An open-label phase 2 trial of entospletinib (GS-9973), a selective spleen tyrosine kinase inhibitor, in chronic lymphocytic leukemia

J Sharman, M Hawkins, K Kolibaba… - Blood, The Journal …, 2015 - ashpublications.org
J Sharman, M Hawkins, K Kolibaba, M Boxer, L Klein, M Wu, J Hu, S Abella, C Yasenchak
Blood, The Journal of the American Society of Hematology, 2015ashpublications.org
Small-molecule inhibitors of kinases involved in B-cell receptor signaling are an important
advance in managing lymphoid malignancies. Entospletinib (GS-9973) is an oral, selective
inhibitor of spleen tyrosine kinase. This multicenter, phase 2 study enrolled subjects with
relapsed or refractory chronic lymphocytic leukemia (CLL; n= 41) or non-Hodgkin lymphoma
(n= 145). Participants received 800 mg entospletinib twice daily. We report efficacy
outcomes in the CLL cohort (n= 41) and safety outcomes in all cohorts (N= 186). The primary …
Abstract
Small-molecule inhibitors of kinases involved in B-cell receptor signaling are an important advance in managing lymphoid malignancies. Entospletinib (GS-9973) is an oral, selective inhibitor of spleen tyrosine kinase. This multicenter, phase 2 study enrolled subjects with relapsed or refractory chronic lymphocytic leukemia (CLL; n = 41) or non-Hodgkin lymphoma (n = 145). Participants received 800 mg entospletinib twice daily. We report efficacy outcomes in the CLL cohort (n = 41) and safety outcomes in all cohorts (N = 186). The primary end point was a progression-free survival (PFS) rate at 24 weeks in subjects with CLL. The PFS rate at 24 weeks was 70.1% (95% confidence interval [CI], 51.3%-82.7%); median PFS was 13.8 months (95% CI, 7.7 months to not reached). The objective response rate was 61.0% (95% CI, 44.5%-75.8%), including 3 subjects (7.3%) who achieved nodal response with persistent lymphocytosis. Fifty-four subjects (29.0%) had serious adverse events (SAEs). The most common treatment-emergent SAEs included dyspnea, pneumonia, febrile neutropenia, dehydration, and pyrexia. Common grade 3/4 laboratory abnormalities included neutropenia (14.5%) and reversible alanine aminotransferase/aspartate aminotransferase elevations (13.4%). Entospletinib demonstrates clinical activity in subjects with relapsed or refractory CLL with acceptable toxicity. This trial was registered at www.clinicaltrials.gov as #NCT01799889.
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