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1. Health-related quality of life in patients with a germline BRCA mutation and metastatic pancreatic cancer receiving maintenance olaparib

Author

Hammel P, Kindler HL, Reni M, Van Cutsem E, Macarulla T, Hall MJ, Park JO, Hochhauser D, Arnold D, Oh DY, Reinacher-Schick A, Tortora G, Algül H, O'Reilly EM, McGuinness D, Cui KY, Joo S, Yoo HK, Patel N, Golan T, Hammel, P, Kindler, Hl, Reni, M, Van Cutsem, E, Macarulla, T, Hall, Mj, Park, Jo, Hochhauser, D, Arnold, D, Oh, Dy, Reinacher-Schick, A, Tortora, G, Algül, H, O'Reilly, Em, Mcguinness, D, Cui, Ky, Joo, S, Yoo, Hk, Patel, N, and Golan, T

Published
2019

2. Ibrutinib in combination with nab-paclitaxel and gemcitabine for first-line treatment of patients with metastatic pancreatic adenocarcinoma: phase III RESOLVE study

Author

Dirk Waldschmidt, J-B. Bachet, Lawrence Fong, J. Tabernero, Michele Reni, H-M. Chang, Sara Lonardi, G. Cole, Margaret A. Tempero, Andrew Eugene Hendifar, D-Y. Oh, L.C. Tsao, Teresa Macarulla, Danelle F. James, E. Van Cutsem, Juan Maurel, Lisa M. Coussens, Naureen Starling, Rocio Garcia-Carbonero, Institut Català de la Salut, [Tempero M] Department of Medicine, University of California San Francisco, San Francisco, USA. [Oh DY] Department of Internal Medicine, Cancer Research Institute, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea. [Tabernero J, Macarulla T] Servei d’Oncologia Mèdica, Vall d'Hebron Hospital Universitari, Barcelona, Spain. Vall d’Hebron Institute of Oncology (VHIO), Barcelona, Spain. IOB-Quiron, UVic-UICC, CIBERONC, Barcelona, Spain. [Reni M] Department of Radiochemotherapy, San Raffaele Hospital Scientific Institute, Milan, Italy. [Van Cutsem E] Department of Digestive Oncology, University Hospitals Gasthuisberg/Leuven & KU Leuven, Leuven, Belgium. [Hendifar A] Department of Medical Oncology, Cedars-Sinai Medical Center, Los Angeles, USA, and Vall d'Hebron Barcelona Hospital Campus

Subjects
0301 basic medicine, Oncology, metastatic pancreatic adenocarcinoma, Other subheadings::Other subheadings::/drug therapy [Other subheadings], Deoxycytidine, Tyrosine-kinase inhibitor, chemistry.chemical_compound, 0302 clinical medicine, Piperidines, Antineoplastic Combined Chemotherapy Protocols, Tumor Microenvironment, neoplasias::neoplasias por localización::neoplasias del sistema digestivo::neoplasias pancreáticas [ENFERMEDADES], terapéutica::terapéutica::farmacoterapia::protocolos antineoplásicos::terapéutica::farmacoterapia::protocolos de quimioterapia antineoplásica combinada [TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS], Hematology, 3. Good health, Treatment Outcome, 030220 oncology & carcinogenesis, Ibrutinib, medicine.drug, medicine.medical_specialty, Randomization, Paclitaxel, medicine.drug_class, Otros calificadores::Otros calificadores::/farmacoterapia [Otros calificadores], Adenocarcinoma, Neutropenia, Placebo, Quimioteràpia combinada, 03 medical and health sciences, ibrutinib, Albumins, Therapeutics::Therapeutics::Drug Therapy::Antineoplastic Protocols::Therapeutics::Drug Therapy::Antineoplastic Combined Chemotherapy Protocols [ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT], Internal medicine, Pàncrees - Càncer - Tractament, medicine, Humans, Adverse effect, Neoplasms::Neoplasms by Site::Digestive System Neoplasms::Pancreatic Neoplasms [DISEASES], business.industry, Adenine, diagnóstico::pronóstico::resultado del tratamiento [TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS], Diagnosis::Prognosis::Treatment Outcome [ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT], medicine.disease, Gemcitabine, phase III, Discontinuation, Pancreatic Neoplasms, 030104 developmental biology, chemistry, Avaluació de resultats (Assistència sanitària), business
Abstract

Ibrutinib; Metastatic pancreatic adenocarcinoma; Phase III Ibrutinib; Adenocarcinoma de páncreas metastásico; Fase III Ibrutinib; Adenocarcinoma de pàncrees metastàtic; Fase III First-line treatment of metastatic pancreatic ductal adenocarcinoma (PDAC) includes nab-paclitaxel/gemcitabine. Ibrutinib, a Bruton's tyrosine kinase inhibitor, exhibits antitumor activity through tumor microenvironment modulation. The safety and efficacy of first-line ibrutinib plus nab-paclitaxel/gemcitabine treatment in patients with PDAC were evaluated. Patients and methods RESOLVE (NCT02436668) was a phase III, randomized, double-blind, placebo-controlled study. Patients (histologically-confirmed PDAC; stage IV diagnosis ≥6 weeks of randomization; Karnofsky performance score ≥70) were randomized to once-daily oral ibrutinib (560 mg) or placebo plus nab-paclitaxel (125 mg/m2) and gemcitabine (1000 mg/m2). Primary endpoints were overall survival (OS) and investigator-assessed progression-free survival (PFS); overall response rate and safety were assessed. Results In total, 424 patients were randomized (ibrutinib arm, n = 211; placebo arm, n = 213). Baseline characteristics were balanced across arms. After a median follow-up of 25 months, there was no significant difference in OS between ibrutinib plus nab-paclitaxel/gemcitabine versus placebo plus nab-paclitaxel/gemcitabine (median of 9.7 versus 10.8 months; P = 0.3225). PFS was shorter for ibrutinib plus nab-paclitaxel/gemcitabine compared with placebo plus nab-paclitaxel/gemcitabine (median 5.3 versus 6.0 months; P < 0.0001). Overall response rates were 29% and 42%, respectively (P = 0.0058). Patients in the ibrutinib arm had less time on treatment and received lower cumulative doses for all agents compared with the placebo arm. The most common grade ≥3 adverse events for ibrutinib versus placebo arms included neutropenia (24% versus 35%), peripheral sensory neuropathy (17% versus 8%), and anemia (16% versus 17%). Primary reasons for any treatment discontinuation were disease progression and adverse events. Conclusions Ibrutinib plus nab-paclitaxel/gemcitabine did not improve OS or PFS for patients with PDAC. Safety was consistent with known profiles for these agents. This work was supported by Pharmacyclics LLC, an AbbVie Company (no grant number).

Published
2021

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