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Results of TRIO-14, a phase II, multicenter, randomized, placebo-controlled trial of carboplatin-paclitaxel versus carboplatin-paclitaxel-ganitumab in newly diagnosed epithelial ovarian cancer

Authors :
P. Haluska
Hsiao-Wang Chen
T.M. Davidson
DJ Slamon
Gottfried E. Konecny
Jalid Sehouli
Sally A. Mullany
John A. Glaspy
A. Yachnin
Paul Cottu
D. Provencher
M. Poelcher
Beth Y. Karlan
Sisi Ma
Lynda D. Roman
G. Feisel-Schwickardi
A.E. Wahner Hendrickson
Peter A. Fasching
A. Rody
Boris Winterhoff
I.L. Ray-Coquard
Sven Mahner
Source :
Gynecologic oncology. 163(3)
Publication Year :
2021

Abstract

Purpose Insulin-like growth factor (IGF) signaling is implicated in pathogenesis and chemotherapy resistance of epithelial ovarian cancer (EOC). We explored efficacy and safety of adding ganitumab, a monoclonal antibody targeting IGF-1R, to carboplatin/paclitaxel (CP) chemotherapy in patients with primary EOC. Design Patients were randomly assigned to receive CP/ganitumab (18 mg/kg q3w) or CP/placebo for 6 cycles followed by 6 cycles of single agent ganitumab/placebo maintenance therapy as front-line therapy. Primary endpoint was progression free survival. Secondary endpoints were time to progression and overall survival. Pretreatment samples were prospectively collected for retrospective biomarker analyses. Results 170 patients enrolled. 165 patients assessable for toxicity. Median PFS was 15.7 months with CP/ganitumab and 16.7 months with CP/placebo (HR 1.23; 95% CI 0.82-1.83, P = 0.313). All grade neutropenia (84.1% vs 71.4%), thrombocytopenia (75.3% vs 57.1%) and hyperglycemia (15.9% vs 2.6%) were more common in the ganitumab group compared to the placebo group. Ganitumab/placebo related serious adverse events were reported in 26.1% of the patients with ganitumab and in 6.5% with placebo. Non-progression related fatal events were more common with ganitumab (5 versus 2 patients). The ganitumab group experienced more dose delays which resulted in lower relative dose intensity of chemotherapy in the experimental group. In an exploratory model IGFBP2 expression was predictive of ganitumab response (treatment interaction; PFS, P = 0.03; OS, P = 0.01). Conclusion Addition of ganitumab to CP chemotherapy in primary EOC did not improve PFS. Our results do not support further study of ganitumab in unselected EOC patients.

Details

ISSN :
10956859
Volume :
163
Issue :
3
Database :
OpenAIRE
Journal :
Gynecologic oncology
Accession number :
edsair.doi.dedup.....e4f8ce097834e2bdd7e9920fb4f683d2