In the first preplanned interim analysis (IA) from ALTA-1L (NCT02737501; median follow-up BRG/CRZ: 11.0/9.3 mo, 99 PFS events), BRG demonstrated superior BIRC-assessed PFS and improved patient-reported quality of life vs CRZ. We report results of the second IA planned at 75% of 198 expected events.
Patients (pts) with ALK inhibitor–naive advanced ALK+ NSCLC and ECOG PS 0–2 were enrolled. One prior chemotherapy for advanced NSCLC was allowed. Asymptomatic CNS metastases were allowed. Pts were stratified by baseline (BL) brain metastases and prior chemotherapy. All pts had brain MRI at each tumor assessment. Pts were randomized 1:1 to BRG 180 mg QD (with 7-day lead-in at 90 mg) or CRZ 250 mg BID. Pts in the CRZ arm were offered BRG at progression. Primary endpoint: BIRC-assessed PFS (RECIST v1.1). Secondary endpoints included confirmed ORR, confirmed iORR, iPFS by BIRC, OS, and safety.
275 pts were randomized (BRG/CRZ, n = 137/138); median age 58/60 y. 26%/27% received prior chemotherapy; 29%/30% had BL brain metastases. As of 28 Jun 2019, median follow-up was BRG/CRZ: 24.9/15.2 mo, with 150 PFS events. HR of BIRC-assessed PFS was 0.49 (95% CI 0.35–0.68, log-rank P < 0.0001); BRG mPFS was 24.0 mo (95% CI 18.5–NE) vs CRZ 11.0 mo (95% CI 9.2–12.9). Investigator-assessed PFS HR was 0.43 (95% CI 0.31–0.61, median 29.4 vs 9.2 mo). OS was immature (total events: 33/37, BRG/CRZ). In pts with BL brain metastases, the PFS HR was 0.25. Data were less mature in pts without BL brain metastases treated with BRG. Table shows additional efficacy data. Most common TEAEs grade ≥3: BRG: increased CPK (24.3%) and lipase (14.0%), hypertension (11.8%); CRZ: increased ALT (10.2%), AST (6.6%), and lipase (6.6%). Any grade ILD/pneumonitis (BRG/CRZ): 5.1%/2.2%; discontinuations due to AE (BRG/CRZ): 12.5%/8.8%. Table: LBA1 BIRC, blinded independent review committee; DoR, duration of response; iDoR, intracranial DoR; iORR, intracranial ORR; iPFS, intracranial PFS; ITT, intent-to-treat; mDoR, median DoR; NE, not estimable; ORR, objective response rate; PFS, progression-free survival. Response, ≥1 assessment; 95% CI; Cochran-Mantel-Haenszel test; Confirmed responders; Log-rank; Per investigator assessment; Per BIRC assessment.BIRC-Assessed Efficacy BRG CRZ P Value All pts (ITT), n 137 138 ORR 79 (71–85 75 (67–82 0.4376 Confirmed ORR, % 74 (66–81 62 (53–70 0.0342 mDoR NE (19–NE 14 (9–21 PFS events, n (%) 63 (46) 87 (63) mPFS, mo 24.0 (18.5–NE 11.0 (9.2–12.9 PFS HR 0.49 (0.35–0.68 <0.0001 Any BL brain metastases, n 40 41 PFS events, n (%) 20 (50) 30 (73) PFS HR 0.25 (0.14–0.46 <0.0001 47 49 iPFS events, n (%) 21 (45) 32 (65) iPFS HR 0.31 (0.17–0.56 <0.0001 No BL brain metastases 97 97 PFS events, n (%) 43 (44) 57 (59) PFS HR 0.65 (0.44–0.97 0.0298 BL measurable brain metastases, n 18 23 iORR 78 (52–94 30 (13–53 0.0036 Confirmed iORR, % 78 (52–94 26 (10–48 0.0014 Median iDoR NE (6–NE 9 (4–9
BRG showed durable PFS superiority vs CRZ in ALK inhibitor–naive ALK+ NSCLC.
NCT02737501.
Peloton Advantage, LLC, an OPEN Health company, Parsippany, NJ, USA, and funded by Millennium Pharmaceuticals, Inc., a wholly owned subsidiary of Takeda Pharmaceutical Company Limited, Cambridge, MA, USA.
ARIAD Pharmaceuticals, Inc., a wholly owned subsidiary of Takeda Pharmaceutical Company Limited.
ARIAD Pharmaceuticals, Inc., a wholly owned subsidiary of Takeda Pharmaceutical Company Limited.
R. Camidge: Honoraria (self): AstraZeneca; Honoraria (self), Research grant / Funding (self): Takeda; Honoraria (self): Arrys/Kyn; Honoraria (self): Novartis; Honoraria (self): Celgene; Honoraria (self): Clovis; Honoraria (self): Orion; Honoraria (self): Revolution Med; Honoraria (self): Lycera; Honoraria (self): Bio-Thera DSMB; Honoraria (self): Hansoh SRC; Honoraria (self): Daichi Sankyo; Honoraria (self): Ignyta; Honoraria (self): Roche/Genentech; Honoraria (self): Mersana Therapeutics; Honoraria (self): G1 Therapeutics; Honoraria (self): Genoptix. H.R. Kim: Honoraria (self), Advisory / Consultancy: AstraZeneca; Honoraria (self), Advisory / Consultancy: Roche; Honoraria (self), Advisory / Consultancy: Boehringer Ingelheim. M. Ahn: Honoraria (self), Advisory / Consultancy: AstraZeneca; Honoraria (self), Advisory / Consultancy: BMS; Honoraria (self), Advisory / Consultancy: Boehringer Ingelheim; Honoraria (self), Advisory / Consultancy: MSD; Honoraria (self), Advisory / Consultancy: Novartis. J.C. Yang: Honoraria (self), Advisory / Consultancy: Boehringer Ingelheim; Honoraria (self), Advisory / Consultancy: Eli Lilly; Honoraria (self), Advisory / Consultancy: Bayer; Honoraria (self), Advisory / Consultancy: Roche/Genentech/Chugai; Honoraria (self), Advisory / Consultancy: Astellas; Honoraria (self), Advisory / Consultancy: MSD; Honoraria (self), Advisory / Consultancy: Merck Serono; Honoraria (self), Advisory / Consultancy: Pfizer; Honoraria (self), Advisory / Consultancy: Novartis; Honoraria (self), Advisory / Consultancy: Celgene; Honoraria (self), Advisory / Consultancy: Merrimack; Honoraria (self), Advisory / Consultancy: Yuhan Pharmaceuticals; Honoraria (self), Advisory / Consultancy: BMS; Honoraria (self), Advisory / Consultancy: Ono Pharmaceutical; Honoraria (self), Advisory / Consultancy: Daiichi Sankyo; Honoraria (self), Advisory / Consultancy: Takeda; Honoraria (self), Advisory / Consultancy: AstraZeneca; Honoraria (self), Advisory / Consultancy: Hansoh Pharmaceuticals. J. Han: Research grant / Funding (self): Roche. M.J. Hochmair: Honoraria (self): AstraZeneca; Honoraria (self): Bristol-Myers Squibb; Honoraria (self), Advisory / Consultancy: Boehringer Ingelheim; Honoraria (self), Advisory / Consultancy: Merck Sharp & Dohme; Honoraria (self): Pfizer; Honoraria (self), Advisory / Consultancy: Roche; Honoraria (self), Advisory / Consultancy: Takeda; Advisory / Consultancy: Novartis. K.H. Lee: Honoraria (self), Advisory / Consultancy: AstraZeneca; Honoraria (self), Advisory / Consultancy: Eli Lilly; Honoraria (self), Advisory / Consultancy: Boehringer Ingelheim. A. Delmonte: Advisory / Consultancy: AstraZeneca; Advisory / Consultancy: Boehringer Ingelheim. M.R. Garcia Campelo: Honoraria (self), Advisory / Consultancy, Speaker Bureau / Expert testimony: Ariad; Honoraria (self), Advisory / Consultancy, Speaker Bureau / Expert testimony: AstraZeneca; Honoraria (self), Advisory / Consultancy, Speaker Bureau / Expert testimony: Roche; Honoraria (self), Advisory / Consultancy, Speaker Bureau / Expert testimony: Pfizer; Honoraria (self), Advisory / Consultancy, Speaker Bureau / Expert testimony: BMS; Honoraria (self), Advisory / Consultancy, Speaker Bureau / Expert testimony: Boehringer Ingelheim. F. Griesinger: Advisory / Consultancy: Ariad; Advisory / Consultancy: Takeda; Advisory / Consultancy: Roche; Advisory / Consultancy: Novartis; Advisory / Consultancy: Pfizer. E. Felip: Advisory / Consultancy: AstraZeneca; Advisory / Consultancy: Boehringer Ingelheim; Advisory / Consultancy: BMS; Advisory / Consultancy: Celgene; Advisory / Consultancy: Eli Lilly; Advisory / Consultancy: Guardant Health; Advisory / Consultancy: MSD; Advisory / Consultancy: Novartis; Advisory / Consultancy: Pfizer; Advisory / Consultancy: Roche; Advisory / Consultancy: Takeda; Advisory / Consultancy: Merck. R. Califano: Honoraria (self), Advisory / Consultancy: AstraZeneca; Honoraria (self), Advisory / Consultancy: BMS; Honoraria (self), Advisory / Consultancy: Roche; Honoraria (self), Advisory / Consultancy: MSD; Honoraria (self), Advisory / Consultancy: Boehringer Ingelheim; Honoraria (self), Advisory / Consultancy: Takeda; Honoraria (self), Advisory / Consultancy: Novartis. A. Spira: Advisory / Consultancy: Ariad; Advisory / Consultancy: AstraZeneca; Advisory / Consultancy: Clovis Oncology; Advisory / Consultancy, Speaker Bureau / Expert testimony: Roche. S. Gettinger: Advisory / Consultancy, Research grant / Funding (self): Ariad; Advisory / Consultancy, Research grant / Funding (self): BMS; Advisory / Consultancy: Janssen; Research grant / Funding (self): AstraZeneca/MedImmune; Research grant / Funding (self): Boehringer Ingelheim; Research grant / Funding (self): Incyte; Research grant / Funding (self): Pfizer; Research grant / Funding (self): Roche/Genentech. M. Tiseo: Advisory / Consultancy, Speaker Bureau / Expert testimony: AstraZeneca; Advisory / Consultancy, Speaker Bureau / Expert testimony: BMS; Advisory / Consultancy, Speaker Bureau / Expert testimony: Boehringer Ingelheim; Advisory / Consultancy, Speaker Bureau / Expert testimony: Eli Lilly; Advisory / Consultancy, Speaker Bureau / Expert testimony: MSD; Advisory / Consultancy, Speaker Bureau / Expert testimony: Novartis; Advisory / Consultancy, Speaker Bureau / Expert testimony: Otsuka; Advisory / Consultancy, Speaker Bureau / Expert testimony: Pfizer; Advisory / Consultancy, Speaker Bureau / Expert testimony: Pierre Fabre; Advisory / Consultancy, Speaker Bureau / Expert testimony: Roche. Q. Ni: Full / Part-time employment: Takeda. P. Zhang: Full / Part-time employment: Takeda. S. Popat: Honoraria (self), Advisory / Consultancy, Research grant / Funding (institution), Travel / Accommodation / Expenses: Boehringer Ingelheim; Research grant / Funding (institution): Epizyme; Advisory / Consultancy, Research grant / Funding (institution), Travel / Accommodation / Expenses: BMS; Research grant / Funding (institution): Clovis Oncology; Honoraria (self), Advisory / Consultancy, Research grant / Funding (institution): Roche; Research grant / Funding (institution): Lilly; Honoraria (self), Research grant / Funding (institution): Takeda; Honoraria (self), Advisory / Consultancy: AstraZeneca; Honoraria (self): Chugai Pharma; Advisory / Consultancy: Novartis; Advisory / Consultancy: Pfizer; Advisory / Consultancy, Travel / Accommodation / Expenses: MSD; Advisory / Consultancy: Guardant Health; Advisory / Consultancy: AbbVie.
Preliminary data from TATTON (NCT02143466, a multi-arm, multi-drug combination study) suggested that adding savolitinib (AZD6094, HMPL-504, volitinib), a potent and highly selective MET TKI, to osimertinib, a 3rd generation, irreversible epidermal growth factor receptor tyrosine kinase inhibitor (EGFR TKI), which selectively inhibits EGFR TKI sensitising (EGFRm) and T790M resistance mutations, may overcome MET-driven resistance to EGFR TKIs. We present updated data from TATTON Part B and data from Part D, for the first time.
Pts were ≥18 years (Japan ≥20 years), mainly Asian, with locally advanced/metastatic, MET-positive, EGFRm NSCLC and disease progression on prior therapy. Pts enrolled based on MET status by local fluorescent in-situ hybridisation (MET gene copy ≥5 or MET/CEP7 ratio ≥2), next-generation sequencing or immunohistochemistry (+3 in ≥ 50% of tumour cells), with retrospective central confirmation. Pts in Part B received osimertinib 80 mg + savolitinib 600 mg or 300 mg orally (PO) once daily (QD). Pts in Part D received osimertinib 80 mg + savolitinib 300 mg PO QD, were T790M negative and had received no prior 3rd generation EGFR TKI. Primary endpoints: safety and tolerability; secondary endpoints included objective response rate and progression-free survival.
In Parts B (N = 138) and D (N = 42); Grade ≥3 AEs reported by 57% and 38%, respectively; serious AEs reported by 45% and 26%, respectively. AEs possibly related to treatment, led to discontinuation of savolitinib in 38 (28%) vs 9 (21%) and osimertinib in 14 (10%) vs 2 (5%), for Parts B and D, respectively. Efficacy data: Table. LBA2 Efficacy endpoints Best response data are for patients who had an opportunity to have two follow-up scans. All confirmed responses were partial response.Part B Part D Endpoint Previously treated with a 3G EGFR TKI No prior 3G EGFR TKI, T790M-negative No prior 3G EGFR TKI, T790M-positive Total No prior 3G EGFR TKI, T790M-negative Best response n = 69 n = 51 n = 18 n = 138 n = 36 ORR 21 (30) [20–43] 33 (65) [50–78] 12 (67) [41–87] 66 (48) [39–56] 23 (64) [46–79] PFS n = 69 n = 51 n = 18 n = 138 n = 42 Median PFS, months 5·4 9·0 11·0 7·6 9·1 [95% CI] [4·1–8·0] [5·5–11·9] [4·0–NR] [5·5–9·2] [5·4–12·9] Total events, n (%) 43 (62) 33 (65) 10 (56) 86 (62) 17 (40)
Our results support that osimertinib + savolitinib may overcome MET-driven resistance to EGFR TKIs, and warrant further exploration of the osimertinib 80 mg + savolitinib 300 mg combination in the SAVANNAH (NCT03778229) and ORCHARD (NCT03944772) studies.
NCT02143466.
Laura Crocker, BMedSci, of iMed Comms, an Ashfield Company, funded by AstraZeneca.
AstraZeneca.
AstraZeneca.
J. Han: Honoraria (self), Advisory / Consultancy: AstraZeneca; Honoraria (self), Advisory / Consultancy: BMS; Advisory / Consultancy: Lilly; Honoraria (self), Advisory / Consultancy: MSD; Advisory / Consultancy: Novartis; Research grant / Funding (self): ONO; Advisory / Consultancy, Research grant / Funding (self): Pfizer; Honoraria (self), Research grant / Funding (self): Roche; Honoraria (self), Advisory / Consultancy, Research grant / Funding (self): Takeda. L.V. Sequist: Honoraria (self), Research grant / Funding (institution): AstraZeneca; Honoraria (self): Janssen; Research grant / Funding (institution): Novartis; Honoraria (self), Research grant / Funding (institution): Merrimack Pharmaceuticals; Research grant / Funding (institution): Boehringer Ingelheim; Research grant / Funding (institution): LOXO; Honoraria (self), Research grant / Funding (institution): Blueprint Medicines; Honoraria (self), Research grant / Funding (institution): Genentech. M. Ahn: Honoraria (self), Advisory / Consultancy: AstraZeneca, Bristol-Myers Squibb, MSD, Ono Pharmaceutical, Roche; Advisory / Consultancy: Takeda, Alpha Pharmaceutical. B.C. Cho: Research grant / Funding (institution): Novartis, Bayer, AstraZeneca, Mogam Institute, Dong-A ST, Champions Oncology, Janssen, Yuhan, Ono Pharmaceutical, Dizal Pharma, MSD; Advisory / Consultancy: Novartis, AstraZeneca, Boehringer Ingelheim, Roche, Bristol-Myers Squibb, Ono Pharmaceutical, Yuhan, Pfizer, Eli Lilly, Janssen, Takeda, and MSD; Shareholder / Stockholder / Stock options: TheraCanVac Inc, Gencurix Inc, Bridgebio Therapeutics; Licensing / Royalties, Patent with royalties paid: Champions Oncology. H. Yu: Advisory / Consultancy: AstraZeneca; Research grant / Funding (institution): AstraZeneca, Lilly, Pfizer, Daiichi, Novartis, Astellas. S. Kim: Advisory / Consultancy, Research grant / Funding (institution): AstraZeneca. J.C. Yang: Honoraria (self): AstraZeneca, Boehringer Ingelheim, Eli Lilly, Bayer, Roche/Genentech, Chugai, MSD, Pfizer, Novartis, Bristol-Myers Squibb, Ono Pharmaceuticals; Advisory / Consultancy: AstraZeneca, Boehringer Ingelheim, Eli Lilly, Bayer, Roche/Genentech, Chugai, Astellas, MSD, Merck Serono, Pfizer, Novartis, Celgene, Merrimack, Yuhan Pharmaceuticals, Bristol-Myers Squibb, Ono Pharmaceuticals, Daiichi Sankyo, Hansoh, Takeda, Blueprint. M. Cantarini: Shareholder / Stockholder / Stock options, Full / Part-time employment, Full time Contractor: AstraZeneca. R.B. Verheijen: Shareholder / Stockholder / Stock options, Full / Part-time employment: AstraZeneca; Shareholder / Stockholder / Stock options: Aduro Biotech. A. Mellemgaard: Shareholder / Stockholder / Stock options, Full / Part-time employment: AstraZeneca. P. Frewer: Shareholder / Stockholder / Stock options, Full / Part-time employment: AstraZeneca. X. Ou: Full / Part-time employment, Full time Contractor: AstraZeneca. G. Oxnard: Honoraria (self): Chugai Pharma, Bio-Rad, Sysmex, Guardant Health, Foundation Medicine; Advisory / Consultancy: AstraZeneca, Inviata, Takeda, Loxo, Ignyta, DropWorks, GRAIL, Illumina, Janssen; Licensing / Royalties, Patent pending: DFCI.
Ph 1b data has shown promising efficacy and safety for atezo + bev in unresectable HCC pts who have not received prior systemic therapy. Here, we report the primary analysis data from the Ph 3 IMbrave150 trial comparing atezo + bev vs sor in this pt population.
IMbrave150 enrolled systemic treatment (tx)-naïve pts with unresectable HCC. Pts were randomised 2:1 to receive either atezo 1200 mg IV q3w + bev 15 mg/kg IV q3w or sor 400 mg BID until unacceptable toxicity or loss of clinical benefit per investigator. Coprimary endpoints were OS and PFS by independent review facility (IRF)-assessed RECIST 1.1. The key secondary endpoints IRF-ORR per RECIST 1.1 and IRF-ORR per HCC mRECIST were also part of the study statistical testing hierarchy.
The ITT population included 336 pts randomised to atezo + bev and 165 randomised to sor. Baseline demographics were well balanced between arms. With a median follow up of 8.6 mo, OS HR was 0.58 (95% CI, 0.42, 0.79; P = 0.0006) and PFS HR was 0.59 (95% CI, 0.47, 0.76; P < 0.0001; see table) for atezo + bev vs sor. ORR was 27% vs 12% (P < 0.0001) per IRF RECIST 1.1 and 33% vs 13% (P < 0.0001) per IRF HCC mRECIST for atezo + bev vs sor, respectively. Results were generally consistent across clinical subgroups. Atezo + bev delayed deterioration of quality of life vs sor. Median tx duration was 7.4 mo for atezo, 6.9 for bev and 2.8 for sor. Grade 3-4 AEs occurred in 57% of pts receiving atezo + bev and 55% of pts receiving sor. Grade 5 AEs were seen in 5% and 6% of pts, respectively.
IMbrave150 demonstrated statistically significant and clinically meaningful improvement in both OS and PFS for atezo + bev vs sor in pts with unresectable HCC who have not received prior systemic therapy. The safety of atezo + bev is consistent with the known safety profile of each agent, and no new safety signals were identified. Atezo + bev has the potential to be a practice changing tx in HCC.
NCT03434379.
Medical writing assistance for this abstract was provided by Jessica Bessler, PhD, of Health Interactions, Ltd. and funded by F. Hoffmann-La Roche, Ltd.
F. Hoffmann-La Roche, Ltd.
F. Hoffmann-La Roche, Ltd. Table: LBA3 NE, non-estimable. Stratified analysis. Log rank.Coprimary endpoints Atezo + bev n = 336 Sor n = 165 OS Median, mo 95% CI NE 13.2 (10.4, NE) HR 0.58 (0.42, 0.79) P value 0.0006 PFS Median, mo 95% CI 6.8 (5.7, 8.3) 4.3 (4.0, 5.6) HR 0.59 (0.47, 0.76) P value <0.0001
A-L. Cheng: Advisory / Consultancy: Bayer Schering Pharma; Advisory / Consultancy: Bristol-Myers Squibb; Honoraria (self), Advisory / Consultancy, Speaker Bureau / Expert testimony, Travel / Accommodation / Expenses: Eisai; Advisory / Consultancy: Merck Serono; Honoraria (self), Advisory / Consultancy, Speaker Bureau / Expert testimony, Travel / Accommodation / Expenses: Novartis; Honoraria (self), Advisory / Consultancy, Speaker Bureau / Expert testimony, Travel / Accommodation / Expenses: Ono Pharmaceutical; Advisory / Consultancy: Exelixis; Advisory / Consultancy: Nucleix Ltd.; Honoraria (self), Advisory / Consultancy, Travel / Accommodation / Expenses: Roche/Genentech; Honoraria (self), Advisory / Consultancy, Travel / Accommodation / Expenses: IQVIA; Speaker Bureau / Expert testimony, Travel / Accommodation / Expenses: Bayer Yakuhin, Ltd; Speaker Bureau / Expert testimony: Amgen Taiwan; Honoraria (self): Bayer; Honoraria (self): Merck Sharp Dohme; Honoraria (self): Merck Serono. M. Ikeda: Honoraria (self): Abbott Japan; Honoraria (self), Advisory / Consultancy, Research grant / Funding (institution): Bayer Yakuhin; Advisory / Consultancy, Research grant / Funding (institution): Bristol-Myers Squibb; Honoraria (self): Bristol-Myers Squibb Japan; Honoraria (self), Research grant / Funding (institution): Chugai Pharma; Honoraria (self), Research grant / Funding (institution): Daiichi Sankyo; Honoraria (self), Honoraria (institution), Research grant / Funding (institution): Eisai; Honoraria (self), Advisory / Consultancy, Research grant / Funding (institution): Lilly Japan; Honoraria (self): Nippon Kayaku; Honoraria (self): Novartis; Honoraria (self), Research grant / Funding (institution): Taiho Pharmaceutical; Advisory / Consultancy, Research grant / Funding (institution): Kyowa Hakko Kirin; Advisory / Consultancy, Research grant / Funding (institution): NanoCarrier; Research grant / Funding (self): ASLAN Pharmaceuticals; Research grant / Funding (self): AstraZeneca; Research grant / Funding (self): Baxter; Research grant / Funding (self): Boehringer Ingelheim; Research grant / Funding (self): Kowa; Research grant / Funding (self): Merck Serono; Research grant / Funding (self): Ono Pharmaceutical, Yakult, Zeria Pharmaceutical. P.R. Galle: Honoraria (self), Research grant / Funding (institution): Bayer; Honoraria (self): Bristol-Myers Squibb; Honoraria (self): MSD; Honoraria (self): AstraZeneca; Honoraria (self): SIRTEX; Honoraria (self): Merck; Honoraria (self): Lilly; Honoraria (self): Blueprint; Honoraria (self): AdaptImmune; Honoraria (self): Eisai; Honoraria (self): Roche; Honoraria (self): Ipsen. M.P. Ducreux: Honoraria (self), Advisory / Consultancy: Lilly; Honoraria (self), Advisory / Consultancy: Servier; Advisory / Consultancy: Amgen; Advisory / Consultancy, Speaker Bureau / Expert testimony, Travel / Accommodation / Expenses: Celgene; Advisory / Consultancy, Speaker Bureau / Expert testimony, Travel / Accommodation / Expenses: Ipsen; Advisory / Consultancy, Travel / Accommodation / Expenses: Merck Serono; Advisory / Consultancy: Novartis; Advisory / Consultancy, Speaker Bureau / Expert testimony, Research grant / Funding (self), Travel / Accommodation / Expenses: Roche; Speaker Bureau / Expert testimony: Bayer; Speaker Bureau / Expert testimony: Merck KGaA; Research grant / Funding (self): Pfizer; Spouse / Financial dependant: Sandoz. A.X. Zhu: Advisory / Consultancy: AstraZeneca; Advisory / Consultancy, Research grant / Funding (institution): Bayer; Advisory / Consultancy, Research grant / Funding (institution): Bristol-Myers Squibb; Advisory / Consultancy: Eisai; Advisory / Consultancy: Exelixis; Advisory / Consultancy, Research grant / Funding (institution): Lilly; Advisory / Consultancy, Research grant / Funding (institution): Merck; Advisory / Consultancy, Research grant / Funding (institution): Novartis; Advisory / Consultancy: Roche/Genentech. M. Kudo: Honoraria (self), Research grant / Funding (institution): AbbVie; Honoraria (self), Advisory / Consultancy: Bayer; Honoraria (self), Research grant / Funding (institution): Bristol-Myers Squibb Japan; Honoraria (self): EA Pharma; Honoraria (self), Advisory / Consultancy: Eisai; Honoraria (self): Gilead Sciences; Honoraria (self): Merck Serono; Honoraria (self), Advisory / Consultancy: MSD; Honoraria (self): Novartis; Honoraria (self): Pfizer; Honoraria (self), Research grant / Funding (institution): Taiho Pharmaceutical; Advisory / Consultancy: Bristol-Myers Squibb; Research grant / Funding (institution): Astellas Pharma; Research grant / Funding (institution): Chugai Pharma; Research grant / Funding (institution): Daiichi Sankyo; Research grant / Funding (institution): Otsuka. V. Breder: Honoraria (self), Speaker Bureau / Expert testimony, Travel / Accommodation / Expenses: Bayer; Honoraria (self), Advisory / Consultancy: BioCad; Honoraria (self), Advisory / Consultancy: Boehringer Ingelheim; Honoraria (self), Advisory / Consultancy, Travel / Accommodation / Expenses: Bristol-Myers Squibb; Honoraria (self), Advisory / Consultancy: Eisai; Honoraria (self), Advisory / Consultancy: MSD Oncology; Honoraria (self), Advisory / Consultancy, Travel / Accommodation / Expenses: Roche; Honoraria (self), Travel / Accommodation / Expenses: Takeda. P. Merle: Research grant / Funding (self): ONXEO; Advisory / Consultancy, Travel / Accommodation / Expenses: Bayer; Advisory / Consultancy, Travel / Accommodation / Expenses: Ipsen; Advisory / Consultancy: Eisai; Advisory / Consultancy, Travel / Accommodation / Expenses: Roche; Advisory / Consultancy, Travel / Accommodation / Expenses: MSD; Travel / Accommodation / Expenses: Bristol-Myers Squibb. A. Kaseb: Shareholder / Stockholder / Stock options: Gilead Sciences; Honoraria (self), Advisory / Consultancy: Bayer Health; Honoraria (self), Advisory / Consultancy, Research grant / Funding (self), Travel / Accommodation / Expenses: Bristol-Myers Squibb; Honoraria (self), Advisory / Consultancy, Travel / Accommodation / Expenses: Exelixis; Honoraria (self), Advisory / Consultancy, Research grant / Funding (self), Travel / Accommodation / Expenses: Merck; Research grant / Funding (self): Genentech; Research grant / Funding (self), Travel / Accommodation / Expenses: Bayer/Onyx. D. Li: Advisory / Consultancy: Bayer; Advisory / Consultancy, Speaker Bureau / Expert testimony: Exelixis; Advisory / Consultancy, Speaker Bureau / Expert testimony: Ipsen; Honoraria (institution), Speaker Bureau / Expert testimony: Lexicon; Advisory / Consultancy: Novartis; Speaker Bureau / Expert testimony: Advanced Accelerator Applications. W. Verret: Full / Part-time employment: Genentech. Z.D. Xu: Full / Part-time employment: Roche. S. Hernandez: Shareholder / Stockholder / Stock options, Full / Part-time employment: Genentech. J. Liu: Full / Part-time employment: Roche. C. Huang: Full / Part-time employment: Roche. S. Mulla: Full / Part-time employment: Roche. R. Finn: Advisory / Consultancy: AstraZeneca; Advisory / Consultancy: Bayer; Advisory / Consultancy: BristolMyersSquibb; Advisory / Consultancy: Eisai; Advisory / Consultancy: Eli Lilly; Advisory / Consultancy: Merck; Advisory / Consultancy: Pfizer; Advisory / Consultancy: Roche/Genentech; Speaker Bureau / Expert testimony: Novartis.