1
|
Le Cesne A, Chevreau C, Perrin C, Italiano A, Hervieu A, Blay JY, Piperno-Neumann S, Saada-Bouzid E, Bertucci F, Firmin N, Kalbacher E, Narciso B, Schiffler C, Yara S, Jimenez M, Bouvier C, Vidal V, Chabaud S, Duffaud F. Regorafenib in patients with relapsed advanced or metastatic chordoma: results of a non-comparative, randomised, double-blind, placebo-controlled, multicentre phase II study. ESMO Open 2023; 8:101569. [PMID: 37285716 DOI: 10.1016/j.esmoop.2023.101569] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Revised: 04/10/2023] [Accepted: 04/24/2023] [Indexed: 06/09/2023] Open
Abstract
BACKGROUND REGOBONE multicohort study explored the efficacy and safety of regorafenib for patients with advanced bone sarcomas; this report details the cohort of patients with relapsed advanced or metastatic chordoma. METHODS Patients with relapsed chordoma progressing despite 0-2 prior lines of systemic therapy, were randomised (2 : 1) to receive regorafenib (160 mg/day, 21/28 days) or placebo. Patients on placebo could cross over to receive regorafenib after centrally-confirmed progression. The primary endpoint was the progression-free rate at 6 months (PFR-6) (by RECIST 1.1). With one-sided α of 0.05, and 80% power, at least 10/24 progression-free patients at 6 months (PFR-6) were needed for success. RESULTS From March 2016 to February 2020, 27 patients were enrolled. A total of 23 patients were assessable for efficacy: 7 on placebo, 16 on regorafenib, 16 were men, median age was 66 (32-85) years. At 6 months, in the regorafenib arm, 1 patient was not assessable, 6/14 were non-progressive (PFR-6: 42.9%; one-sided 95% CI = 20.6) 3/14 discontinued regorafenib due to toxicity; and in the placebo arm, 2/5 patients were non-progressive (PFR-6: 40.0%; one-sided 95% CI = 7.6), 2 were non-assessable. Median progression-free survival was 8.2 months (95% CI 4.5-12.9 months) on regorafenib and 10.1 months (95% CI 0.8 months-non evaluable [NE]) on placebo. Median overall survival rates were 28.3 months (95% CI 14.8 months-NE) on regorafenib but not reached in placebo arm. Four placebo patients crossed over to receive regorafenib after centrally-confirmed progression. The most common grade ≥3 regorafenib-related adverse events were hand-foot skin reaction (22%), hypertension (22%), pain (22%), and diarrhoea (17%), with no toxic death. CONCLUSION This study failed to show any signal of benefit for regorafenib in patients with advanced/metastatic recurrent chordoma.
Collapse
Affiliation(s)
- A Le Cesne
- Medical Oncology Department, Gustave Roussy, Villejuif
| | - C Chevreau
- Medical Oncology Department, Institut Universitaire de Cancérologie de Toulouse, Oncopole, Toulouse
| | - C Perrin
- Medical Oncology Unit, Centre Eugène Marquis, Rennes
| | - A Italiano
- Medical Oncology Department, Institut Bergonié, Bordeaux
| | - A Hervieu
- Medical Oncology Department, Centre Georges Francois Leclerc, Dijon
| | - J Y Blay
- Medical Oncology Department, Centre Léon Bérard, Lyons. https://twitter.com/jeanyvesblay
| | | | - E Saada-Bouzid
- Medical Oncology Department, Centre Antoine Lacassagne, Nice
| | - F Bertucci
- Medical Oncology Department, Institut Paoli Calmettes, Marseille
| | - N Firmin
- Medical Oncologie Department, Centre Valdorelle, Montpellier
| | - E Kalbacher
- Medical Oncology Department, CHU J Minjoz, Besançon
| | - B Narciso
- Medical Oncology Department, CHU Bretonneau, Tours
| | - C Schiffler
- Department of Statistics, Centre Léon Bérard, Lyons
| | | | | | - C Bouvier
- Aix Marseille Univ, APHM Hopital La Timone, Pathology Department, Marseille
| | - V Vidal
- Aix Marseille Univ, APHM Hopital La Timone, Radiology Department, Marseille
| | - S Chabaud
- Department of Statistics, Centre Léon Bérard, Lyons
| | - F Duffaud
- Aix Marseille University (AMU), APHM Hopital La Timone, Medical Oncology Unit, APHM, Marseille, France.
| |
Collapse
|
2
|
DuBois SG, Marina N, Glade-Bender J. Angiogenesis and vascular targeting in Ewing sarcoma: a review of preclinical and clinical data. Cancer 2010; 116:749-57. [PMID: 20029966 PMCID: PMC2815027 DOI: 10.1002/cncr.24844] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Ewing sarcoma is the second most common type of bone cancer in children and young adults. In recent years, the mechanisms by which these tumors develop and maintain their vascular supply have been elucidated. Additional work has demonstrated that inhibition of angiogenic pathways or disruption of established vasculature can attenuate the growth of Ewing sarcoma mouse xenografts. Early clinical data suggest that these results also may extend to patients with Ewing sarcoma who are treated with antiangiogenic or antivascular therapies. For the current review, the authors summarized the available data supporting this approach.
Collapse
Affiliation(s)
- Steven G DuBois
- Department of Pediatrics, University of California at San Francisco School of Medicine, San Francisco, California 94143-0106, USA.
| | | | | |
Collapse
|