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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
- 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.
- Subjects :
- Oncology
medicine.medical_specialty
Paclitaxel
medicine.medical_treatment
Placebo-controlled study
Neutropenia
Carcinoma, Ovarian Epithelial
Placebo
Antibodies, Monoclonal, Humanized
Carboplatin
chemistry.chemical_compound
Maintenance therapy
Somatomedins
Internal medicine
Antineoplastic Combined Chemotherapy Protocols
medicine
Clinical endpoint
Biomarkers, Tumor
Humans
Progression-free survival
Neoplasm Staging
Ovarian Neoplasms
Chemotherapy
business.industry
Obstetrics and Gynecology
Middle Aged
medicine.disease
Progression-Free Survival
Insulin-Like Growth Factor Binding Protein 2
chemistry
Female
business
Subjects
Details
- ISSN :
- 10956859
- Volume :
- 163
- Issue :
- 3
- Database :
- OpenAIRE
- Journal :
- Gynecologic oncology
- Accession number :
- edsair.doi.dedup.....e4f8ce097834e2bdd7e9920fb4f683d2