Showing papers by "Joachim von Pawel published in 2015"
TL;DR: E + T was well tolerated and increased PFS but did not improve OS in the overall nonsquamous NSCLC population, and exploratory subgroup analyses suggested OS improvement in patients with high MET expression.
Abstract: Purpose Tivantinib, a MET receptor tyrosine kinase inhibitor, demonstrated increased anticancer activity in preclinical and early clinical studies when combined with erlotinib. Our study aimed to confirm efficacy and safety of the combination in previously treated patients with non–small-cell lung cancer (NSCLC). Patients and Methods Patients with advanced nonsquamous NSCLC previously treated with one to two systemic regimens, including a platinum doublet, were randomly assigned at a 1:1 ratio to receive erlotinib 150 mg daily plus oral tivantinib 360 mg twice daily (E + T) or erlotinib plus placebo (E + P) until disease progression. Tumor specimens were evaluated for EGFR and KRAS mutations, MET expression, and MET gene amplification. The primary end point was overall survival (OS). Secondary and exploratory objectives included progression-free survival (PFS), OS in molecular subgroups, and safety. Results The study enrolled 1,048 patients and was discontinued for futility at the interim analysis. OS did...
238 citations
TL;DR: The findings show no evidence to suggest that the addition of necitumumab to pemetrexed and cisplatin increases survival of previously untreated patients with stage IV non-squamous NSCLC.
Abstract: Summary Background Necitumumab is a second-generation recombinant human immunoglobulin G1 EGFR monoclonal antibody that competitively inhibits ligand binding. We aimed to compare necitumumab plus pemetrexed and cisplatin with pemetrexed and cisplatin alone in patients with previously untreated, stage IV, non-squamous non-small-cell lung cancer (NSCLC). Methods We did this randomised, open-label, controlled phase 3 study at 103 sites in 20 countries. Patients aged 18 years or older, with an Eastern Cooperative Oncology Group (ECOG) performance status of 0–2 and adequate organ function, were randomly assigned 1:1 to treatment with a block randomisation scheme (block size of four) via a telephone-based interactive voice-response system or interactive web-response system. Patients received either cisplatin 75 mg/m 2 and pemetrexed 500 mg/m 2 on day 1 of a 3-week cycle for a maximum of six cycles alone, or with necitumumab 800 mg on days 1 and 8. Necitumumab was continued after the end of chemotherapy until disease progression or unacceptable toxic effects. Randomisation was stratified by smoking history, ECOG performance status, disease histology, and geographical region. Patients and study investigators were not masked to group assignment. The primary endpoint was overall survival. Efficacy analyses were by intention to treat. This trial is registered with ClinicalTrials.gov, number NCT00982111. Findings Between Nov 11, 2009, and Feb 2, 2011, we randomly assigned 633 patients to receive either necitumumab plus pemetrexed and cisplatin (n=315) or pemetrexed and cisplatin alone (n=318). Enrolment was stopped on Feb 2, 2011, after a recommendation from the independent data monitoring committee. There was no significant difference in overall survival between treatment groups, with a median overall survival of 11·3 months (95% CI 9·5–13·4) in the necitumumab plus pemetrexed and cisplatin group versus 11·5 months (10·1–13·1) in the pemetrexed and cisplatin group (hazard ratio 1·01 [95% CI 0·84–1·21]; p=0·96). The incidence of grade 3 or worse adverse events, including deaths, was higher in the necitumumab plus pemetrexed and cisplatin group than in the pemetrexed and cisplatin group; in particular, deaths regarded as related to study drug were reported in 15 (5%) of 304 patients in the necitumumab group versus nine (3%) of 312 patients in the pemetrexed and cisplatin group. Serious adverse events were likewise more frequent in the necitumumab plus pemetrexed and cisplatin group than in the pemetrexed and cisplatin group (155 [51%] of 304 vs 127 [41%] of 312 patients). Patients in the necitumumab plus pemetrexed and cisplatin group had more grade 3–4 rash (45 [15%] of 304 vs one [ vs seven [2%] patients), and grade 3 or higher venous thromboembolic events (23 [8%] vs 11 [4%] patients) than did those in the pemetrexed and cisplatin alone group. Interpretation Our findings show no evidence to suggest that the addition of necitumumab to pemetrexed and cisplatin increases survival of previously untreated patients with stage IV non-squamous NSCLC. Unless future studies identify potentially useful predictive biomarkers, necitumumab is unlikely to provide benefit in this patient population when combined with pemetrexed and cisplatin. Funding Eli Lilly and Company.
101 citations
TL;DR: The significant OS benefit observed with the addition of nintedanib to docetaxel therapy was achieved with no detrimental effect on patient self-reported QoL.
54 citations
TL;DR: A case study of a prospective–retrospective approach for a continuous biomarker identified after patient enrollment but defined prospectively before the unblinding of data, which was successful in clinically validating a probable predictive biomarker.
38 citations
TL;DR: Survival benefits from addition of nintedanib to docetaxel in patients with adenocarcinoma after first-line therapy can be achieved alongside a manageable safety profile.
29 citations
TL;DR: A PTX dosing algorithm for avoidance of supra- or subtherapeutic PTX exposure based on Tc > 0.05 determined from a single blood sample drawn 18-30 hours after starting PTX infusion is developed.
Abstract: 8051 Background: Variability of chemotherapy exposure may cause severe toxicity or lack of efficacy. Paclitaxel (PTX) exposure (time above a plasma concentration of 0.05mM, Tc > 0.05) has been show...
2 citations
TL;DR: These data support the previously demonstrated ability of VeriStrat to be both prognostic and predictive for survival in erlotinib treated patients, but not for tivantinibtreated patients.
Abstract: Background: MET, the high-affinity receptor for hepatocyte growth factor, is frequently deregulated in human cancer and is thought to be involved in resistance to EGFR TKIs. Tivantinib is an orally administered MET inhibitor currently under development as a cancer therapy. The Phase 3 MARQUEE trial enrolled 1048 subjects with locally-advanced or metastatic non-squamous NSCLC who had received one or two lines of prior systemic therapy. Patients were randomized 1:1 to T+E (N = 526) or P+E (N = 522) until disease progression. In the ITT population, addition of tivantinib to erlotinib significantly improved PFS and ORR but did not improve OS, the primary endpoint. VeriStrat® (VS) is a multivariate serum protein test that utilizes MALDI-TOF mass spectrometry to assign a “GOOD” (VS-G) or “POOR” (VS-P) classification and has demonstrated broad prognostic and predictive utility for EGFR TKI treatment regimens. Methods: Pre-treatment serum samples from the MARQUEE study were blinded to clinical outcome and analyzed by VeriStrat. Clinical benefit of T+E vs. P+E was analyzed as a function of VS status, in the ITT population as well as in pre-defined subgroups. Results: A total of 996 subjects were classified: 718 as VS-G and 278 as VS-P. Subjects testing VS-G had superior outcomes to those testing VS-P in both the T+E arm (OS HR = 0.32, CI: 0.26-0.41, p Conclusion: These data support the previously demonstrated ability of VS to be both prognostic and predictive for survival in erlotinib treated patients, but not for tivantinib treated patients. Citation Format: Giorgio Scagliotti, Wallace Akerley, Joachim von Pawel, Joanna Roder, Dale Shuster, Brian Schwartz, Dominic Spinella. Retrospective evaluation, of the randomized Phase 3 MARQUEE trial of tivantinib (T) + erlotinib (E) versus placebo (P) + erlotinib (E) using VeriStrat in patients with previously treated nonsquamous NSCLC. [abstract]. In: Proceedings of the 106th Annual Meeting of the American Association for Cancer Research; 2015 Apr 18-22; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Res 2015;75(15 Suppl):Abstract nr 560. doi:10.1158/1538-7445.AM2015-560
1 citations