Non-pegylated liposomal doxorubicin (NPLD, Myocet®) + carboplatin in patients with platinum sensitive ovarian cancers: A ARCAGY-GINECO phase IB-II trial.


Journal

Gynecologic oncology
ISSN: 1095-6859
Titre abrégé: Gynecol Oncol
Pays: United States
ID NLM: 0365304

Informations de publication

Date de publication:
01 2019
Historique:
received: 28 06 2018
revised: 29 10 2018
accepted: 30 10 2018
pubmed: 18 11 2018
medline: 5 2 2019
entrez: 18 11 2018
Statut: ppublish

Résumé

Carboplatin and pegylated liposomal doxorubicin combination is a standard regimen in platinum-sensitive recurrent ovarian cancer patients. The pegylated liposomal doxorubicin shortage from 2011 to 2013 urged assessment of the efficacy and tolerance of non-pegylated liposomal doxorubicin in combination with carboplatin. MYCA was a multicenter 2-step phase Ib-II single arm trial meant to assess the safety and efficacy of carboplatin AUC 5 mg/min.mL combined with non-pegylated liposomal (dose escalation from 40 to 50 mg/m From 2012 to 2014, 87 patients were enrolled. They were treated as second (78%) or third line (22%) treatment. Total of 67 patients (78%) completed 6 cycles. G-CSF support was prescribed to 58% patients. The DCR at 12 months was 30.0% (95% CI, 20.3-39.7); the median PFS was 10.0 months (95% CI, 8.6-11.0). The median overall survival was 28.1 months (95% CI, 22.3-32.5); and the objective response rate was 58% (95% CI, 47-68). Grade 3-4 neutropenia, anemia and thrombocytopenia were observed in 17%, 13% and 1%, respectively; febrile neutropenia in 6%. One patient who did not receive GCSF support died from febrile neutropenia. Non-pegylated liposomal doxorubicin-carboplatin combination exhibits an acceptable safety profile, with GCSF prophylaxis. Acknowledging the lack of direct comparison, efficacy in terms of 12 month DCR was comparable with standard treatments.

Sections du résumé

BACKGROUND
Carboplatin and pegylated liposomal doxorubicin combination is a standard regimen in platinum-sensitive recurrent ovarian cancer patients. The pegylated liposomal doxorubicin shortage from 2011 to 2013 urged assessment of the efficacy and tolerance of non-pegylated liposomal doxorubicin in combination with carboplatin.
METHODS
MYCA was a multicenter 2-step phase Ib-II single arm trial meant to assess the safety and efficacy of carboplatin AUC 5 mg/min.mL combined with non-pegylated liposomal (dose escalation from 40 to 50 mg/m
RESULTS
From 2012 to 2014, 87 patients were enrolled. They were treated as second (78%) or third line (22%) treatment. Total of 67 patients (78%) completed 6 cycles. G-CSF support was prescribed to 58% patients. The DCR at 12 months was 30.0% (95% CI, 20.3-39.7); the median PFS was 10.0 months (95% CI, 8.6-11.0). The median overall survival was 28.1 months (95% CI, 22.3-32.5); and the objective response rate was 58% (95% CI, 47-68). Grade 3-4 neutropenia, anemia and thrombocytopenia were observed in 17%, 13% and 1%, respectively; febrile neutropenia in 6%. One patient who did not receive GCSF support died from febrile neutropenia.
CONCLUSION
Non-pegylated liposomal doxorubicin-carboplatin combination exhibits an acceptable safety profile, with GCSF prophylaxis. Acknowledging the lack of direct comparison, efficacy in terms of 12 month DCR was comparable with standard treatments.

Identifiants

pubmed: 30446275
pii: S0090-8258(18)31358-1
doi: 10.1016/j.ygyno.2018.10.043
pii:
doi:

Substances chimiques

liposomal doxorubicin 0
Polyethylene Glycols 3WJQ0SDW1A
Doxorubicin 80168379AG
Carboplatin BG3F62OND5

Banques de données

ClinicalTrials.gov
['NCT01705158']

Types de publication

Clinical Trial, Phase I Clinical Trial, Phase II Journal Article Multicenter Study Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

68-75

Informations de copyright

Copyright © 2018 Elsevier Inc. All rights reserved.

Auteurs

Clémence Romeo (C)

CITOHL, Centre Hospitalier Lyon Sud, Institut de Cancérologie des Hospices Civils de Lyon (IDCRC-HCL), 69310 Pierre-Bénite, France.

Florence Joly (F)

Centre François Baclesse, 3 Avenue du Général Harris, 14000 Caen, France. Electronic address: f.joly@baclesse.unicancer.fr.

Isabelle Ray-Coquard (I)

Centre Léon Bérard, 28 rue Laennec, 69008 Lyon, & University Claude Bernard Lyon 1, Lyon, France. Electronic address: isabelle.ray-coquard@lyon.unicancer.fr.

Claude El Kouri (C)

Centre Catherine de Sienne, 2 Rue Eric Tabarly, 44202 Nantes, France. Electronic address: claude.elkouri@groupeconfluent.fr.

Anne Mercier-Blas (A)

Centre Hospitalier Privé de Saint-Grégoire, 6 Boulevard de la Boutière, 35760 Saint-Grégoire, France. Electronic address: amercierblas@vivalto-sante.com.

Dominique Berton-Rigaud (D)

Institut de Cancérologie de l'Ouest, Centre René Gauducheau, Boulevard Professeur Jacques Monod, 44805 Saint-Herblain, France. Electronic address: dominique.berton-rigaud@ico.unicancer.fr.

Elsa Kalbacher (E)

Hôpital Jean Minjoz, 3, boulevard A. Fleming, 25030 Besançon, France. Electronic address: ekalbacher@chu-besancon.fr.

Oana Cojocarasu (O)

Centre Hospitalier du Mans, 194 Avenue Rubillard, 72037 Le Mans, France. Electronic address: ocojocarasu@ch-lemans.fr.

Michel Fabbro (M)

Institut du Cancer de Montpellier Val d'Aurelle, 208 Avenue des Apothicaires, 34298 Montpellier, France. Electronic address: michel.fabbro@icm.unicancer.fr.

Jacques Cretin (J)

Polyclinique KENVAL - Site de Valdegour, 772 Chemin de Valdegour, 30900 Nîmes, France.

Alain Zannetti (A)

Centre Hospitalier de Cholet, 1 Rue de Marengo, 49300 Cholet, France. Electronic address: alain.zannetti@ch-cholet.fr.

Sophie Abadie-Lacourtoisie (S)

Institut de Cancérologie de l'Ouest, Paul Papin, 15, rue André Boquel, 49055 Angers, France. Electronic address: sophie.abadie-lacourtoisie@ico.unicancer.fr.

Delphine Mollon (D)

Centre Hospitalier Intercommunal de Cornouaille, 14bis Avenue Yves Thépot, 29107 Quimper, France. Electronic address: d.mollon@ch-cornouaille.fr.

Anne-Claire Hardy-Bessard (AC)

Clinique Armoricaine de Radiologie, 22000 Saint-Brieuc, France. Electronic address: ac.hardy@cario-sante.fr.

Magali Provansal (M)

Institut Paoli Calmettes, 232 Boulevard de Sainte-Marguerite, 13009 Marseille, France. Electronic address: provansalm@ipc.unicancer.fr.

Emmanuel Blot (E)

Groupe Hospitalier Saint-Joseph, 56000 Vannes, France. Electronic address: emmanuel.blot@ch-bretagne-atlantique.fr.

Catherine Delbaldo (C)

Hôpital des Diaconesses Croix St Simon, 75020 Paris, France. Electronic address: CDelbaldo@hopital-dcss.org.

Anne Lesoin (A)

Centre Oscar Lambret, 3 Rue Frédéric Combemale, 59000 Lille, France. Electronic address: a-lesoin@o-lambret.fr.

Gilles Freyer (G)

CITOHL, Centre Hospitalier Lyon Sud, Institut de Cancérologie des Hospices Civils de Lyon (IDCRC-HCL), 69310 Pierre-Bénite, France; EMR UCBL/HCL 3738, Université Claude Bernard Lyon 1, Lyon, France. Electronic address: gilles.freyer@univ-lyon1.fr.

Benoît You (B)

CITOHL, Centre Hospitalier Lyon Sud, Institut de Cancérologie des Hospices Civils de Lyon (IDCRC-HCL), 69310 Pierre-Bénite, France; EMR UCBL/HCL 3738, Université Claude Bernard Lyon 1, Lyon, France. Electronic address: benoit.you@chu-lyon.fr.

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Classifications MeSH