Presentado Domingo 6 de Mayo :Extending platinum-free interval (PFI) in partially platinum-sensitive (PPS) patients (pts) with recurrent ovarian cancer (ROC) treated with trabectedin (Tr) plus pegylated liposomal doxorubicin (Tr+PLD) versus PLD alone: Results from a PPS cohort of a phase III study.
Abstract No: 5012
Author(s): A. Poveda, S. Tjulandin, B. Kong, M. Roy, S. Chan, E. Filipczyk-Cisarz, H. Hagberg, C. Lebedinsky, T. V. Parekh, B. J. Monk; Instituto Valenciano de Oncologia, Valencia, Spain; N. N. Blokhin Russian Cancer Research Center, Moscow, Russia; Qilu Hospital, Shandong University China, Jinan City, China; CHUQ Pavillon Hotel-Dieu, Quebec, QC, Canada; Nottingham University Hospital, Nottingham, United Kingdom; Dolnoslaskie Centrum Onkologii, Wroclaw, Poland; Akademiska Sjukhuset, Uppsala, Sweden; PharmaMar, Colmenar Viejo, Madrid, Spain; Ortho Biotech Oncology Research and Development, Raritan, NJ; University of California, Irvine Medical Center, Orange, CA
Abstract:
Background: OVA-301, a phase III study comparing Tr+PLD vs. PLD alone in 672 ROC pts progressing after one prior platinum-based regimen, showed significantly longer progression-free survival (PFS), higher response rate (RR) for the combination by 3 separate assessments: independent radiology (IR), independent oncology (IO) and investigators (IA) and a positive trend for longer survival (OS) (Monk, Ann Oncol 2008 vol 19 Sup8). Methods: PFI > 6 mo was found in 430 (64%) of 672 randomized pts, including 214 (32%) pts with PPS disease (PFI 6-12 mo). Outcomes of this nonplatinum combination on PFS, RR and OS (protocol-specified interim analysis, cutoff May 08) are shown for the PPS population. We evaluated time from randomization to subsequent platinum (SP) and survival time from SP.
Results: Baseline characteristics of pts with PPS were balanced and consistent with those of the overall study population. Median (med) no. cycles, 6 (Tr+PLD) vs. 5 (PLD); 40% vs. 24% pts received ≥ 7 cycles. RR and PFS by IR significantly favored Tr+PLD: 33% vs. 15% (p = 0.0041); med PFS 7.4 vs. 5.5 mo (HR 0.65; p = 0.0152), with consistently superior outcomes by both IO and IA. Med OS from randomization was in favor of Tr+PLD: 20.7 vs. 17.2 mo (HR: 0.59; p=0.0090). Proportion of pts receiving SP was comparable in both arms. A significant delay in the administration of SP with the combination (med 15.3 vs. 11.6 mo; HR 0.60, p = 0.0093) was observed. Med survival time from start of SP until death or last contact was 11.0 vs. 9.2 mo (HR 0.72, p = 0.2480). The Tr+PLD safety profile of PPS cohort agreed with that of the overall study population and was consistent with known toxicities of each agent. No new or unexpected toxicities were seen.
Conclusions: In the PPS cohort of OVA-301, Tr+PLD induced significantly superior RR, PFS and OS (3.5 mo prolongation in med OS). Significant delay in time to SP and longer survival after SP therapy was seen after this nonplatinum regimen. Safety was manageable rendering a highly favorable benefit/risk ratio in this population with high unmet need for new therapeutic options.