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在针对表皮生长因子受体(EGFR)扩增的复发性胶质母细胞瘤的II期欧洲癌症研究与治疗组织(EORTC)1410/INTELLANCE 2试验中,depatuxizumab mafodotin对健康相关生活质量和神经功能的影响。

Impact of depatuxizumab mafodotin on health-related quality of life and neurological functioning in the phase II EORTC 1410/INTELLANCE 2 trial for EGFR-amplified recurrent glioblastoma.

作者信息

Clement Paul M J, Dirven Linda, Eoli Marica, Sepulveda-Sanchez Juan M, Walenkamp Annemiek M E, Frenel Jean S, Franceschi Enrico, Weller Michael, Chinot Olivier, De Vos Filip Y F L, Whenham Nicolas, Sanghera Paul, Looman Jim, Kundu Madan G, Peter de Geus Jan, Nuyens Sarah, Spruyt Maarten, Gorlia Thierry, Coens Corneel, Golfinopoulos Vassilis, Reijneveld Jaap C, van den Bent Martin J

机构信息

Department of Oncology, Leuven Cancer Institute, KU Leuven, Leuven, Belgium.

Department of Neurology, Leiden University Medical Center, Leiden, the Netherlands; Department of Neurology, Haaglanden Medical Center, The Hague, the Netherlands.

出版信息

Eur J Cancer. 2021 Apr;147:1-12. doi: 10.1016/j.ejca.2021.01.010. Epub 2021 Feb 15.

Abstract

BACKGROUND

In the EORTC 1410/INTELLANCE 2 randomised, phase II study (NCT02343406), with the antibody-drug conjugate depatuxizumab mafodotin (Depatux-M, ABT-414) in patients with recurrent EGFR-amplified glioblastoma, the primary end-point (overall survival) was not met, and the drug had ocular dose-limiting toxicity. This study reports results from the prespecified health-related quality of life (HRQoL) and neurological deterioration-free survival (NDFS) exploratory analysis.

PATIENTS AND METHODS

Patients (n = 260) were randomised 1:1:1 to receive either Depatux-M 1.25 mg/kg or 1.0 mg/kg intravenously every 2 weeks with oral temozolomide (TMZ) 150 mg/m, Depatux-M alone, or TMZ or oral lomustine (CCNU) 110 mg/m (TMZ/CCNU). HRQoL outcomes were recorded using the EORTC core Quality of Life QLQ-C30, and brain cancer-specific QLQ-BN20 questionnaires. Questionnaires were completed at baseline, weeks 8 and 16, and month 6, and changes from baseline to each time point were calculated. NDFS was defined as time to first deterioration in World Health Organisation performance status.

RESULTS

Compliance with HRQoL was 88.1% at baseline and decreased to 37.9% at month 6. Differences from baseline between Depatux-M arms and TMZ/CCNU in global health/QoL status throughout treatment did not reach clinical relevance (≥10 points). Self-reported visual disorders deteriorated to a clinically relevant extent with Depatux-M arms versus TMZ/CCNU at all timepoints (mean differences range: 24.6-35.1 points). Changes from baseline for other HRQoL scales and NDFS were generally similar between treatment arms.

CONCLUSIONS

Depatux-M had no impact on HRQoL and NDFS in patients with EGFR-amplified recurrent glioblastoma, except for more visual disorders, an expected side-effect of the study drug.

CLINICAL TRIAL REGISTRATION

NCT02343406.

摘要

背景

在欧洲癌症研究与治疗组织(EORTC)1410/INTELLANCE 2随机II期研究(NCT02343406)中,将抗体药物偶联物depatuxizumab mafodotin(Depatux-M,ABT-414)用于复发性表皮生长因子受体(EGFR)扩增的胶质母细胞瘤患者,主要终点(总生存期)未达到,且该药物存在眼部剂量限制性毒性。本研究报告了预先设定的健康相关生活质量(HRQoL)和无神经功能恶化生存期(NDFS)探索性分析的结果。

患者与方法

260例患者按1:1:1随机分组,分别接受每2周静脉注射Depatux-M 1.25 mg/kg或1.0 mg/kg联合口服替莫唑胺(TMZ)150 mg/m²,单独使用Depatux-M,或TMZ或口服洛莫司汀(CCNU)110 mg/m²(TMZ/CCNU)。使用EORTC核心生活质量问卷QLQ-C30和脑癌特异性问卷QLQ-BN20记录HRQoL结果。问卷在基线、第8周、第16周和第6个月完成,并计算从基线到每个时间点的变化。NDFS定义为世界卫生组织表现状态首次恶化的时间。

结果

基线时HRQoL的依从率为88.1%,第6个月降至37.9%。在整个治疗过程中,Depatux-M组与TMZ/CCNU组在总体健康/生活质量状态方面与基线的差异未达到临床相关性(≥10分)。在所有时间点,与TMZ/CCNU组相比,Depatux-M组自我报告的视觉障碍在临床上有明显恶化(平均差异范围:24.6 - 35.1分)。各治疗组之间其他HRQoL量表和NDFS与基线的变化总体相似。

结论

对于EGFR扩增的复发性胶质母细胞瘤患者,Depatux-M对HRQoL和NDFS没有影响,但视觉障碍更多,这是研究药物的预期副作用。

临床试验注册号

NCT02343406。

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