Reck Martin, Luft Alexander, Bondarenko Igor, Shevnia Serhii, Trukhin Dmytro, Kovalenko Nadezhda V, Vacharadze Kakha, Andrea Fülöp, Hontsa Anatoliy, Choi Jihye, Shin Donghoon
Department of Thoracic Oncology, Lung Clinic Grosshansdorf, Airway Research Center North, German Center of Lung Research, Lung Clinic, Woehrendamm 80, 22927 Grosshansdorf, Germany.
Department of Thoracic Surgery, Leningrad Regional Clinical Hospital, St. Petersburg, Russian Federation.
Lung Cancer. 2020 Aug;146:12-18. doi: 10.1016/j.lungcan.2020.05.027. Epub 2020 May 28.
Efficacy, safety, pharmacokinetics (PK), and immunogenicity of the biosimilar candidate SB8 was compared to its reference product bevacizumab (BEV) in patients with metastatic or recurrent nonsquamous non-small cell lung cancer.
Patients were randomized (1:1) in a phase III, double-blind study to receive intravenous SB8 or BEV 15 mg/kg with paclitaxel/carboplatin every 3 weeks for 24 weeks, followed by SB8 or BEV maintenance monotherapy. The primary endpoint was best overall response rate (ORR) by 24 weeks. Secondary endpoints included survival outcomes, safety, PK, and immunogenicity.
763 patients (SB8, n = 379; BEV, n = 384) were randomized; baseline characteristics were well balanced. Best ORR in the FAS was 47.6% and 42.8%, and best ORR in the PPS was 50.1% and 44.8% for SB8 and BEV, respectively. The risk ratio of best ORR was 1.11 (90% CI, 0.975-1.269), and the risk difference in best ORR was 5.3% (95% CI, -2.2%-12.9%). Median survival outcomes were comparable between SB8 and BEV: progression-free survival was 8.50 vs 7.90 months, respectively (HR [95% CI], 0.99 [0.83-1.18]; p = 0.9338); overall survival was 14.90 vs 15.80 months, respectively (HR [95% CI], 1.03 [0.83-1.28]; p = 0.7713); and duration of response was 7.70 vs 7.00 months, respectively (HR [95% CI], 1.05 [0.81-1.37]; p = 0.6928). Severity and incidence of treatment-emergent adverse events, PK, and immunogenicity were comparable between SB8 and BEV.
This study demonstrated equivalence between SB8 and BEV in terms of best ORR risk ratio, with comparable safety, PK, and immunogenicity.
在转移性或复发性非鳞状非小细胞肺癌患者中,比较生物类似药候选药物SB8与其对照产品贝伐单抗(BEV)的疗效、安全性、药代动力学(PK)和免疫原性。
在一项III期双盲研究中,患者被随机(1:1)分组,接受静脉注射SB8或BEV 15mg/kg,每3周一次,联合紫杉醇/卡铂,共24周,随后接受SB8或BEV维持单药治疗。主要终点是24周时的最佳总体缓解率(ORR)。次要终点包括生存结果、安全性、PK和免疫原性。
763例患者(SB8组,n = 379;BEV组,n = 384)被随机分组;基线特征均衡。SB8和BEV在全分析集(FAS)中的最佳ORR分别为47.6%和42.8%,在符合方案集(PPS)中的最佳ORR分别为50.1%和44.8%。最佳ORR的风险比为1.11(90%CI,0.975 - 1.269),最佳ORR的风险差异为5.3%(95%CI,-2.2% - 12.9%)。SB8和BEV的中位生存结果相当:无进展生存期分别为8.50个月和7.90个月(HR[95%CI],0.99[0.83 - 1.18];p = 0.9338);总生存期分别为14.90个月和15.80个月(HR[95%CI],1.03[0.83 - 1.28];p = 0.7713);缓解持续时间分别为7.70个月和7.00个月(HR[95%CI],1.05[0.81 - 1.37];p = 0.6928)。SB8和BEV在治疗中出现的不良事件的严重程度和发生率、PK和免疫原性方面相当。
本研究表明,SB8和BEV在最佳ORR风险比方面具有等效性,且安全性、PK和免疫原性相当。