(Pleural Mesothelioma) Cediranib Plus Pemetrexed Disodium Plus Cisplatin: Is It Effective?
Medical Supporter — Avis d’information
Cet article est une synthèse d’informations médicales internationales et ne constitue pas un avis médical ; il ne remplace pas le diagnostic ni le plan de traitement de votre médecin traitant. Les informations présentées sont compilées à partir de publications publiques et de déclarations officielles d’établissements médicaux japonais ; l’adéquation et les résultats de toute thérapie varient selon chaque patient et doivent être évalués individuellement par un médecin qualifié.
- September 17, 2019
- 2 min read
On August 6, 2019, Dr. Anne S. Tsao published results in the Journal of Clinical Oncology from the SWOG S0905 Phase 2 clinical trial evaluating the efficacy and safety of combining the anti-VEGFR inhibitor Cediranib with pemetrexed disodium and cisplatin in unresectable, chemotherapy-naive malignant pleural mesothelioma patients.
The SWOG S0905 trial was a randomized Phase 2 study enrolling 92 patients with unresectable, chemotherapy-naive malignant pleural mesothelioma. The primary endpoint was progression-free survival (PFS); secondary endpoints were overall survival (OS) and objective response rate (ORR). Treatment was on a 21-day cycle:
- Cediranib group (N=45): Pemetrexed 500 mg/m² (Day 1) + Cisplatin 75 mg/m² (Day 1) + Cediranib 20 mg orally once daily (Days 1–21)
- Placebo group (N=47): Pemetrexed 500 mg/m² (Day 1) + Cisplatin 75 mg/m² (Day 1) + Placebo once daily (Days 1–21)
Background: Malignant pleural mesothelioma is a rare cancer with poor prognosis and limited treatment options. Systemic chemotherapy combined with VEGFR inhibitors was expected to enhance anti-tumor efficacy. This trial evaluated oral VEGFR inhibitor Cediranib combined with chemotherapy.
Patient Demographics:
| Parameter | Cediranib | Placebo |
|---|---|---|
| Median age | 72 years (46–82) | 72 years (51–85) |
| Male | 84% | 85% |
| Caucasian | 96% | 89% |
| ECOG 0–1 | 93% | 94% |
| Prior radiation | 18% | 19% |
| Prior neo/adjuvant chemo | 13% | 13% |
Results at median follow-up of 31 months:
Primary endpoint median PFS: Cediranib 7.2 months vs. placebo 5.6 months — Cediranib improved disease progression risk by 29% (HR: 0.71).
Secondary endpoint median OS: Cediranib 10 months vs. placebo 8.5 months — Cediranib improved survival risk by 12%, but without statistical significance (HR: 0.88). ORR: Cediranib 50% vs. placebo 20% — statistically significant improvement.
Safety:
Overall adverse event incidence: Cediranib 100% vs. placebo 91%. Grade 3–4 adverse events: Cediranib 69% vs. placebo 57%. Higher rates in the Cediranib arm included: anorexia (51% vs. 38%), diarrhea (46.7% vs. 17%), epistaxis (13% vs. 0%), muscle atrophy (16% vs. 9%), hypertension (44% vs. 15%), nausea (76% vs. 66%), peripheral neuropathy (20% vs. 11%), weight loss (36% vs. 21%), myelosuppression (44% vs. 30%).
Conclusion: Based on the SWOG S0905 trial results, Dr. Tsao concluded that Cediranib combined with pemetrexed disodium and cisplatin improved PFS and ORR in unresectable, chemotherapy-naive malignant pleural mesothelioma patients.
Disclaimer: Medical Supporter translates overseas clinical trial data for informational purposes only. Please consult your healthcare provider for medical decisions.
Source: Phase II Trial of Cediranib in Combination With Cisplatin and Pemetrexed in Chemotherapy-Naïve Patients With Unresectable Malignant Pleural Mesothelioma (SWOG S0905). J Clin Oncol. 2019 Aug 6: JCO1900269.
Pleural Mesothelioma
-
Clinical Trial Medications
- (Lung Cancer) Phase II results for Topotecan and Topotecan + Berzosertib combination.
- (Lung Cancer) Efficacy of Enhertu in HER2-mutant non-small cell lung cancer (NSCLC).
- (Lung Cancer) Clinical outcomes of anti-B7-H3 antibody-drug conjugate DS-7300.
Medical Supporter was formerly certified as an international medical visa guarantor by Japan's Ministry of Foreign Affairs and the Ministry of Economy, Trade and Industry (B-066).
Vous envisagez des soins au Japon ? Besoin d’informations et d’aide ?
Nous vous aidons à rassembler les informations nécessaires pour un déplacement médical au Japon, à contacter les établissements japonais et à organiser une consultation de second avis.La première consultation est gratuite ; un conseiller vous aide à clarifier les prochaines étapes.
Figure 1
Figure 2
Figure 3
Figure 4