A phase Ib/II study of cancer stemness inhibitor napabucasin (BB608) combined with weekly paclitaxel in platinum-resistant ovarian cancer.
Bibliographic record
Abstract
5578 Background: Napabucasin (BBI-608, BB608) is a first-in-class cancer stemness inhibitor targeting the STAT3 pathway that has shown potent synergistic anti-tumor activity with paclitaxel in vivo. In a dose escalation study, BB608 plus weekly paclitaxel was well tolerated in patients (pts) with advanced solid tumors. RP2D expansion included accrual of pts with platinum resistant ovarian cancer (PROC). Methods: Pts with advanced epithelial ovarian, fallopian, or peritoneal cancer who have progressed on a prior taxane-based regimen and who were platinum resistant or refractory were enrolled. BB608 240-480 mg twice daily was administered orally with paclitaxel 80 mg/m2 IV weekly 3 of every 4 weeks. A sample size of 40 set the bounds of the 90% CI at ±10% to 14%, assuming a disease control rate (DCR) of 60% to 80%. DCR is the proportion with stable disease (SD) at least 8 weeks or ,partial (PR) or complete response (CR) per RECIST 1.1. Results: 56 pts were enrolled after a median 4 prior lines of therapy, including prior taxanes (92% paclitaxel only, 4% docetaxel only, 4% both). Treatment was tolerated without dose-limiting toxicity or unexpected adverse events (AE). Grade 3 AE included rapidly-reversible diarrhea (18%), vomiting (7%), abdominal pain (7%), nausea (5%), dehydration and fatigue ( < 4% each). 80% of pts with grade 3 AE continued study at a reduced dose. In evaluable pts (n = 40), DCR was 68%, tumor regression occurred in 40%, and ORR (PR+CR) was 25%, including 1 with CR. Prior to being evaluated, 2 pts withdrew due to neuropathy, 6 for other AE, 5 for deterioration, 2 for noncompliance, and 1 for MI (unrelated). In the intent to treat (ITT) pts (n = 56), DCR was 48%, ORR was 18%, median progression free survival was 15 weeks and median overall survival was 38 weeks. In pts with up to 2 prior lines of therapy (n = 11), ORR was 45%. Conclusions: BB608 can be safely combined with weekly paclitaxel with acceptable tolerability in pts with heavily pretreated PROC who have progressed on prior taxane-based regimens. Complete and partial response, durable disease control, and prolonged progression free survival and overall survival have been observed in this population, warranting further clinical study. Clinical trial information: NCT01325441.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.004 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".