MEDI4736 (Durvalumab) in Patients With Brain Metastasis From Epithelial-derived Tumors
Status:
Terminated
Trial end date:
2018-01-11
Target enrollment:
Participant gender:
Summary
Brain metastases are the most common intracranial malignancy occurring in 20-40% of all
cancers, and the presence of CNS metastases is associated with a poor prognosis. As such, the
median overall survival of patients with symptomatic brain lesions is a dismal 2-3 months
regardless of tumor type. Because standard chemotherapy largely does not cross the blood
brain barrier at a meaningful concentration, standard treatment is limited and usually
involves surgical resection and/or stereotactic radiosurgery for isolated lesions and whole
brain radiation for multiple lesions. Unfortunately, the median overall survival is only
improved by about 6 months with this multimodality approach2, and there is a paucity of
second-line therapies to treat recurrence. Furthermore, re-resection and re-radiation are
often not feasible options due to concern for increasing complications or neurotoxicity,
respectively. Thus, there is a dire clinical need for additional treatment options for this
patient population.
Checkpoint blockade therapy, in particular PD-1 and PD-L1 inhibition, has recently shown
clinical efficacy in multiple types of solid tumors. The investigators propose to study the
efficacy of checkpoint blockade therapy in patients with solid tumors and
refractory/recurrent brain metastases. The investigators will assess the efficacy of
MEDI4736, a novel PD-L1 inhibitory monoclonal antibody, in this study.