First-line bevacizumab + reduced-dose interferon-alpha2a in patients (pts) with metastatic renal cell carcinoma (mRCC): an update on overall survival

Konference: 2009 34st Congress ESMO a 15th Congress ECCO - účast ČR

Kategorie: Genitourinární nádory

Téma: Poster session II: Genitourinary malignancies - Renal cancer

Číslo abstraktu: P-7123

Autoři: prof. MUDr. Bohuslav Melichar, Ph.D.; Sergio Bracarda; MD Joaquim Bellmunt; Prof. MD Alain Ravaud, PhD; S.N. Negrier; S. Jethwa; MD Bernard J. Escudier

Background: The randomised, double-blind, phase III trial, AVOREN (BO17705F), demonstrated that bevacizumab (BEV, Avastin®) significantly improves duration of progression-free survival (PFS) when combined with interferon-alpha2a (IFN) in pts with untreated mRCC compared with IFN + placebo [Escudier, Lancet 2007]. A previous retrospective subgroup analysis showed that BEV + lower-dose (LD) IFN improved tolerability and maintained PFS [Melichar, Ann Oncol 2008]. We report overall survival (OS) and tolerability in this subgroup of pts based on longer follow-up from the final data cutoff for OS.

Methods: Between June 2004 and October 2005, 649 nephrectomised pts with clear cell mRCC were randomised to IFN at a recommended dose of 9 MIU 3×/week for up to 52 weeks + BEV 10 mg/kg q2w or placebo until disease progression. The protocol specified that IFN should first be withheld and the dose then lowered to 6 or 3 MIU for grade ≥3 adverse events (AEs) attributable to IFN that did not resolve within 28 days or for other investigator-defined reasons.

Results: IFN dose was reduced in 131 and 97 pts in the BEV and placebo arms, respectively. Baseline characteristics, including MSKCC score, were similar in pts who reduced the dose of IFN compared with the overall population. Median OS in pts who received BEV + reduced doses of IFN (26.0 months) was consistent with the total BEV + IFN population (23.3 months). With longer follow up, no new safety signals were observed. A lower incidence of grade ≥3 IFN-related events, including fatigue, asthenia, influenza-like illness, pyrexia and malaise, was observed during the 6 weeks after IFN dose reduction (18%) than during the 6 weeks prior to dose reduction (44%) in pts treated with BEV + reduced doses of IFN.

Conclusions: The OS benefit of BEV + reduced doses of IFN (median 26 months) is comparable to that of the overall BEV + IFN population. These data suggest that reducing the dose of IFN used in combination with BEV is an effective measure to manage toxicity and improve tolerability without compromising efficacy.

Trial sponsored by F. Hoffmann-La Roche, Ltd.

Publikováno v: European Journal of Cancer Supplements, Vol 7 No 2, September 2009, Page 430

Datum přednesení příspěvku: 21. 9. 2009