MD Conference Express - ELCC 2015 - (Page 15)
Figure 1. Best Overall Response (Change in Tumor Size) in
PGG Beta-Glucan vs Control Group
SD, PD
Best Percent Change in SLD, % Best Percent Change in SLD, %
targeted antibody, approved in both the United States and
Europe, for first-line treatment of unresectable, locally
advanced, recurrent, or metastatic NSCLC when administered in combination with C/P chemotherapy.
Ada Braun, MD, PhD, Biothera, Eagan, Minnesota,
USA, and colleagues presented results from a multicenter, open-label, randomized phase 2 trial [Braun A
et al. Ann Oncol. 2015] investigating the efficacy of PGG
beta-glucan when added to bevacizumab and C/P combination therapy for previously untreated stage IV nonsquamous NSCLC. The primary end point for this study was
an objective response rate, whereas the secondary end
points included duration of response, progression-free
survival, time to progression, overall survival, and safety.
The investigators enrolled 92 patients between 2009
and 2013 from 12 centers across Germany and the United
States, with histologically or cytologically confirmed,
previously untreated, stage IV nonsquamous NSCLC.
Eligibility required adequate organ function (hematologic, hepatic, renal, coagulation) and an ECOG performance status (PS) of 0 or 1. Patients were randomized 2:1
to bevacizumab plus PGG (n = 61; PGG 4 mg/kg intravenously; day 1, 8, 15 of each cycle; PGG beta-glucan group)
or bevacizumab alone (n = 31; control group) in combination with C/P for 4 to 6 cycles until documented progression or unacceptable toxicity. All patients had either
progressed or had completed at least 18 treatment cycles.
Baseline patient characteristics including age, sex,
race, time from diagnosis to randomization, and prior
treatments (surgery, radiation therapy) were balanced
between the PGG beta-glucan and control treatment
groups. A higher proportion of patients in the control
group than in the PGG beta-glucan group had a good
ECOG PS of 0 at baseline (66.7% vs 52.5%). Thus, a better
clinical prognosis and clinical outcomes would have been
expected in the patients in the control group, because
ECOG PS 0 is a major prognostic factor, according to
Prof Braun.
An objective response was achieved in 29 of 48
(60.4%; 95% CI, 45.3 to 74.2) patients in the PGG betaglucan group and in 10 of 23 (43.5%; 95% CI, 23.2 to
65.5) patients in the control group (P = .2096; Figure 1).
The investigators reported that the tumor size continued
to regress post chemotherapy in the PGG beta-glucan
maintenance group.
In the PGG beta-glucan and control groups, respectively, the median duration of response was 10.3 months
PR
CR
PGG beta-glucan group
20
0
-20
-40
-60
-80
-100
20
Control group
0
-20
-40
-60
-80
-100
Patientsa
CR, complete response; PD, progressive disease; PR, partial response; SD, stable disease;
SLD, sum of the longest diameters.
a
Each bar shows the results for a single patient.
Reproduced with permission from A Braun, MD, PhD.
and 5.6 months (P = .9040); the time to disease progression was 11.6 months and 9.6 months (HR, 1.31; 95% CI,
0.54 to 3.65; P = .5639); and progression-free survival was
11.9 months and 10.2 months (HR, 0.86; 95% CI, 0.49 to
1.54; P = .5901).
The overall survival was a median 11.6 months in the
control group and 16.1 months in the PGG beta-glucan
group (HR, 0.66; 95% CI, 0.38 to 1.16; P = .1345); the study
was not powered to detect a statistical difference in survival between the study groups.
The incidence of adverse events (AEs) was similar between the treatment arms; however, 37.3% of the
PGG beta-glucan cohort and 43.3% of the control cohort
discontinued the study due to AEs. PGG beta-glucanrelated AEs included chills (13.6%); dyspnea and fatigue
(10.2% each); and nausea, pyrexia, and infusion-related
reactions (8.5% each). The investigators concluded
that PGG beta-glucan showed promise as an adjunct to
antibody-based therapies for improving clinical outcomes in patients with NSCLC.
Peer-Reviewed Highlights From the European Society for Medical Oncology 2015 European Lung Cancer Conference
15
Table of Contents for the Digital Edition of MD Conference Express - ELCC 2015
Contents
MD Conference Express - ELCC 2015
MD Conference Express - ELCC 2015 - (Page Cover1)
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