Cilengitide combined with standard treatment for patients with newly diagnosed glioblastoma with methylated MGMT promoter (CENTRIC EORTC 26071-22072 study): a multicentre, randomised, open-label, phase 3 trial

Background - Cilengitide is a selective αvβ3 and αvβ5 integrin inhibitor. Data from phase 2 trials suggest that it has antitumour activity as a single agent in recurrent glioblastoma and in combination with standard temozolomide chemoradiotherapy in newly diagnosed glioblastoma (particularly in tumo...

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Hauptverfasser: Stupp, Roger (VerfasserIn) , Hegi, Monika E (VerfasserIn) , Gorlia, Thierry (VerfasserIn) , Erridge, Sara C (VerfasserIn) , Perry, James (VerfasserIn) , Hong, Yong-Kil (VerfasserIn) , Aldape, Kenneth D (VerfasserIn) , Lhermitte, Benoit (VerfasserIn) , Pietsch, Torsten (VerfasserIn) , Grujicic, Danica (VerfasserIn) , Steinbach, Joachim Peter (VerfasserIn) , Wick, Wolfgang (VerfasserIn) , Tarnawski, Rafał (VerfasserIn) , Nam, Do-Hyun (VerfasserIn) , Hau, Peter (VerfasserIn) , Weyerbrock, Astrid (VerfasserIn) , Taphoorn, Martin J B (VerfasserIn) , Shen, Chiung-Chyi (VerfasserIn) , Rao, Nalini (VerfasserIn) , Thurzo, László (VerfasserIn) , Herrlinger, Ulrich (VerfasserIn) , Gupta, Tejpal (VerfasserIn) , Kortmann, Rolf-Dieter (VerfasserIn) , Adamska, Krystyna (VerfasserIn) , McBain, Catherine (VerfasserIn) , Brandes, Alba A (VerfasserIn) , Tonn, Joerg Christian (VerfasserIn) , Schnell, Oliver (VerfasserIn) , Wiegel, Thomas (VerfasserIn) , Kim, Chae-Yong (VerfasserIn) , Nabors, Louis Burt (VerfasserIn) , Reardon, David A (VerfasserIn) , van den Bent, Martin J (VerfasserIn) , Hicking, Christine (VerfasserIn) , Markivskyy, Andriy (VerfasserIn) , Picard, Martin (VerfasserIn) , Weller, Michael (VerfasserIn)
Dokumenttyp: Article (Journal)
Sprache:Englisch
Veröffentlicht: August 20, 2014
In: The lancet. Oncology
Year: 2014, Jahrgang: 15, Heft: 10, Pages: 1100-1108
ISSN:1474-5488
DOI:10.1016/S1470-2045(14)70379-1
Online-Zugang:Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1016/S1470-2045(14)70379-1
Verlag, lizenzpflichtig, Volltext: http://www.sciencedirect.com/science/article/pii/S1470204514703791
Volltext
Verfasserangaben:Roger Stupp, Monika E Hegi, Thierry Gorlia, Sara C Erridge, James Perry, Yong-Kil Hong, Kenneth D Aldape, Benoit Lhermitte, Torsten Pietsch, Danica Grujicic, Joachim Peter Steinbach, Wolfgang Wick, Rafał Tarnawski, Do-Hyun Nam, Peter Hau, Astrid Weyerbrock, Martin J B Taphoorn, Chiung-Chyi Shen, Nalini Rao, László Thurzo, Ulrich Herrlinger, Tejpal Gupta, Rolf-Dieter Kortmann, Krystyna Adamska, Catherine McBain, Alba A Brandes, Joerg Christian Tonn, Oliver Schnell, Thomas Wiegel, Chae-Yong Kim, Louis Burt Nabors, David A Reardon, Martin J van den Bent, Christine Hicking, Andriy Markivskyy, Martin Picard, Michael Weller for the European Organisation for Research and Treatment of Cancer (EORTC), the Canadian Brain Tumor Consortium, and the CENTRIC study team

MARC

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520 |a Background - Cilengitide is a selective αvβ3 and αvβ5 integrin inhibitor. Data from phase 2 trials suggest that it has antitumour activity as a single agent in recurrent glioblastoma and in combination with standard temozolomide chemoradiotherapy in newly diagnosed glioblastoma (particularly in tumours with methylated MGMT promoter). We aimed to assess cilengitide combined with temozolomide chemoradiotherapy in patients with newly diagnosed glioblastoma with methylated MGMT promoter. - Methods - In this multicentre, open-label, phase 3 study, we investigated the efficacy of cilengitide in patients from 146 study sites in 25 countries. Eligible patients (newly diagnosed, histologically proven supratentorial glioblastoma, methylated MGMT promoter, and age ≥18 years) were stratified for prognostic Radiation Therapy Oncology Group recursive partitioning analysis class and geographic region and centrally randomised in a 1:1 ratio with interactive voice response system to receive temozolomide chemoradiotherapy with cilengitide 2000 mg intravenously twice weekly (cilengitide group) or temozolomide chemoradiotherapy alone (control group). Patients and investigators were unmasked to treatment allocation. Maintenance temozolomide was given for up to six cycles, and cilengitide was given for up to 18 months or until disease progression or unacceptable toxic effects. The primary endpoint was overall survival. We analysed survival outcomes by intention to treat. This study is registered with ClinicalTrials.gov, number NCT00689221. - Findings - Overall, 3471 patients were screened. Of these patients, 3060 had tumour MGMT status tested; 926 patients had a methylated MGMT promoter, and 545 were randomly assigned to the cilengitide (n=272) or control groups (n=273) between Oct 31, 2008, and May 12, 2011. Median overall survival was 26·3 months (95% CI 23·8-28·8) in the cilengitide group and 26·3 months (23·9-34·7) in the control group (hazard ratio 1·02, 95% CI 0·81-1·29, p=0·86). None of the predefined clinical subgroups showed a benefit from cilengitide. We noted no overall additional toxic effects with cilengitide treatment. The most commonly reported adverse events of grade 3 or worse in the safety population were lymphopenia (31 [12%] in the cilengitide group vs 26 [10%] in the control group), thrombocytopenia (28 [11%] vs 46 [18%]), neutropenia (19 [7%] vs 24 [9%]), leucopenia (18 [7%] vs 20 [8%]), and convulsion (14 [5%] vs 15 [6%]). - Interpretation - The addition of cilengitide to temozolomide chemoradiotherapy did not improve outcomes; cilengitide will not be further developed as an anticancer drug. Nevertheless, integrins remain a potential treatment target for glioblastoma. - Funding - Merck KGaA, Darmstadt, Germany. 
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700 1 |a Hong, Yong-Kil  |e VerfasserIn  |4 aut 
700 1 |a Aldape, Kenneth D  |e VerfasserIn  |4 aut 
700 1 |a Lhermitte, Benoit  |e VerfasserIn  |4 aut 
700 1 |a Pietsch, Torsten  |e VerfasserIn  |4 aut 
700 1 |a Grujicic, Danica  |e VerfasserIn  |4 aut 
700 1 |a Steinbach, Joachim Peter  |e VerfasserIn  |4 aut 
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700 1 |a Nam, Do-Hyun  |e VerfasserIn  |4 aut 
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700 1 |a Weyerbrock, Astrid  |e VerfasserIn  |4 aut 
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700 1 |a Shen, Chiung-Chyi  |e VerfasserIn  |4 aut 
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700 1 |a Adamska, Krystyna  |e VerfasserIn  |4 aut 
700 1 |a McBain, Catherine  |e VerfasserIn  |4 aut 
700 1 |a Brandes, Alba A  |e VerfasserIn  |4 aut 
700 1 |a Tonn, Joerg Christian  |e VerfasserIn  |4 aut 
700 1 |a Schnell, Oliver  |e VerfasserIn  |4 aut 
700 1 |a Wiegel, Thomas  |e VerfasserIn  |4 aut 
700 1 |a Kim, Chae-Yong  |e VerfasserIn  |4 aut 
700 1 |a Nabors, Louis Burt  |e VerfasserIn  |4 aut 
700 1 |a Reardon, David A  |e VerfasserIn  |4 aut 
700 1 |a van den Bent, Martin J  |e VerfasserIn  |4 aut 
700 1 |a Hicking, Christine  |e VerfasserIn  |4 aut 
700 1 |a Markivskyy, Andriy  |e VerfasserIn  |4 aut 
700 1 |a Picard, Martin  |e VerfasserIn  |4 aut 
700 1 |a Weller, Michael  |e VerfasserIn  |4 aut 
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