Division of Oncology, Mayo Clinic, Rochester, MN, USA.
Centre Léon Bérard, Lyon, France.
Gynecol Oncol. 2023 Mar;170:221-228. doi: 10.1016/j.ygyno.2023.01.021. Epub 2023 Jan 27.
IGF signaling has been implicated in the pathogenesis and progression of ovarian carcinoma (OC). Single agent activity and safety of ganitumab (AMG 479), a fully human monoclonal antibody against IGF1R that blocks binding of IGF1 and IGF2, were evaluated in patients with platinum-sensitive recurrent OC.
Patients with CA125 progression (GCIG criteria) or measurable disease per RECIST following primary platinum-based therapy received 18 mg/kg of ganitumab q3w. The primary endpoint was objective response rate (ORR) assessed per RECIST 1.1 by an independent radiology review committee (IRC) and/or GCIG CA125 criteria. Secondary endpoints included clinical benefit rate (CBR), progression free survival (PFS) and overall survival (OS).
61 pts. were accrued. Objective responses were seen in 5/61 patients (ORR 8.2%, 95% CI, 3.1-18.8) with 1 partial response (PR) by RECIST and 2 complete responses (CR) as well as 2 PR by CA125 criteria. CBR was 80.3% (95% CI, 67.8-89.0%). The median PFS according to RECIST by IRC was 2.1 months (95% CI, 2.0-3.1). The median PFS per RECIST IRC and/or CA125 was 2.0 months (95% CI, 1.8-2.2). The median OS was 21 months (95% CI, 19.5-NA). The most common overall adverse events were fatigue (36.1%) and hypertension (34.4%). Grade 1/2 hyperglycemia occurred in 30.4% of patients. Hypertension (11.5%) and hypersensitivity (8.2%) were the most frequent grade 3 adverse events.
IGF1R inhibition with ganitumab was well-tolerated, however, our results do not support further study of ganitumab as a single agent in unselected OC patients.
胰岛素样生长因子(IGF)信号通路与卵巢癌(OC)的发病机制和进展有关。评估了针对 IGF1R 的完全人源单克隆抗体 ganitumab(AMG 479)在铂类敏感复发性 OC 患者中的单药活性和安全性。
在初次基于铂的治疗后根据 GCIG 标准出现 CA125 进展(GCIG 标准)或根据 RECIST 标准出现可测量疾病的患者接受 18mg/kg ganitumab,每 3 周一次。主要终点是根据 RECIST 1.1 由独立放射学审查委员会(IRC)和/或 GCIG CA125 标准评估的客观缓解率(ORR)。次要终点包括临床获益率(CBR)、无进展生存期(PFS)和总生存期(OS)。
共入组 61 例患者。61 例患者中 5 例(8.2%,95%CI,3.1-18.8)观察到客观缓解,其中 1 例符合 RECIST 标准的部分缓解(PR)和 2 例完全缓解(CR),以及 2 例 CA125 标准的 PR。CBR 为 80.3%(95%CI,67.8-89.0%)。IRC 根据 RECIST 评估的中位 PFS 为 2.1 个月(95%CI,2.0-3.1)。根据 RECIST IRC 和/或 CA125 的中位 PFS 为 2.0 个月(95%CI,1.8-2.2)。中位 OS 为 21 个月(95%CI,19.5-NR)。最常见的总体不良事件是疲劳(36.1%)和高血压(34.4%)。30.4%的患者发生 1/2 级高血糖。最常见的 3 级不良事件是高血压(11.5%)和过敏反应(8.2%)。
IGF1R 抑制作用ganitumab 具有良好的耐受性,然而,我们的结果不支持进一步研究 ganitumab 作为一种单一药物在未经选择的 OC 患者中的应用。