Study Design
FIREFLY-1 Design
Baseline Characteristics
FIREFLY-1 Design
The largest clinical trial in BRAF-altered R/R pLGG to date1,2
137 patients received OJEMDA in the pivotal FIREFLY-1 trial3
FIREFLY-1 is a global, open-label, nonrandomized, multicenter, phase 2 trial.1,3
Key Inclusion Criteria3
- 6 months - 25 years old
- BRAF-altered R/R pLGG
- At least 1 prior systemic therapy with documented radiographic progression
Key Exclusion Criteria3
Patients with:
- Tumors harboring additional activating alterations (eg, IDH1/2 mutations, FGFR mutations, etc.)
- Known or suspected diagnosis of NF1
OJEMDA 420 mg/m2 once weekly (max 600 mg)1,3*
Primary Efficacy Analysis (N=76)1
- Arm 1† (registrational arm)
- Median duration of treatment was 15.8 months (0.7-23.7 months)3
Primary Safety Analysis (N=137)1
- Arm 1 + Arm 2‡ (registrational and extension arms)
- Median duration of treatment was 12 months (0.7-23.7 months)4
Major Outcomes
Major efficacy outcome3§
- ORR (RAPNO-LGG criteria)‖
Select secondary outcomes3
- CBR¶
- Time to response
- Duration of response
Safety outcome4
- Safety and tolerability
- FIREFLY-1 concluded its investigational period in 20243
- The last patient from Arm 1 reached 2 years on therapy in the second quarter of 20244
- Long-term follow-up is ongoing for patients continuing therapy or on drug holiday4
- *Patients received OJEMDA approximately 420 mg/m2 orally once weekly (range: 290 to 476 mg/m2, 0.76-1.25 times the approved recommended dosage) according to BSA with a maximum dosage of 600 mg until disease progression or unacceptable toxicity.1
- †77 patients were enrolled in Arm 1; 76 patients were considered evaluable for response by RAPNO-LGG criteria.1,3
- ‡Arm 2 is an extension arm, which provided treatment access for patients with BRAF-altered pLGG after the registrational arm closure.3
- §The primary endpoint was the ORR according to RANO-HGG criteria.3
- IIORR was defined as the proportion of patients with CR, PR, or MR by independent review based on RAPNO-LGG criteria.1
- ¶CBR defined as proportion of patients with best overall response of confirmed CR, PR, MR, or SD lasting 12 months or more based on RAPNO criteria.3
In FIREFLY-1, OJEMDA delivered clinically meaningful tumor shrinkage.1
See the results
Baseline Characteristics
Baseline characteristics from FIREFLY-1, reflective of patients seen in clinical practice5
OJEMDA was studied in a patient population for whom multiple lines of prior therapies failed3
Baseline Characteristics (N=76)1,3
Age (Years) |
---|
Median (range) 8.5 (2-21) |
Sex |
Male 53% |
Female 47% |
BRAF alterations |
BRAF fusion 74% |
V600E mutation 16% |
Other (including BRAF duplication or rearrangement) 11% |
Number of prior systemic regimens |
---|
Median (range) 3 (1-9) |
1 22% |
2 27% |
≥3 51% |
Prior MAPK-targeted therapy |
No 41% |
Yes 59% |
Common Tumor Locations1
Cerebral hemisphere
0%
Optic pathway
0%
Cerebellum
0%
Brain
stem
0%
Deep midline structures
0%
BRAF=v-Raf murine sarcoma viral oncogene homolog B1; BSA=body surface area; CBR=clinical benefit rate; CR=complete response; FGFR=fibroblast growth factor receptor; IDH=isocitrate dehydrogenase; MAPK=mitogen-activated protein kinase; MR=minor response; NF1=neurofibromatosis type 1; ORR=overall response rate; PR=partial response; RANO-HGG=Response Assessment for Neuro-Oncology High-Grade Glioma; RAPNO-LGG=Response Assessment in Pediatric Neuro-Oncology for Low-Grade Glioma; R/R pLGG=relapsed/refractory pediatric low-grade glioma; SD=stable disease.
Discover clinically meaningful responses
Discover the efficacy data
References
- 1. OJEMDA™ [Package Insert]. Brisbane, CA: Day One Biopharmaceuticals, Inc.; 2024.
- 2. Bouffet E, Hansford JR, Garrè ML, et al. Dabrafenib plus trametinib in pediatric glioma with BRAF V600 mutations. N Engl J Med. 2023;389(12):1108-1120. doi:10.1056/NEJMoa2303815
- 3. Kilburn LB, Khuong-Quang DA, Hansford JR, et al. The type II RAF inhibitor tovorafenib in relapsed/refractory pediatric low-grade glioma: the phase 2 FIREFLY-1 trial. Nat Med. 2024;30(1):207-217. doi:10.1038/s41591-023-02668-y
- 4. Data on file. Day One Biopharmaceuticals, Inc.
- 5. Ryall S, Zapotocky M, Fukuoka K, et al. Integrated molecular and clinical analysis of 1,000 pediatric low-grade gliomas. Cancer Cell. 2020;37(4):569-583.e5. doi:10.1016/j.ccell.2020.03.011