Preliminary Results of a Real-World Study of the Safety and Efficacy of Surufatinib in BTC

March 2024, Vol 5, No 1

Surufatinib, a small-molecule inhibitor targeting VEGFR1, VEGFR2, VEGFR3, FGFR1, and CSF-1R, has exhibited satisfactory clinical effectiveness and favorable safety and tolerability profiles when utilized as monotherapy in the treatment of patients with biliary tract cancer (BTC) in the second-line setting.

This study included patients who have undergone resection for BTC with positive margins, as this patient population has a poor prognosis with no proper treatment recommendation. Zongli Zhang, MD, PhD, presented these preliminary results during ASCO GI. A real-world study assessed the efficacy and safety of surufatinib as a therapy for BTC.1,2

This is an ongoing single-arm, multicenter, open-label, real-world study (NCT05064852) conducted in China. It aims to enroll 200 patients with unresectable or margin-positive (MP) BTC. Physicians will administer surufatinib with or without combination as adjuvant (for patients with MP-BTC), first-line, or further-line therapy at 200 to 300 mg once daily in 28-day cycles.

The primary endpoint of this study is relapse-free survival (RFS) for patients with MP-BTC and progression-free survival (PFS) for those who had evaluable lesions. Secondary endpoints include objective response rate (ORR), disease control rate (DCR), median overall survival (OS), and safety. If available, tumor assessments will be performed every 2 cycles ± 7 days according to RECIST (version 1.1).

As of September 10, 2023, 56 patients had been enrolled, of which 28 had evaluable lesions. Patients have a median age of 64 years, and 40% are male. In comparison, 28 (50.0%), 24 (42.9%), and 4 (7.1%) patients received surufatinib as an adjuvant, first-line, and above-treatment, respectively.

This is an ongoing single-arm, multicenter, open-label, real-world study (NCT05064852) conducted in China. It aims to enroll 200 patients with unresectable or margin-positive (MP) BTC.

The location of primary lesions varied: 23 cases were intrahepatic cholangiocarcinoma (iCCA), 33 cases were extrahepatic cholangiocarcinoma (eCCA), and 33 cases were gallbladder cancer (GBC). The global median RFS/PFS was 10.4 (95% confidence interval [CI], 8.97-13.9) months.

The median PFS of patients who received surufatinib as adjuvant treatment was 11.3 (95% confidence interval [CI], 10.4-not achieved [NA]) months, and that of those who received surufatinib as a systematic treatment was 9.0 (95% CI, 7.8-10.8) months.

Patients with iCCA demonstrated a median PFS of 10.4 (5.8-NA) months, and those with eCCA or GBC demonstrated a median PFS of 10.4 (9.5-NA) months. The global median OS was 15.8 (12.4-NA) months.

Among those with primary lesions unresected (n=28), 3 (10.7%) patients achieved a complete response, 4 (14.3%) patients achieved a partial response, 16 (57.1%) patients had stable disease, and 5 (17.9%) patients suffered progressive disease. The ORR in patients receiving surufatinib as first-line therapy was 25%, and the DCR was 79.2%.

The ORR in patients receiving surufatinib in later lines of therapy was 25%, and the DCR was 100%. The ORR in patients receiving surufatinib in later lines of therapy was 25%, and the DCR was 100%.

The most common adverse events (AEs) included hypertension (8.9%) and anorexia (3.6%). There were no reported deaths from AEs, no severe AEs, and no patients discontinued treatment due to AEs. The AEs, however, are still being collected.

The real-world application of surufatinib revealed promising efficacy and manageable toxicity in patients suffering from BTC. Surufatinib may, therefore, be a beneficial therapy for patients with BTC.2

References

  1. Xu J, Bai Y, Sun H, et al. A single-arm, multicenter, open-label phase 2 trial of surufatinib in patients with unresectable or metastatic biliary tract cancer. Cancer. 2021;127(21):3975-3984.
  2. Zhang Z, Ma C, Li E, et al. Efficacy and safety of surufatinib in biliary tract cancer: preliminary results of a real-world study. San Francisco, CA, & online: presented at ASCO Gastrointestinal Cancers Symposium; January 18-20, 2024: poster C11.

Related Items

Tasurgratinib for Patients With FGFR2 Gene Fusion–Positive CCA: A Phase 2 Study
March 2024, Vol 5, No 1
Junji Furuse, MD, PhD, presented the results of a phase 2 study of tasurgratinib efficacy on patients with FGFR2 fusion-positive cholangiocarcinoma following gene fusion status confirmation by fluorescence in situ hybridization.
Safety and Efficacy of Telotristat Ethyl Plus First-Line Chemotherapy in Patients With Advanced BTC: A Phase 2, Open-Label Study
March 2024, Vol 5, No 1
Richard Kim, MD, presented the results of a phase 2, open-label study of patients who underwent telotristat ethyl plus first-line chemotherapy for the treatment of advanced biliary tract cancer.
Efficacy and Safety of Brigimadlin (BI 907828) in Patients With Advanced BTC: Data From 2 Phase 1a/1b Dose-Escalation/Expansion Trials
March 2024, Vol 5, No 1
Teresa Macarulla, MD, PhD, presented the results of 2 phase 1a/1b dose-escalation/expansion trials, studies that measured the efficacy and safety of brigimadlin in patients with advanced biliary tract cancer.
COMPANION-002: A Phase 2/3 Randomized Study Design of CTX-009 Combination in Second-Line BTC
March 2024, Vol 5, No 1
A recombinant bispecific antibody, CTX-009, is discussed regarding its role in an ongoing phase 2/3 open-label, randomized, controlled study—a study being conducted to measure the efficacy of CTX-009 in previously treated, advanced, or metastatic biliary tract cancer.
A Phase 2 Clinical Trial of Anlotinib Plus TQB2450 (PD-L1 Blockade) Plus Nab-Paclitaxel and Cisplatin as First-Line Treatment for Advanced BTC
March 2024, Vol 5, No 1
Cholangiocarcinoma experts presented the preliminary results of a phase 2 clinical trial regarding anlotinib plus TQB2450, nab-paclitaxel, and cisplatin—a study conducted for the treatment of advanced biliary tract cancer.
Genomic Factors Indicating Sensitivity to IO and Chemotherapy in CCA
March 2024, Vol 5, No 1
Riya Jayesh Patel, MD, presented how the impact of transcriptomic signatures related to chemotherapy and immunotherapy sensitivity in the cholangiocarcinoma (CCA) cohort of The Cancer Genome Atlas could serve as evidence supporting the effectiveness of metabolism-targeted therapies in overcoming CCA therapeutic resistance.
Examining Real-World Testing, Treatment Patterns, and Outcomes After Liquid Biopsy in aCCA
March 2024, Vol 5, No 1
Amit Mahipal, MD, presented results from a real-world data study examining the rates of molecular alterations detected using circulating tumor DNA (ctDNA) for patients receiving ivosidenib following circulating tumor ctDNA-detected IDH1 mutations.
A Phase 2 Primary Analysis of Tislelizumab Plus Lenvatinib and GEMOX as Conversion Therapy in Potentially Resectable Locally Advanced BTC (ZSAB-TransGOLP)
March 2024, Vol 5, No 1
Jia Fan, PhD, presented results from a phase 2 trial that investigated the efficacy and safety of lenvatinib and a programmed cell death protein-1 antibody as conversion therapy for the treatment of potentially resectable and locally advanced biliary tract cancer.
Role of CD27 Agonist in Combination With PD-L1 and MEK Inhibition on Antitumor Effect and CD8+ T Cells: Expanding Immunotherapy Options in CCA
March 2024, Vol 5, No 1
Frances J. Bennett, MD, presented the results of a phase 2 trial that tested the antitumor effect of dual programmed death-ligand 1 plus mitogen-activated protein kinase inhibition in patients with advanced biliary tract cancer.
Phase 3 Study of Tinengotinib Versus Physician’s Choice in Patients With FGFR-Altered, Chemotherapy- and FGFR Inhibitor-R/R CCA: Study Design of FIRST-308
March 2024, Vol 5, No 1
FIRST-308 is an open-label, phase 2, randomized, global, multicenter study that will evaluate the efficacy and safety of oral tinengotinib versus physician’s choice in patients with fibroblast growth factor receptor (FGFR)-altered, chemotherapy- and FGFR inhibitor-refractory/relapsed cholangiocarcinoma—this article will review the study’s eligibility criteria, primary endpoints, and more.

Subscribe Today!

To sign up for our newsletter or print publications, please enter your contact information below.

I'd like to receive: