker analysis on their archival tumor samples. And then on the basis of those results, patients were able to enter a number of randomized placebo controlled Phase II trials that were running in parallel, as maintenance treatment options following on from chemotherapy.
So the data we presented here was for the first of these, which was looking at rucaparib or placebo as maintenance treatments with a primary endpoint of progression-free survival (PFS). So we saw an extension of PFS for patients that received rucaparib, which was 35 weeks compared to 15 weeks for placebo, with a hazard ratio of 0.53. So this was a small Phase II trial, and we think now that that justifies further development of PARP inhibitors, but within a biomarker selected group of patients. And there was a second trial presented, which had similar results in a slightly different clinical setting for urothelial carcinoma. So it’s interesting data, we think, and warrants further work.
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