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Positron emission tomography response evaluation from a randomized phase III trial of weekly nab-paclitaxel plus gemcitabine versus gemcitabine alone for patients with metastatic adenocarcinoma of the pancreas†

Identifieur interne : 000695 ( Pmc/Checkpoint ); précédent : 000694; suivant : 000696

Positron emission tomography response evaluation from a randomized phase III trial of weekly nab-paclitaxel plus gemcitabine versus gemcitabine alone for patients with metastatic adenocarcinoma of the pancreas†

Auteurs : R. K. Ramanathan [États-Unis] ; D. Goldstein [Australie] ; R. L. Korn ; F. Arena [États-Unis] ; M. Moore [Canada] ; S. Siena [Italie] ; L. Teixeira [France] ; J. Tabernero [Espagne] ; J.-L. Van Laethem [Belgique] ; H. Liu ; D. Mcgovern ; B. Lu ; D. D. Von Hoff [États-Unis]

Source :

RBID : PMC:4803456

Abstract

In a phase III pancreatic cancer study, tumor response by positron emission tomography (PET) (exploratory end point) predicted treatment efficacy, including longer overall survival. nab-Paclitaxel/gemcitabine had a significantly higher rate of metabolic response versus gemcitabine. Overall, 5× more patients had a metabolic response by PET compared with RECIST. PET may be a more sensitive measure of response than radiographic modalities.


Url:
DOI: 10.1093/annonc/mdw020
PubMed: 26802153
PubMed Central: 4803456


Affiliations:


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PMC:4803456

Le document en format XML

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<addr-line>Department of Medical Oncology</addr-line>
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,
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,
<addr-line>Milan</addr-line>
,
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<addr-line>Department of Medical Oncology</addr-line>
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,
<addr-line>Barcelona</addr-line>
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<nlm:aff id="mdw020_af9">
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,
<addr-line>Brussels</addr-line>
,
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</nlm:aff>
<country xml:lang="fr">Belgique</country>
<wicri:regionArea># see nlm:aff country strict</wicri:regionArea>
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<p>In a phase III pancreatic cancer study, tumor response by positron emission tomography (PET) (exploratory end point) predicted treatment efficacy, including longer overall survival.
<italic>nab</italic>
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<name sortKey="Goldstein, D" uniqKey="Goldstein D">D Goldstein</name>
</author>
<author>
<name sortKey="El Maraghi, Rh" uniqKey="El Maraghi R">RH El-Maraghi</name>
</author>
<author>
<name sortKey="Hammel, P" uniqKey="Hammel P">P Hammel</name>
</author>
</analytic>
</biblStruct>
<biblStruct>
<analytic>
<author>
<name sortKey="Von Hoff, Dd" uniqKey="Von Hoff D">DD Von Hoff</name>
</author>
<author>
<name sortKey="Ervin, T" uniqKey="Ervin T">T Ervin</name>
</author>
<author>
<name sortKey="Arena, Fp" uniqKey="Arena F">FP Arena</name>
</author>
</analytic>
</biblStruct>
<biblStruct>
<analytic>
<author>
<name sortKey="Prior, Jo" uniqKey="Prior J">JO Prior</name>
</author>
<author>
<name sortKey="Montemurro, M" uniqKey="Montemurro M">M Montemurro</name>
</author>
<author>
<name sortKey="Orcurto, Mv" uniqKey="Orcurto M">MV Orcurto</name>
</author>
</analytic>
</biblStruct>
<biblStruct>
<analytic>
<author>
<name sortKey="Wu, Aj" uniqKey="Wu A">AJ Wu</name>
</author>
<author>
<name sortKey="Goodman, Ka" uniqKey="Goodman K">KA Goodman</name>
</author>
</analytic>
</biblStruct>
</listBibl>
</div1>
</back>
</TEI>
<pmc article-type="research-article">
<pmc-dir>properties open_access</pmc-dir>
<front>
<journal-meta>
<journal-id journal-id-type="nlm-ta">Ann Oncol</journal-id>
<journal-id journal-id-type="iso-abbrev">Ann. Oncol</journal-id>
<journal-id journal-id-type="publisher-id">annonc</journal-id>
<journal-id journal-id-type="hwp">annonc</journal-id>
<journal-title-group>
<journal-title>Annals of Oncology</journal-title>
</journal-title-group>
<issn pub-type="ppub">0923-7534</issn>
<issn pub-type="epub">1569-8041</issn>
<publisher>
<publisher-name>Oxford University Press</publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id pub-id-type="pmid">26802153</article-id>
<article-id pub-id-type="pmc">4803456</article-id>
<article-id pub-id-type="doi">10.1093/annonc/mdw020</article-id>
<article-id pub-id-type="publisher-id">mdw020</article-id>
<article-categories>
<subj-group subj-group-type="heading">
<subject>Original Articles</subject>
<subj-group subj-group-type="heading">
<subject>Gastrointestinal Tumors</subject>
</subj-group>
</subj-group>
</article-categories>
<title-group>
<article-title>Positron emission tomography response evaluation from a randomized phase III trial of weekly
<italic>nab</italic>
-paclitaxel plus gemcitabine versus gemcitabine alone for patients with metastatic adenocarcinoma of the pancreas
<sup>
<xref ref-type="author-notes" rid="mdw020_AN1"></xref>
</sup>
</article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname>Ramanathan</surname>
<given-names>R. K.</given-names>
</name>
<xref ref-type="aff" rid="mdw020_af1">1</xref>
<xref ref-type="corresp" rid="mdw020_cor1">*</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Goldstein</surname>
<given-names>D.</given-names>
</name>
<xref ref-type="aff" rid="mdw020_af2">2</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Korn</surname>
<given-names>R. L.</given-names>
</name>
<xref ref-type="aff" rid="mdw020_af3">3</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Arena</surname>
<given-names>F.</given-names>
</name>
<xref ref-type="aff" rid="mdw020_af4">4</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Moore</surname>
<given-names>M.</given-names>
</name>
<xref ref-type="aff" rid="mdw020_af5">5</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Siena</surname>
<given-names>S.</given-names>
</name>
<xref ref-type="aff" rid="mdw020_af6">6</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Teixeira</surname>
<given-names>L.</given-names>
</name>
<xref ref-type="aff" rid="mdw020_af7">7</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Tabernero</surname>
<given-names>J.</given-names>
</name>
<xref ref-type="aff" rid="mdw020_af8">8</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Van Laethem</surname>
<given-names>J.-L.</given-names>
</name>
<xref ref-type="aff" rid="mdw020_af9">9</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Liu</surname>
<given-names>H.</given-names>
</name>
<xref ref-type="aff" rid="mdw020_af10">10</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>McGovern</surname>
<given-names>D.</given-names>
</name>
<xref ref-type="aff" rid="mdw020_af10">10</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Lu</surname>
<given-names>B.</given-names>
</name>
<xref ref-type="aff" rid="mdw020_af10">10</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Von Hoff</surname>
<given-names>D. D.</given-names>
</name>
<xref ref-type="aff" rid="mdw020_af11">11</xref>
</contrib>
<aff id="mdw020_af1">
<label>1</label>
<addr-line>Division of Hematology/Oncology</addr-line>
,
<institution>Mayo Clinic</institution>
,
<addr-line>Scottsdale</addr-line>
,
<country>USA</country>
</aff>
<aff id="mdw020_af2">
<label>2</label>
<addr-line>Department of Medical Oncology</addr-line>
,
<institution>Prince of Wales Hospital</institution>
,
<addr-line>Sydney</addr-line>
,
<country>Australia</country>
</aff>
<aff id="mdw020_af3">
<label>3</label>
<addr-line>Diagnostic Radiology</addr-line>
,
<institution>Scottsdale Medical Imaging, Ltd</institution>
,
<addr-line>Scottsdale</addr-line>
</aff>
<aff id="mdw020_af4">
<label>4</label>
<addr-line>Hematology/Oncology</addr-line>
,
<institution>NYU Langone Arena Oncology</institution>
,
<addr-line>Lake Success</addr-line>
,
<country>USA</country>
</aff>
<aff id="mdw020_af5">
<label>5</label>
<institution>Provencial Health Services Authority, BC Cancer Agency</institution>
,
<addr-line>Vancouver</addr-line>
,
<country>Canada</country>
</aff>
<aff id="mdw020_af6">
<label>6</label>
<addr-line>Falck Division of Oncology, Department of Oncology and Hematology</addr-line>
,
<institution>Niguarda Cancer Center, Ospedale Niguarda Ca’ Granda and Università degli Studi di Millano</institution>
,
<addr-line>Milan</addr-line>
,
<country>Italy</country>
</aff>
<aff id="mdw020_af7">
<label>7</label>
<addr-line>Department of Medical Oncology</addr-line>
,
<institution>Hôpital Saint-Antoine</institution>
,
<addr-line>Paris</addr-line>
,
<country>France</country>
</aff>
<aff id="mdw020_af8">
<label>8</label>
<addr-line>Department of Medical Oncology</addr-line>
,
<institution>Vall d'Hebron University Hospital and Institute of Oncology (VHIO), Universitat Autònoma de Barcelona</institution>
,
<addr-line>Barcelona</addr-line>
,
<country>Spain</country>
</aff>
<aff id="mdw020_af9">
<label>9</label>
<institution>University Clinic of Brussels, Hôpital Erasme</institution>
,
<addr-line>Brussels</addr-line>
,
<country>Belgium</country>
</aff>
<aff id="mdw020_af10">
<label>10</label>
<institution>Biostatistics and Research and Design, Celgene Corporation</institution>
,
<addr-line>Summit</addr-line>
</aff>
<aff id="mdw020_af11">
<label>11</label>
<addr-line>Clinical Research</addr-line>
,
<institution>Translational Genomics Research Institute and Honor Health</institution>
,
<addr-line>Scottsdale</addr-line>
,
<country>USA</country>
</aff>
</contrib-group>
<author-notes>
<corresp id="mdw020_cor1">
<label>*</label>
<italic>Correspondence to:</italic>
Dr Ramesh K. Ramanathan, Division of Hematology/Oncology, Mayo Clinic, 13400 E. Shea Blvd, Scottsdale, AZ 85259, USA. Tel: +1-480-301-8000; E-mail:
<email>ramanathan.ramesh@mayo.edu</email>
</corresp>
<fn id="mdw020_AN1" fn-type="con">
<label></label>
<p>Previous presentations: ASCO 2013, ESMO 2013, ASCO GI 2014.</p>
</fn>
</author-notes>
<pub-date pub-type="ppub">
<month>4</month>
<year>2016</year>
</pub-date>
<pub-date pub-type="epub">
<day>22</day>
<month>1</month>
<year>2016</year>
</pub-date>
<pub-date pub-type="pmc-release">
<day>22</day>
<month>1</month>
<year>2016</year>
</pub-date>
<pmc-comment> PMC Release delay is 0 months and 0 days and was based on the . </pmc-comment>
<volume>27</volume>
<issue>4</issue>
<fpage>648</fpage>
<lpage>653</lpage>
<history>
<date date-type="received">
<day>23</day>
<month>11</month>
<year>2015</year>
</date>
<date date-type="rev-recd">
<day>29</day>
<month>12</month>
<year>2015</year>
</date>
<date date-type="accepted">
<day>30</day>
<month>12</month>
<year>2015</year>
</date>
</history>
<permissions>
<copyright-statement>© The Author 2016. Published by Oxford University Press on behalf of the European Society for Medical Oncology.</copyright-statement>
<copyright-year>2016</copyright-year>
<license license-type="creative-commons" xlink:href="http://creativecommons.org/licenses/by-nc/4.0/">
<license-p>This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (
<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by-nc/4.0/">http://creativecommons.org/licenses/by-nc/4.0/</ext-link>
), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com</license-p>
</license>
</permissions>
<self-uri content-type="pdf" xlink:href="mdw020.pdf"></self-uri>
<abstract abstract-type="precis">
<p>In a phase III pancreatic cancer study, tumor response by positron emission tomography (PET) (exploratory end point) predicted treatment efficacy, including longer overall survival.
<italic>nab</italic>
-Paclitaxel/gemcitabine had a significantly higher rate of metabolic response versus gemcitabine. Overall, 5× more patients had a metabolic response by PET compared with RECIST. PET may be a more sensitive measure of response than radiographic modalities.</p>
</abstract>
<abstract>
<sec>
<title>Background</title>
<p>In the phase III MPACT trial,
<italic>nab</italic>
-paclitaxel plus gemcitabine (
<italic>nab</italic>
-P + Gem) demonstrated superior efficacy versus Gem alone for patients with metastatic pancreatic cancer. We sought to examine the feasibility of positron emission tomography (PET) and to compare metabolic response rates and associated correlations with efficacy in the MPACT trial.</p>
</sec>
<sec>
<title>Patients and methods</title>
<p>Patients with previously untreated metastatic adenocarcinoma of the pancreas were randomized 1:1 to receive
<italic>nab</italic>
-P + Gem or Gem alone. Treatment continued until disease progression by RECIST or unacceptable toxicity.</p>
</sec>
<sec>
<title>Results</title>
<p>PET scans were carried out on the first 257 patients enrolled at PET-equipped centers (PET cohort). Most patients (252 of 257) had ≥2 PET-avid lesions, and median maximum standardized uptake values at baseline were 4.6 and 4.5 in the
<italic>nab</italic>
-P + Gem and Gem-alone arms, respectively. In a pooled treatment arm analysis, a metabolic response by PET (best response at any time during study) was associated with longer overall survival (OS) (median 11.3 versus 6.9 months; HR, 0.56;
<italic>P</italic>
< 0.001). Efficacy results within each treatment arm appeared better for patients with a metabolic response. The metabolic response rate (best response and week 8 response) was higher for
<italic>nab</italic>
-P + Gem (best response: 72% versus 53%,
<italic>P</italic>
= 0.002; week 8: 67% versus 51%;
<italic>P</italic>
= 0.014). Efficacy in the PET cohort was greater for
<italic>nab</italic>
-P + Gem versus Gem alone, including for OS (median 10.5 versus 8.4 months; hazard ratio [HR], 0.71;
<italic>P</italic>
= 0.009) and ORR by RECIST (31% versus 11%;
<italic>P</italic>
< 0.001).</p>
</sec>
<sec>
<title>Conclusion</title>
<p>Pancreatic lesions were PET avid at baseline, and the rate of metabolic response was significantly higher for
<italic>nab</italic>
-P + Gem versus Gem alone at week 8 and for best response during study. Having a metabolic response was associated with longer survival, and more patients experienced a metabolic response than a RECIST-defined response.</p>
</sec>
<sec>
<title>ClinicalTrials.gov</title>
<p>NCT00844649.</p>
</sec>
</abstract>
<kwd-group>
<kwd>pancreatic cancer</kwd>
<kwd>positron emission tomography</kwd>
<kwd>
<italic>nab</italic>
-paclitaxel</kwd>
<kwd>gemcitabine</kwd>
<kwd>metabolic response</kwd>
</kwd-group>
<funding-group>
<award-group id="funding-1">
<funding-source>Celgene Corporation</funding-source>
</award-group>
</funding-group>
</article-meta>
</front>
</pmc>
<affiliations>
<list>
<country>
<li>Australie</li>
<li>Belgique</li>
<li>Canada</li>
<li>Espagne</li>
<li>France</li>
<li>Italie</li>
<li>États-Unis</li>
</country>
</list>
<tree>
<noCountry>
<name sortKey="Korn, R L" sort="Korn, R L" uniqKey="Korn R" first="R. L." last="Korn">R. L. Korn</name>
<name sortKey="Liu, H" sort="Liu, H" uniqKey="Liu H" first="H." last="Liu">H. Liu</name>
<name sortKey="Lu, B" sort="Lu, B" uniqKey="Lu B" first="B." last="Lu">B. Lu</name>
<name sortKey="Mcgovern, D" sort="Mcgovern, D" uniqKey="Mcgovern D" first="D." last="Mcgovern">D. Mcgovern</name>
</noCountry>
<country name="États-Unis">
<noRegion>
<name sortKey="Ramanathan, R K" sort="Ramanathan, R K" uniqKey="Ramanathan R" first="R. K." last="Ramanathan">R. K. Ramanathan</name>
</noRegion>
<name sortKey="Arena, F" sort="Arena, F" uniqKey="Arena F" first="F." last="Arena">F. Arena</name>
<name sortKey="Von Hoff, D D" sort="Von Hoff, D D" uniqKey="Von Hoff D" first="D. D." last="Von Hoff">D. D. Von Hoff</name>
</country>
<country name="Australie">
<noRegion>
<name sortKey="Goldstein, D" sort="Goldstein, D" uniqKey="Goldstein D" first="D." last="Goldstein">D. Goldstein</name>
</noRegion>
</country>
<country name="Canada">
<noRegion>
<name sortKey="Moore, M" sort="Moore, M" uniqKey="Moore M" first="M." last="Moore">M. Moore</name>
</noRegion>
</country>
<country name="Italie">
<noRegion>
<name sortKey="Siena, S" sort="Siena, S" uniqKey="Siena S" first="S." last="Siena">S. Siena</name>
</noRegion>
</country>
<country name="France">
<noRegion>
<name sortKey="Teixeira, L" sort="Teixeira, L" uniqKey="Teixeira L" first="L." last="Teixeira">L. Teixeira</name>
</noRegion>
</country>
<country name="Espagne">
<noRegion>
<name sortKey="Tabernero, J" sort="Tabernero, J" uniqKey="Tabernero J" first="J." last="Tabernero">J. Tabernero</name>
</noRegion>
</country>
<country name="Belgique">
<noRegion>
<name sortKey="Van Laethem, J L" sort="Van Laethem, J L" uniqKey="Van Laethem J" first="J.-L." last="Van Laethem">J.-L. Van Laethem</name>
</noRegion>
</country>
</tree>
</affiliations>
</record>

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