Randomized phase II study of the PDGFRα antibody olaratumab plus liposomal doxorubicin versus liposomal doxorubicin alone in patients with platinum-refractory or platinum-resistant advanced ovarian cancer
Open Access
- 27 December 2018
- journal article
- research article
- Published by Springer Nature in BMC Cancer
- Vol. 18 (1) , 1292
Abstract
Olaratumab is a platelet-derived growth factor receptor-α (PDGFRα)-targeting monoclonal antibody blocking PDGFRα signaling. PDGFRα expression is associated with a more aggressive phenotype and poor ovarian cancer outcomes. This randomized, open label phase II study evaluated olaratumab plus liposomal doxorubicin compared with liposomal doxorubicin alone in advanced ovarian cancer patients. Patients with platinum-refractory or platinum-resistant advanced ovarian cancer were randomized 1:1 to receive liposomal doxorubicin (40 mg/m2, intravenous infusion) administered every 4 weeks with or without olaratumab (20 mg/kg, IV infusion) every 2 weeks. Patients were stratified based on prior response to platinum therapy (refractory vs resistant). The primary efficacy endpoint was progression-free survival (PFS). Secondary endpoints included overall survival (OS), objective response rate, duration of response, and safety. A total of 123 patients were treated (62 olaratumab+liposomal doxorubicin; 61 liposomal doxorubicin). Median PFS was 4.2 months for olaratumab+liposomal doxorubicin and 4.0 months for liposomal doxorubicin (stratified hazard ratio [HR] = 1.043; 95% confidence interval [CI] 0.698–1.558; p = 0.837). Median OS was 16.6 months and 16.2 months in the olaratumab+liposomal doxorubicin and liposomal doxorubicin arms, respectively (HR = 1.098; 95% CI 0.71–1.71). In the platinum-refractory subgroup, median PFS was 5.5 months (95% CI 1.6–9.2) and 3.7 months (95% CI 1.9–9.2) in the olaratumab+liposomal doxorubicin (n = 15) and liposomal doxorubicin arms (n = 16), respectively (HR = 0.85; 95% CI 0.38–1.91). Overall, 59.7% (olaratumab+liposomal doxorubicin) and 65.6% (liposomal doxorubicin) of patients reported grade ≥ 3 adverse events regardless of causality. The most common treatment-emergent adverse events (all grades) regardless of causality were fatigue related (61%), nausea (57%), and constipation (52%) with olaratumab+liposomal doxorubicin and nausea (64%), fatigue related (62%), and mucositis (46%) with liposomal doxorubicin. The addition of olaratumab to liposomal doxorubicin did not result in significant prolongation of PFS or OS in platinum-resistant or platinum-refractory ovarian cancer. ClinicalTrials.gov identifier: NCT00913835 ; registered June 2, 2009.Keywords
Funding Information
- ImClone System LLC, a wholly owned subsidiary of Eli Lilly and Company
This publication has 21 references indexed in Scilit:
- Newly diagnosed and relapsed epithelial ovarian carcinoma: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-upAnnals of Oncology, 2013
- PDGF, TGF-β, and FGF signaling is important for differentiation and growth of mesenchymal stem cells (MSCs): transcriptional profiling can identify markers and signaling pathways important in differentiation of MSCs into adipogenic, chondrogenic, and osteogenic lineagesBlood, 2008
- Phase II study of the combination of pegylated liposomal doxorubicin and topotecan in platinum-resistant ovarian cancerInternational Journal of Gynecological Cancer, 2006
- Clinical and pharmacokinetic phase II study of pegylated liposomal doxorubicin and vinorelbine in heavily pretreated recurrent ovarian carcinomaAnnals of Oncology, 2005
- Phase II study of liposomal doxorubicin and gemcitabine in the salvage treatment of ovarian cancerBritish Journal of Cancer, 2003
- Phase II study of liposomal doxorubicin and weekly paclitaxel for recurrent Müllerian tumorsGynecologic Oncology, 2003
- Involvement of platelet-derived growth factor in disease: development of specific antagonists2001
- Signal transduction via platelet-derived growth factor receptorsBiochimica et Biophysica Acta (BBA) - Reviews on Cancer, 1998
- Responses to salvage chemotherapy in ovarian cancer: a critical need for precise definitions of the treated population.Journal of Clinical Oncology, 1992
- Two Classes of PDGF Receptor Eecognize Different Isoforms of PDGFScience, 1988