“The use of maintenance sunitinib improved progression-free survival (PFS) over placebo among patients with untreated extensive-stage small-cell lung cancer (SCLC) in a new phase II study.
“ ‘Most of the 30,000 patients newly diagnosed each year with SCLC in the United States have extensive-stage disease,’ wrote study authors led by Neal E. Ready, MD, PhD, of Duke University Medical Center in Durham, North Carolina. ‘Despite achieving good disease control initially, patients with SCLC usually experience relapse within 6 months of first-line chemotherapy and often do not respond to subsequent chemotherapy.’
“In previous studies, maintenance chemotherapy after standard platinum-based therapy did not show any overall survival benefit. The new study aimed to test whether sunitinib, a small-molecule tyrosine kinase inhibitor that inhibits VEGF receptors and other targets. Results of the new study were published online ahead of print in the Journal of Clinical Oncology.
“The study enrolled a total of 144 patients, 49 of whom progressed or did not complete induction chemotherapy; 95 patients were randomly assigned to a placebo maintenance therapy group (46 patients) or a sunitinib maintenance therapy group (49 patients), and five patients on each arm did not receive the maintenance therapy. Sunitinib patients received 37.5 mg per day until progression.”
The gist: People with advanced non-squamous non-small cell lung cancer (NSCLC) might do better if a drug called linifanib is added to chemo treatment with the drugs carboplatin and paclitaxel. In a clinical trial with volunteer patients, people who took all three drugs went for several weeks longer without their disease worsening than patients who took only carboplatin and paclitaxel.
“The addition of linifanib to a carboplatin and paclitaxel regimen offered significantly improved progression-free survival (PFS) over placebo in a randomized phase II trial of patients with advanced non-squamous non–small-cell lung cancer (NSCLC).
“Previous work has shown that adding inhibitors of VEGF to standard chemotherapy can improve survival outcomes in advanced NSCLC. Linifanib (Abbott Laboratories) is a tyrosine kinase inhibitor with activity against VEGF and PDGF receptors. “Single-agent activity of linifanib in phase I and II clinical studies in patients with advanced NSCLC encouraged further evaluation of linifanib as a component of therapy for these patients,” wrote study authors led by Suresh S. Ramalingam, MD, of Winship Cancer Institute of Emory University in Atlanta…
“ ‘Although additional studies of linifanib in NSCLC are not currently planned, further evaluation of linifanib in patients with the identified biomarker signature is warranted,’ the authors concluded. ‘These findings are also of potential significance for other antiangiogenic agents presently under development for NSCLC.’ ”
“Baseline circulating tumor cell count independently predicted PFS and OS for patients with metastatic breast cancer, study results showed.
“The addition of circulating tumor cell (CTC) count to full clinicopathological predictive models also improved prognosis in this patient population, whereas serum markers did not.”
Editor’s note: “PFS” stands for “progression-free survival,” and refers to patients surviving without their tumors growing or spreading. “OS” stands for “overall survival,” and refers to time of survival with or without disease progression. This article reports results from a study that found that blood tests that measure the amount of circulating tumor cells (CTCs) in a metastatic breast cancer patient could potentially be used to predict PFS and OS.
“Tasquinimod prolonged survival in men with minimally symptomatic, metastatic castration-resistant prostate cancer compared with placebo, according to results of a randomized, phase 2 study. Results suggest the survival advantage was particularly apparent among men with skeletal metastases. The study included 201 men. Researchers assigned 134 of them to tasquinimod (Active Biotech), an oral immunomodulatory, anti-angiogenic and anti-metastatic novel agent. The other 67 men were assigned placebo; however, 41 of them crossed over to treatment with tasquinimod during the study.”
“Exelixis, Inc. today announced that it has initiated a phase II clinical trial comparing cabozantinib plus abiraterone and prednisone (abiraterone/prednisone) versus abiraterone/prednisone in patients with castration-resistant prostate cancer (CRPC) who have bone metastases and have not been previously treated with chemotherapy. The primary endpoint for the randomized, open-label trial is radiographic progression-free survival (PFS).”
Gelsomino F, Agustoni F, Niger M, Valota M, Haspinger ER. Journal of Clinical Oncology. Aug 12, 2013.
“TO THE EDITOR: Laurie et al recently published a review article in Journal of Clinical Oncology on the role of epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) in patients with EGFR wild-type (WT) non–small-cell lung cancer (NSCLC). The authors clearly stated that the majority of patients have a WT phenotype; therefore, the treatment of this molecular subgroup represents a relevant issue. At present, all indirect data suggest a superiority of chemotherapy (CT) over TKIs in all settings in patients with EGFR WT disease, at least for progression-free survival (PFS).”
Nathanson KL, Martin AM, Wubbenhorst B, Greshock J, et al. Clinical Cancer Research. Jul 5, 2013.
“Dabrafenib is a selective inhibitor of V600-mutant BRAF kinase, which recently demonstrated improved progression free survival (PFS) as compared with dacarbazine, in metastatic melanoma patients. The current study examined potential genetic markers associated with response and PFS in the phase I study of dabrafenib.”
Campos-Parra AD, Zuloaga C, Manríquez ME, Avilés A, et al. Am J Clin Oncol. Mar 28, 2013.
“In patients with non-small cell lung cancer (NSCLC), knowledge of the epidermal growth factor receptor (EGFR) mutation status is fundamental for selecting the treatment involving EGFR-tyrosine kinase inhibitors (EGFR-TKIs). Little information is available regarding the response and progression-free survival (PFS) in platinum-based chemotherapy (CT) versus EGFR-TKIs in the presence or absence of KRAS mutation, particularly in patients without EGFR mutation…”