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ReNeu: A Pivotal, Phase IIb Trial of Mirdametinib in Adults and Children With Symptomatic Neurofibromatosis Type 1-Associated Plexiform Neurofibroma

Title: ReNeu: A Pivotal, Phase IIb Trial of Mirdametinib in Adults and Children With Symptomatic Neurofibromatosis Type 1-Associated Plexiform Neurofibroma
Authors: Moertel, Christopher L; Hirbe, Angela C; Shuhaiber, Hans H; Bielamowicz, Kevin; Sidhu, Alpa; Viskochil, David; Weber, Michael D; Lokku, Armend; Smith, L Mary; Foreman, Nicholas K; Hajjar, Fouad M; McNall-Knapp, Rene Y; Weintraub, Lauren; Antony, Reuben; Franson, Andrea T; Meade, Julia; Schiff, David; Walbert, Tobias; Ambady, Prakash; Bota, Daniela A; Campen, Cynthia J; Kaur, Gurcharanjeet; Klesse, Laura J; Maraka, Stefania; Moots, Paul L; Nevel, Kathryn; Bornhorst, Miriam; Aguilar-Bonilla, Ana; Chagnon, Sarah; Dalvi, Nagma; Gupta, Punita; Khatib, Ziad; Metrock, Laura K; Nghiemphu, P Leia; Roberts, Ryan D; Robison, Nathan J; Sadighi, Zsila; Stapleton, Stacie; Babovic-Vuksanovic, Dusica; Gershon, Timothy R; Investigators, ReNeu Study; Raslan, Ahmed; Walter, Andrew; Van Tine, Brian; Koschmann, Carl; Campen, Cynthia; Capal, Jamie K; Slopis, John; Gill, Jonathan; Nghiemphu, Leia; Kilburn, Lindsay; Mrugala, Maciej M; Schmidt, Mary Lou; Foreman, Nick K; Dhamija, Radhika; Antony, Rueben; Merrell, Ryan
Source: Journal of Clinical Oncology, vol 43, iss 6
Publisher Information: eScholarship, University of California
Publication Year: 2025
Collection: University of California: eScholarship
Subject Terms: 32 Biomedical and Clinical Sciences (for-2020); 3202 Clinical Sciences (for-2020); Rare Diseases (rcdc); Clinical Research (rcdc); Chronic Pain (rcdc); Neurosciences (rcdc); Pain Research (rcdc); Clinical Trials and Supportive Activities (rcdc); Pediatric (rcdc); Neurofibromatosis (rcdc); 6.1 Pharmaceuticals (hrcs-rac); Humans (mesh); Child (mesh); Neurofibroma; Plexiform (mesh); Neurofibromatosis 1 (mesh); Adolescent (mesh); Male (mesh); Adult (mesh); Female (mesh); Child; Preschool (mesh); Middle Aged (mesh); Young Adult (mesh); Benzamides (mesh); Quality of Life (mesh); Aged (mesh); Magnetic Resonance Imaging (mesh); Antineoplastic Agents (mesh); ReNeu Trial Investigators
Subject Geographic: 716 - 729
Description: PURPOSE: Pharmacologic therapies for neurofibromatosis type 1-associated plexiform neurofibromas (NF1-PNs) are limited; currently, none are US Food and Drug Administration-approved for adults. METHODS: ReNeu is an open-label, multicenter, pivotal, phase IIb trial of mirdametinib in 58 adults (≥18 years of age) and 56 children (2 to 17 years of age) with NF1-PN causing significant morbidities. Patients received mirdametinib capsules or tablets for oral suspension (2 mg/m2 twice daily, maximum 4 mg twice daily), regardless of food intake, in 3 weeks on/1 week off 28-day cycles. The primary end point was confirmed objective response rate (ORR; proportion of patients with a ≥20% reduction of target PN volume from baseline on consecutive scans during the 24-cycle treatment phase) assessed by blinded independent central review (BICR) of volumetric magnetic resonance imaging. RESULTS: Twenty-four of 58 adults (41%) and 29 of 56 children (52%) had a BICR-confirmed objective response during the 24-cycle treatment phase; in addition, two adults and one child had confirmed responses during long-term follow-up. Median (range) target PN volumetric best response was -41% (-90 to 13) in adults and -42% (-91 to 48) in children. Both cohorts reported significant and clinically meaningful improvement in patient- or parent proxy-reported outcome measures of worst tumor pain severity, pain interference, and health-related quality of life (HRQOL) that began early and were sustained during treatment. The most commonly reported treatment-related adverse events were dermatitis acneiform, diarrhea, and nausea in adults and dermatitis acneiform, diarrhea, and paronychia in children. CONCLUSION: In ReNeu, the largest multicenter NF1-PN trial reported to date, mirdametinib treatment demonstrated significant confirmed ORRs by BICR, deep and durable PN volume reductions, and early, sustained, and clinically meaningful improvement in pain and HRQOL. Mirdametinib was well-tolerated in adults and children.
Document Type: article in journal/newspaper
File Description: application/pdf
Language: unknown
Relation: qt2sh3011g; https://escholarship.org/uc/item/2sh3011g; https://escholarship.org/content/qt2sh3011g/qt2sh3011g.pdf
DOI: 10.1200/jco.24.01034
Availability: https://escholarship.org/uc/item/2sh3011g; https://escholarship.org/content/qt2sh3011g/qt2sh3011g.pdf; https://doi.org/10.1200/jco.24.01034
Rights: CC-BY-NC-ND
Accession Number: edsbas.FAB1337B
Database: BASE