Pazopanib for treatment of advanced extraskeletal myxoid chondrosarcoma: a multicentre, single-arm, phase 2 trial - 05/09/19
, Stefano Ferrari, MD e, Andres Redondo, MD f, Nadia Hindi, MD h, i, Emanuela Palmerini, MD e, Maria Angeles Vaz Salgado, MD j, Anna Maria Frezza, MD a, Paolo Giovanni Casali, ProfMD a, k, Antonio Gutierrez, MD l, Antonio Lopez-Pousa, MD m, Giovanni Grignani, MD n, Antoine Italiano, ProfMD o, Axel LeCesne, MD p, Sarah Dumont, MD p, Jean Yves Blay, ProfMD q, s, Nicolas Penel, MD t, Daniel Bernabeu, MD g, Enrique de Alava, ProfMD i, u, Marie Karanian, MD r, Carlo Morosi, MD b, Silvia Brich, PhD c, Gian Paolo Dagrada, PhD c, Viviana Vallacchi, PhD d, Chiara Castelli, PhD d, Monica Brenca, PhD v, Dominga Racanelli, PhD v, Roberta Maestro, PhD v, Paola Collini, MD c, Josefina Cruz, MD w, Javier Martin-Broto, MD h, iSummary |
Background |
Extraskeletal myxoid chondrosarcoma is a rare sarcoma with low sensitivity to cytotoxic chemotherapy. Retrospective evidence suggests that antiangiogenic drugs could be a treatment option. We aimed to investigate the activity of pazopanib, an antiangiogenic drug, in patients with advanced extraskeletal myxoid chondrosarcoma.
Methods |
In this single-arm, open-label phase 2 trial, three parallel independent cohorts of different histotypes of advanced sarcomas were recruited (extraskeletal myxoid chondrosarcoma, typical solitary fibrous tumour, and malignant-dedifferentiated solitary fibrous tumour). In each cohort, patients received pazopanib. In this Article, we report the results of the cohort of patients with advanced extraskeletal myxoid chondrosarcoma. Separate reporting of the three cohorts was prespecified in the study protocol. In this cohort, adult patients (aged ≥18 years) with a diagnosis of NR4A3-translocated, metastatic, or unresectable extraskeletal myxoid chondrosarcoma, who had Response Evaluation Criteria in Solid Tumors (RECIST) progression in the previous 6 months, and had an Eastern Cooperative Oncology Group performance status of 0–2, were enrolled at 11 study sites of the Spanish, Italian, and French sarcoma groups. Patients received oral pazopanib (800 mg/day) continuously, until disease progression, unacceptable toxicity, death, non-compliance, patient refusal, or investigator’s decision. The primary endpoint was the proportion of patients achieving an objective response according to RECIST 1·1 in the modified intention-to-treat population (patients who provided consent and had a central molecularly confirmed diagnosis of extraskeletal myxoid chondrosarcoma). The safety analysis included all patients who received at least one dose of pazopanib. This study is registered with ClinicalTrials.gov, number NCT02066285.
Findings |
Between June 24, 2014, and Jan 17, 2017, 26 patients entered the study and started pazopanib. Of these, 23 met the eligibility criteria for the modified intention-to-treat analysis. Median follow-up was 27 months (IQR 18–30). 22 patients (one patient died before the primary analysis) were evaluable for the primary endpoint: four (18% [95% CI 1–36]) had a RECIST objective response. No deaths or grade 4 adverse events occurred. The most frequent grade 3 adverse events were hypertension (nine [35%] of 26 patients), increased concentration of alanine aminotransferase (six [23%]), and increased aspartate aminotransferase (five [19%]).
Interpretation |
Pazopanib had clinically meaningful antitumour activity in patients with progressive and advanced extraskeletal myxoid chondrosarcoma, and could be considered a suitable option after failure to respond to first-line anthracycline-based chemotherapy in these patients.
Funding |
Spanish Group for Research on Sarcomas, Italian Sarcoma Group, French Sarcoma Group, GlaxoSmithKline, and Novartis.
Le texte complet de cet article est disponible en PDF.Plan
Vol 20 - N° 9
P. 1252-1262 - septembre 2019 Retour au numéro
Article précédent
- Pembrolizumab versus ipilimumab in advanced melanoma (KEYNOTE-006): post-hoc 5-year results from an open-label, multicentre, randomised, controlled, phase 3 study
- Caroline Robert, Antoni Ribas, Jacob Schachter, Ana Arance, Jean-Jacques Grob, Laurent Mortier, Adil Daud, Matteo S Carlino, Catriona M McNeil, Michal Lotem, James M G Larkin, Paul Lorigan, Bart Neyns, Christian U Blank, Teresa M Petrella, Omid Hamid, Shu-Chih Su, Clemens Krepler, Nageatte Ibrahim, Georgina V Long
- Pazopanib or methotrexate–vinblastine combination chemotherapy in adult patients with progressive desmoid tumours (DESMOPAZ): a non-comparative, randomised, open-label, multicentre, phase 2 study
- Maud Toulmonde, Marina Pulido, Isabelle Ray-Coquard, Thierry Andre, Nicolas Isambert, Christine Chevreau, Nicolas Penel, Emmanuelle Bompas, Esma Saada, François Bertucci, Celeste Lebbe, Axel Le Cesne, Patrick Soulie, Sophie Piperno-Neumann, Stephen Sweet, Fabiola Cecchi, Todd Hembrough, Carine Bellera, Michèle Kind, Amandine Crombe, Carlo Lucchesi, François Le Loarer, Jean-Yves Blay, Antoine Italiano
Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?