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*Tissue sample suitable for initial diagnosis of CUP at study site, confirmation of CUP *Tissue sample suitable for initial diagnosis of CUP at study site, confirmation of CUP

*Tissue sample suitable for initial diagnosis of CUP at study site, confirmation of CUP - PowerPoint Presentation

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Uploaded On 2020-06-30

*Tissue sample suitable for initial diagnosis of CUP at study site, confirmation of CUP - PPT Presentation

Sample suitable for analysis of circulating tumour DNA using Foundation Liquid assay MX39795 Study Design Inclusion criteria Histologically confirmed CUP nonspecific subset No prior lines of therapy ID: 790256

study cup induction criteria cup study criteria induction comprehensive chemo inclusion tumour responders primary exclusion genomic laboratory protocol diagnosis

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Presentation Transcript

Slide1

*Tissue sample suitable for initial diagnosis of CUP at study site, confirmation of CUP diagnosis and generation of Foundation One comprehensive genomic profile at central laboratory

Sample suitable for analysis of circulating tumour DNA using Foundation Liquid assay

MX39795 Study Design

Inclusion criteria

Histologically confirmed CUP (non-specific subset)

No prior lines of therapy

ECOG PS 0–1

≥1 measurable lesion

N=790

Induction

Carboplatin + paclitaxel or cisplatin + gemcitabine

(3 cycles)

Non-responders

PD or intolerable toxicity

n=318 (40%)

Responders

CR, PR or SD

n=472 (60%)

Investigator choice (following Molecular Tumour Board advice)

n=354

Alectinib (

ALK

or

RET

rearrangements)

Erlotinib + bevacizumab (

EGFR

Mut+)

Trastuzumab + pertuzumab + continued

induction chemo (

ERBB2

)

Vismodegib (

PTCH1

, SUFU or SMO)

Vemurafenib + cobimetinib (BRAF MutV600)

Ipatasertib (AKT1 or PI3K)

Olaparib (BRCA1, BRCA2 or HRD)

Atezolizumab (TMB high or MSI-high)

Atezolizumab + continued induction chemo (patients with no other option)

R3:1

n=118

Investigator choice (following Molecular Tumour Board advice)

Assigned as per randomised arm

Carboplatin + paclitaxel or cisplatin + gemcitabine (3 cycles)

Screening

Genomic profilingTissue* and blood‡plus select biomarkers (e.g. PD-L1)

Primary endpoint: pooled PFS from 9 molecularly guided regimens vs chemo in responders to induction chemo [PFS1]Secondary endpoint: OS

Category 1

Category 2

Slide2

* A more comprehensive list can be found in the study protocol.

Selected inclusion criteria for CUPISCO

Inclusion criteria*

Histologically confirmed metastatic or advanced

unresectable

CUP as defined in

ESMO

guidelines

No prior lines of systemic CUP therapy

ECOG performance status of 0 or 1

Eligible

for platinum-based

doublet chemotherapy

Adequate hematologic and

end-organ

function

At least one lesion that is measurable (RECIST v1.1)

18 years of

age

Life

expectancy ≥ 12 weeks

Sufficient

FFPE tumour tissue sample for:

Diagnosis of CUP at the study site’s local laboratory and

FoundationOne

® comprehensive genomic profiling at a central reference pathology laboratory

Inclusion

Slide3

Selected exclusion criteria for CUPISCO

Exclusion criteria*

*

A more comprehensive list can be found in the study protocol

.

CUP: cancer of unknown primary site.

Roche data on file, study protocol MX39795

version 1.1

.

Favourable prognostic subset

(e.g., resectable)

Non-CUP neoplasms

Immunohistochemistry profile

that provides a definitive clinical suspicion of a primary cancer with a specific treatment

Leptomeningeal disease

Brain

or spinal

cord

metastases

Exclusion