Interim Analysis of the Phase II Study: Noninferiority Study of Doxorubicin with Upfront Dexrazoxane plus Olaratumab for Advanced or Metastatic Soft-Tissue Sarcoma
| Autor: | John Gorcsan, George A. Heberton, Peter Huntjens, Brian A. Van Tine, Joshua D. Mitchell, Peter Oppelt, Jose Alvarez-Cardona, Ronald J. Krone, Michele Landeau, Richa Rathore, Fei Wan, Justin M. Vader, Angela C. Hirbe, Kathleen W. Zhang, Yoku Soyama, Daniel J. Lenihan, Shellie Berry, Ashley Frith |
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| Rok vydání: | 2021 |
| Předmět: |
Cancer Research
medicine.medical_specialty Cardiotoxicity Ejection fraction business.industry Soft tissue sarcoma Urology Phases of clinical research 030204 cardiovascular system & hematology medicine.disease Interim analysis 03 medical and health sciences 0302 clinical medicine Oncology 030220 oncology & carcinogenesis medicine Doxorubicin Dexrazoxane business Olaratumab medicine.drug |
| Zdroj: | Clinical Cancer Research. 27:3854-3860 |
| ISSN: | 1557-3265 1078-0432 |
| DOI: | 10.1158/1078-0432.ccr-20-4621 |
| Popis: | Purpose: To report the interim analysis of the phase II single-arm noninferiority trial, testing the upfront use of dexrazoxane with doxorubicin on progression-free survival (PFS) and cardiac function in soft-tissue sarcoma (STS). Patients and Methods: Patients with metastatic or unresectable STS who were candidates for first-line treatment with doxorubicin were deemed eligible. An interim analysis was initiated after 33 of 65 patients were enrolled. Using the historical control of 4.6 months PFS for doxorubicin in the front-line setting, we tested whether the addition of dexrazoxane affected the efficacy of doxorubicin in STS. The study was powered so that a decrease of PFS to 3.7 months would be considered noninferior. Secondary aims included cardiac-related mortality, incidence of heart failure/cardiomyopathy, and expansion of cardiac monitoring parameters including three-dimensional echocardiography. Patients were allowed to continue on doxorubicin beyond 600 mg/m2 if they were deriving benefit and were not demonstrating evidence of symptomatic cardiac dysfunction. Results: At interim analysis, upfront use of dexrazoxane with doxorubicin demonstrated a PFS of 8.4 months (95% confidence interval: 5.1–11.2 months). Only 3 patients were removed from study for cardiotoxicity, all on > 600 mg/m2 doxorubicin. No patients required cardiac hospitalization or had new, persistent cardiac dysfunction with left ventricular ejection fraction remaining below 50%. The median administered doxorubicin dose was 450 mg/m2 (interquartile range, 300–750 mg/m2). Conclusions: At interim analysis, dexrazoxane did not reduce PFS in patients with STS treated with doxorubicin. Involvement of cardio-oncologists is beneficial for the monitoring and safe use of high-dose anthracyclines in STS. See related commentary by Benjamin and Minotti, p. 3809 |
| Databáze: | OpenAIRE |
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