Chemotherapy-refractory microsatellite stable (MSS) advanced gastric/gastroesophageal/esophageal adenocarcinoma — Anwaar Saeed, MD (University of Pittsburgh); Collaborators: AstraZeneca, Exelixis
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SAMETA: the 1st biomarker driven R3 papillary RCC study #GU25 . CALYPSO is the phase 2 data supporting it. RR PFS and OS in the MET driven group looks promising for durva/savolitinib. @drfrankiejs…
⏩ @ASCO #GU25:
Durvalumab + Savolitinib shows strong efficacy in MET-driven advanced papillary RCC + promising ctDNA-based prognostic insights:
🔹 Response Rate: 34% (all aPRC), 59% (MET-driven)
🔹…
PhII single-arm CALYPSO of savolitinib + durva in VEGF naive/refractory papillary #RCC ➡️ median OS 18.3 mos (27.4 when MET-driven), OS 33.3 mos in those ctDNA- at baseline & 31.3 mos w/ctDNA…
Durvalumab + Savolitinib in MET-driven aPRC: Strong Efficacy!
-RR 59%, PFS 16.7m, OS 27.4m in MET-driven tumors.
🧬ctDNA positivity linked to worse OS
🩸🧬ctDNA clearance = better PFS
Francesca…
Updated data from Calypso trial demonstrating activity of savolitinib + durvalumab in MET driven papillary RCC. #GU25 @DrChoueiri @tompowles1 https://t.co/lzoUuMHgLJ
Durvalumab + Savolitinib in MET-driven aPRC: Strong Results!
RR 59%, PFS 16.7m, OS 27.4m in MET-driven tumors.
🧬ctDNA positivity = worse OS
🔎 ctDNA clearance predicts better PFS Francesca…
CAMILLA G/E cohort demonstrated anti-tumor activity of cabozantinib + durvalumab in chemotherapy-refractory MSS advanced gastric/gastroesophageal/esophageal adenocarcinoma. Overall ORR 20.69%, but striking signal in PD-L1 CPS >5 subgroup: ORR 25% with median OS 19.3 months (vs. 5.6 months overall). Investigators concluded further evaluation in PD-L1 CPS ≥5 warranted in a randomized trial. Competes for later-line activity with FGFR2b (bemarituzumab), CLDN18.2 (zolbetuximab), Trop-2 ADCs, and HER2-low T-DXd approaches in this setting. Part of University of Pittsburgh's multi-cohort CAMILLA basket (total enrollment 117 planned).
Median: 20.69 % ORR (6/29 evaluable; 5 PR + 1 CR) (cabozantinib 40mg + durvalumab 1500mg Q4W). Overall G/E cohort (N=29 evaluable) rate: 20.69% (ORR %) vs. 86.2% (DCR %) vs. 4.4% (mPFS months) vs. 5.6% (mOS months). PD-L1 CPS >5 subgroup (n=12) rate: 25% (ORR %) vs. 5.5% (mPFS months) vs. 19.3% (mOS months). Phase II multi-cohort trial (CAMILLA basket). G/E adenocarcinoma cohort: N=31 enrolled, 29 evaluable. Chemotherapy-refractory MSS advanced disease. Median age 61 (range 32-79); 86% ECOG 1; 48% with ≥2 prior systemic lines (range 1-4). Intervention: cabozantinib 40mg QD + durvalumab 1500mg IV Q4W (RP2D). Primary ORR 20.69% (6 confirmed: 5 PR + 1 CR). DCR 86.2% (25/29). Median PFS 4.4 months (95% CI 2.2-5.4); median OS 5.6 months (95% CI 3.6-8.3). PD-L1 CPS >5 subgroup (12/29): ORR 25%, mPFS 5.5 months (95% CI 1.8-12.4), mOS 19.3 months (95% CI 2.3-28.2) — notable OS signal in biomarker-selected subset. Park et al., JCO 2024;42(3)_suppl:373.
Overall median OS 5.6 months. PD-L1 CPS >5 subgroup: median OS 19.3 months (95% CI 2.3-28.2) — substantial signal. Supports PD-L1-selected randomized trial as next step.
Grade ≥3 adverse events: 19% (cabo_durva). Key AEs: fatigue (65%), anorexia (58%), liver enzymes elevation (39%), diarrhea (35%). Grade >3 TRAEs in 19% of patients. Immune-related AEs Grade >3: 6%. Manageable safety profile. No new safety signals beyond known cabozantinib + durvalumab combination profiles.
🔄 Phase 2 signal worth randomized evaluation in PD-L1 CPS ≥5 chemo-refractory gastric/esophageal. CAMILLA G/E cohort demonstrated anti-tumor activity of cabozantinib + durvalumab in chemotherapy-refractory MSS advanced gastric/gastroesophageal/esophageal adenocarcinoma. Overall ORR 20.69%, but striking signal in PD-L1 CPS >5 subgroup: ORR 25% with median OS 19.3 months (vs. 5.6 months overall). Investigators concluded further evaluation in PD-L1 CPS ≥5 warranted in a randomized trial. Competes for later-line activity with FGFR2b (bemarituzumab), CLDN18.2 (zolbetuximab), Trop-2 ADCs, and HER2-low T-DXd approaches in this setting. Part of University of Pittsburgh's multi-cohort CAMILLA basket (total enrollment 117 planned).