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Wang FH, Wang Y, Sun GP, Chen JH, Lin YC, Liu W, Zheng RS, Chen J, Zhang HL, Lan HT, Qi J, Liu YQ, Deng YM, Zhao H, Xiong JP, Xu Q, Jiang WQ, Li YH. Efficacy and safety of recombinant human lymphotoxin-α derivative with cisplatin and fluorouracil in patients with metastatic esophageal squamous cell carcinoma: A randomized, multicenter, open-label, controlled, phase 2b trial. Cancer 2017; 123:3986-3994. [PMID: 28640389 DOI: 10.1002/cncr.30845] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2017] [Revised: 05/20/2017] [Accepted: 05/24/2017] [Indexed: 02/05/2023]
Abstract
BACKGROUND Recombinant human lymphotoxin-α derivative (rhLTα-Da) is a lymphotoxin-α derivative that is missing 27 N-terminal amino acid residues. Previous studies indicated a benefit from the addition of rhLTα-Da to cisplatin-based treatment in patients with metastatic esophageal squamous cell carcinoma. The current study was conducted to evaluate the efficacy and safety of rhLTα-Da plus cisplatin and fluorouracil (PF) in patients with mESCC. METHODS Patients from 15 centers in China were randomly assigned (1:1:1) to 3 arms (arm A, PF plus 10 μg/m2 daily rhLTα-Da; arm B, PF plus 20 μg/m2 daily rhLTα-Da; arm C, PF alone). The primary endpoints included progression-free survival (PFS) and the confirmed overall response rate (ORR). An exploratory analysis was performed to evaluate the role of serum tumor necrosis factor receptor II (TNFR II) in predicting the efficacy of rhLTα-Da. RESULTS Between September 2010 and May 2013, 150 patients were enrolled. No significant differences in either PFS or ORR were observed between the 3 arms. However, in a small subset of patients who had low serum TNFR II levels, the median PFS was significantly longer for those in arm B than for these in other 2 arms (7.2 months [95% confidence interval, 5.1-8.6 months] for arm B vs 3.5 months [95% confidence interval, 1.7-5.5 months] for arm A [P = .022] and 4.0 months [95% confidence interval, 3.2-6.3 months] for arm C [P = .027]). The addition of rhLTα-Da significantly increased the incidence of chills (P < .001). CONCLUSIONS rhLTα-Da combined with the PF regimen failed to improve PFS and ORR in patients with mESCC, except in a small subset that had low serum TNFR II concentrations. Cancer 2017;123:3986-94. © 2017 American Cancer Society.
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Affiliation(s)
- Feng-Hua Wang
- Department of Medical Oncology, Sun Yat-sen University Cancer Center, Guangzhou, People's Republic of China
- State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Collaborative Innovation Center for Cancer Medicine, Guangdong Esophageal Cancer Institute, Guangzhou, People's Republic of China
| | - Yun Wang
- Department of Medical Oncology, Sun Yat-sen University Cancer Center, Guangzhou, People's Republic of China
- State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Collaborative Innovation Center for Cancer Medicine, Guangdong Esophageal Cancer Institute, Guangzhou, People's Republic of China
| | - Guo-Ping Sun
- Department of Medical Oncology, First Affiliated Hospital of Anhui Medical University, Hefei, People's Republic of China
| | - Jian-Hua Chen
- Department of Medical Oncology, Hunan Cancer Hospital, Changsha, People's Republic of China
| | - Ying-Cheng Lin
- Department of Medical Oncology, Cancer Hospital of Shantou University Medical College, Shantou, People's Republic of China
| | - Wei Liu
- Department of Oncology, Fourth Hospital of Hebei Medical University, Shijiazhuang, People's Republic of China
| | - Rong-Sheng Zheng
- Department of Medical Oncology, Anhui Provincial Cancer Hospital, Bengbu, People's Republic of China
| | - Jia Chen
- Department of Oncology, Jiangsu Cancer Hospital, Nanjing, People's Republic of China
| | - He-Long Zhang
- Department of Oncology, Tangdu Hospital, Fourth Military Medical University, Xi'an, People's Republic of China
| | - Hai-Tao Lan
- Department of Oncology, Sichuan Provincial People's Hospital, Chengdu, People's Republic of China
| | - Jun Qi
- Department of Thoracic Surgery, Chongqing Cancer Hospital, Chongqing, People's Republic of China
| | - Yang-Qing Liu
- Department of Medical Oncology, Huai'an First People's Hospital, Huai'an, People's Republic of China
| | - Yan-Ming Deng
- Department of Medical Oncology, First People's Hospital of Foshan, Foshan, People's Republic of China
| | - Heng Zhao
- Department of Thoracic Surgery, Shanghai Chest Hospital, Shanghai Jiaotong University, Shanghai, People's Republic of China
| | - Jian-Ping Xiong
- Department of Oncology, First Affiliated Hospital of Nanchang University, Nanchang, People's Republic of China
| | - Qing Xu
- Department of Oncology, Shanghai 10th People's Hospital, Shanghai, People's Republic of China
| | - Wen-Qi Jiang
- Department of Medical Oncology, Sun Yat-sen University Cancer Center, Guangzhou, People's Republic of China
- State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Collaborative Innovation Center for Cancer Medicine, Guangdong Esophageal Cancer Institute, Guangzhou, People's Republic of China
| | - Yu-Hong Li
- Department of Medical Oncology, Sun Yat-sen University Cancer Center, Guangzhou, People's Republic of China
- State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Collaborative Innovation Center for Cancer Medicine, Guangdong Esophageal Cancer Institute, Guangzhou, People's Republic of China
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Wang FH, Wang Y, Chen ZD, Chen JH, Qin FZ, Jiang WQ, Li YH. A phase IIa study of rhLTα-Da in combination with cisplatin and fluorouracil for patients with metastatic esophageal squamous cell carcinoma or gastric adenocarcinoma. Med Oncol 2016; 33:125. [DOI: 10.1007/s12032-016-0846-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2016] [Accepted: 10/05/2016] [Indexed: 01/26/2023]
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