Phase II randomised discontinuation trial of brivanib in patients with advanced solid tumours

Jones, R. L. et al. (2019) Phase II randomised discontinuation trial of brivanib in patients with advanced solid tumours. European Journal of Cancer, 120, pp. 132-139. (doi: 10.1016/j.ejca.2019.07.024) (PMID:31522033)

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Abstract

Background: Brivanib is a selective inhibitor of vascular endothelial growth factor and fibroblast growth factor (FGF) signalling. We performed a phase II randomised discontinuation trial of brivanib in 7 tumour types (soft-tissue sarcomas [STS], ovarian cancer, breast cancer, pancreatic cancer, non-small-cell lung cancer [NSCLC], gastric/esophageal cancer and transitional cell carcinoma [TCC]). Patients and methods: During a 12-week open-label lead-in period, patients received brivanib 800 mg daily and were evaluated for FGF2 status by immunohistochemistry. Patients with stable disease at week 12 were randomised to brivanib or placebo. A study steering committee evaluated week 12 response to determine if enrolment in a tumour type would continue. The primary objective was progression-free survival (PFS) for brivanib versus placebo in patients with FGF2-positive tumours. Results: A total of 595 patients were treated, and stable disease was observed at the week 12 randomisation point in all tumour types. Closure decisions were made for breast cancer, pancreatic cancer, NSCLC, gastric cancer and TCC. Criteria for expansion were met for STS and ovarian cancer. In 53 randomised patients with STS and FGF2-positive tumours, the median PFS was 2.8 months for brivanib and 1.4 months for placebo (hazard ratio [HR]: 0.58, p = 0.08). For all randomised patients with sarcomas, the median PFS was 2.8 months (95% confidence interval [CI]: 1.4–4.0) for those treated with brivanib compared with 1.4 months (95% CI: 1.3–1.6) for placebo (HR = 0.64, 95% CI: 0.38–1.07; p = 0.09). In the 36 randomised patients with ovarian cancer and FGF2-positive tumours, the median PFS was 4.0 (95% CI: 2.6–4.2) months for brivanib and 2.0 months (95% CI: 1.2–2.7) for placebo (HR: 0.56, 95% CI: 0.26–1.22). For all randomised patients with ovarian cancer, the median PFS in those randomised to brivanib was 4.0 months (95% CI: 2.6–4.2) and was 2.0 months (95% CI: 1.2–2.7) in those randomised to placebo (HR = 0.54, 95% CI: 0.25–1.17; p = 0.11). Conclusion: Brivanib demonstrated activity in STS and ovarian cancer with an acceptable safety profile. FGF2 expression, as defined in the protocol, is not a predictive biomarker of the efficacy of brivanib.

Item Type:Articles
Additional Information:Funding: This trial was funded by the Bristol-Myers Squibb company.
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Evans, Professor Jeff
Authors: Jones, R. L., Ratain, M. J., O'Dwyer, P. J., Siu, L. L., Jassem, J., Medioni, J., DeJonge, M., Rudin, C., Sawyer, M., Khayat, D., Awada, A., de Vos-Geelen, J. M.P.G.M., Evans, T.R. J., Obel, J., Brockstein, B., DeGreve, J., Baurain, J.-F., Maki, R., D'Adamo, D., Dickson, M., Undevia, S., Geary, D., Janisch, L., Bedard, P. L., Abdul Razak, A. R., Kristeleit, R., Vitfell-Rasmussen, J., Walters, I., Kaye, S. B., and Schwartz, G.
College/School:College of Medical Veterinary and Life Sciences > School of Cancer Sciences
Journal Name:European Journal of Cancer
Publisher:Elsevier
ISSN:0959-8049
ISSN (Online):1879-0852
Published Online:12 September 2019
Copyright Holders:Copyright © 2019 The Authors
First Published:First published in European Journal of Cancer 120:132-139
Publisher Policy:Reproduced under a Creative Commons license

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