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Jones RL, Ratain MJ, O'Dwyer PJ, Siu LL, Jassem J, Medioni J, DeJonge M, Rudin C, Sawyer M, Khayat D, Awada A, de Vos-Geelen JMPGM, Evans TRJ, Obel J, Brockstein B, DeGreve J, Baurain JF, Maki R, D'Adamo D, Dickson M, Undevia S, Geary D, Janisch L, Bedard PL, Abdul Razak AR, Kristeleit R, Vitfell-Rasmussen J, Walters I, Kaye SB, Schwartz G. Phase II randomised discontinuation trial of brivanib in patients with advanced solid tumours. Eur J Cancer 2019; 120:132-139. [PMID: 31522033 PMCID: PMC8852771 DOI: 10.1016/j.ejca.2019.07.024] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Revised: 07/20/2019] [Accepted: 07/23/2019] [Indexed: 01/29/2023]
Abstract
BACKGROUND Brivanib is a selective inhibitor of vascular endothelial growth factor and fibroblast growth factor (FGF) signalling. We performed a phase II randomised discontinuation trial of brivanib in 7 tumour types (soft-tissue sarcomas [STS], ovarian cancer, breast cancer, pancreatic cancer, non-small-cell lung cancer [NSCLC], gastric/esophageal cancer and transitional cell carcinoma [TCC]). PATIENTS AND METHODS During a 12-week open-label lead-in period, patients received brivanib 800 mg daily and were evaluated for FGF2 status by immunohistochemistry. Patients with stable disease at week 12 were randomised to brivanib or placebo. A study steering committee evaluated week 12 response to determine if enrolment in a tumour type would continue. The primary objective was progression-free survival (PFS) for brivanib versus placebo in patients with FGF2-positive tumours. RESULTS A total of 595 patients were treated, and stable disease was observed at the week 12 randomisation point in all tumour types. Closure decisions were made for breast cancer, pancreatic cancer, NSCLC, gastric cancer and TCC. Criteria for expansion were met for STS and ovarian cancer. In 53 randomised patients with STS and FGF2-positive tumours, the median PFS was 2.8 months for brivanib and 1.4 months for placebo (hazard ratio [HR]: 0.58, p = 0.08). For all randomised patients with sarcomas, the median PFS was 2.8 months (95% confidence interval [CI]: 1.4-4.0) for those treated with brivanib compared with 1.4 months (95% CI: 1.3-1.6) for placebo (HR = 0.64, 95% CI: 0.38-1.07; p = 0.09). In the 36 randomised patients with ovarian cancer and FGF2-positive tumours, the median PFS was 4.0 (95% CI: 2.6-4.2) months for brivanib and 2.0 months (95% CI: 1.2-2.7) for placebo (HR: 0.56, 95% CI: 0.26-1.22). For all randomised patients with ovarian cancer, the median PFS in those randomised to brivanib was 4.0 months (95% CI: 2.6-4.2) and was 2.0 months (95% CI: 1.2-2.7) in those randomised to placebo (HR = 0.54, 95% CI: 0.25-1.17; p = 0.11). CONCLUSION Brivanib demonstrated activity in STS and ovarian cancer with an acceptable safety profile. FGF2 expression, as defined in the protocol, is not a predictive biomarker of the efficacy of brivanib.
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Affiliation(s)
- Robin L Jones
- Royal Marsden Hospital, Institute of Cancer Research, London, United Kingdom.
| | | | | | | | | | - Jacques Medioni
- Hôpital Européen Georges Pompidou, Paris, France; Paris-Descartes University, Paris, France
| | - Maja DeJonge
- Erasmus University Medical Center, Rotterdam, the Netherlands
| | | | | | | | | | - Judith M P G M de Vos-Geelen
- Department of Internal Medicine, Division of Medical Oncology, GROW - School for Oncology and Developmental Biology, Maastricht UMC+, Maastricht, the Netherlands
| | - T R Jeffry Evans
- Beatson West of Scotland Cancer Centre, University of Glasgow, Glasgow, United Kingdom
| | - Jennifer Obel
- North Shore University Health System, Evanston, IL, USA
| | | | | | | | | | - David D'Adamo
- Eisai Inc, Woodcliff Lake, NJ Previously Memorial Sloan-Kettering Cancer Center, New York, NY, USA
| | - Mark Dickson
- Memorial Sloan-Kettering Cancer Center, New York, NY, USA
| | | | | | | | | | | | - Rebecca Kristeleit
- Royal Marsden Hospital, Institute of Cancer Research, London, United Kingdom
| | | | - Ian Walters
- Intensity Therapeutics Inc, Westport, CT Previously BMS, USA
| | - Stan B Kaye
- Royal Marsden Hospital, Institute of Cancer Research, London, United Kingdom
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