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ASCO 2017: First-in-Class Cancer Stemness Inhibitor in Nonsquamous NSCLC

By: Meg Barbor, MPH
Posted: Friday, July 21, 2017

In patients with heavily pretreated nonsquamous non–small cell lung cancer (NSCLC) who received napabucasin—a first-in-class cancer stemness inhibitor—plus weekly paclitaxel, the investigational treatment appeared to be clinically safe, with signs of anticancer activity. At the 2017 American Society of Clinical Oncology (ASCO) Annual Meeting, Carlos Becerra, MD, of Baylor University Medical Center, presented the findings of this early-stage trial (Abstract 9052).

A phase Ib dose-escalation study of napabucasin plus paclitaxel showed preclinical antitumor activity in patients with advanced solid tumors, leading to a phase II expansion cohort for patients with advanced NSCLC. In the cohort, 23 patients with advanced nonsquamous NSCLC were evaluated. Prior platinum-based systemic therapy was required, and patients with an EGFR or ALK mutation required appropriately targeted therapy. Napabucasin was administered orally at a starting dose of 240 or 480 mg twice daily, with the addition of intravenous paclitaxel at 80 mg/m2 weekly 3 of every 4 weeks.

The researchers observed an objective response rate of 26%, including 6 partial responses. Median progression-free survival was 5.4 months, and median overall survival was 11 months. Tumor regression occurred in eight patients.

“The objective response rate, progression-free survival, and overall survival in this population warrant further clinical evaluation and a controlled phase II/III trial,” the investigators concluded.