Biomarker (BM) evaluations in the phase III AVAglio study of bevacizumab (Bv) plus standard radiotherapy (RT) and temozolomide (T) for newly diagnosed glioblastoma (GBM).

Authors

null

Ryo Nishikawa

Saitama Medical University International Medical Center, Saitama, Japan

Ryo Nishikawa , Frank Saran , Warren Mason , Wolfgang Wick , Timothy Francis Cloughesy , Roger Henriksson , Magalie Hilton , Josep Garcia , Tobias Vogt , Celine Pallaud , Oliver L. Chinot

Organizations

Saitama Medical University International Medical Center, Saitama, Japan, The Royal Marsden NHS Foundation Trust, London, United Kingdom, Princess Margaret Hospital, Toronto, ON, Canada, University of Heidelberg Medical Center, Heidelberg, Germany, University of California, Los Angeles, Los Angeles, CA, Regional Cancer Center Stockholm; Umeå University Hospital, Stockholm/Umeå, Sweden, F. Hoffmann-La Roche Ltd, Basel, Switzerland, Genentech Inc., South San Francisco, CA, Aix-Marseille University, AP-HM, Service de Neuro-Oncologie, CHU Timone, Marseille, France

Research Funding

Pharmaceutical/Biotech Company

Background: Bv plus 1st-line standard of care (SoC; T+RT) achieved a PFS benefit in the AVAglio phase III, randomized, double-blind, placebo [P]-controlled trial in patients (pts) with newly diagnosed GBM. AVAglio includes BM evaluation to identify pts benefiting most from Bv. Analysis of plasma VEGF-A and VEGFR-2 was prioritized based on encouraging findings in Bv trials in several tumor types. Methods: AVAglio includes an optional, exploratory correlative BM analysis; participating pts provided informed consent for BMs. Baseline (BL) plasma samples were analyzed using the Roche IMPACT platform, based on multiplex ELISA technology. Pts were dichotomized according to BM levels using either Q1, median or Q3 cut-offs. Potential interactions between BL BM levels and PFS were tested using Cox regression analyses. Results: Of 921 patients enrolled, 571 (62%) were evaluable in the BM study. Baseline characteristics and PFS outcome were comparable in the ITT and BM-evaluable populations. Median BL VEGF-A and VEGFR-2 levels were 77.0 pg/mL and 12.6 ng/mL, respectively. No significant interaction for PFS was seen at α=0.025. Conclusions: The potential predictive (VEGF-A, VEGFR-2) and prognostic (VEGF-A) value seen in breast, pancreatic and gastric cancers was not apparent in BL BM samples from AVAglio using a median, Q1 or Q3 cut-off. Additional plasma and tumor BM analyses are ongoing. Clinical trial information: NCT00943826.

VEGF-A VEGFR-2
P
(n=287)
Bv
(n=278)
P
(n=283)
Bv
(n=279)
N/
events
Median
PFS (mo)
N/
events
MedianPFS
(mo)
HR
95% CI
P N/
events
Median
PFS (mo)
N/
events
MedianPFS
(mo)
HR
95% CI
P
Q1
Low 148/123 6.1 137/107 11.8 0.64 [0.48; 0.84] 0.610 Low 78/69 6.4 63/49 10.3 0.49 [0.32; 0.75] 0.831
High 139/122 5.9 141/113 10.1 0.59 [0.45; 0.78] High 205/172 5.9 216/172 11.3 0.63 [0.51; 0.79]
Median
Low 148/123 6.1 137/107 11.8 0.64 [0.48; 0.84] 0.610 Low 145/129 6.1 136/108 10.5 0.54 [0.41; 0.71] 0.736
High 139/122 5.9 141/113 10.1 0.59 [0.45; 0.78] High 138/112 5.9 143/113 11.5 0.66 [0.50; 0.87]
Q3
Low 215/184 6.0 209/166 10.9 0.63 [0.50; 0.78] 0.678 Low 216/185 6.0 206/162 10.6 0.61 [0.49; 0.75] 0.716
High 72/61 5.7 69/54 10.8 0.58 [0.39; 0.87] High 67/56 6.1 73/59 11.5 0.61 [0.41; 0.92]

Q = quartile.

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Abstract Details

Meeting

2013 ASCO Annual Meeting

Session Type

Poster Discussion Session

Session Title

Central Nervous System Tumors

Track

Central Nervous System Tumors

Sub Track

Central Nervous System Tumors

Clinical Trial Registration Number

NCT00943826

Citation

J Clin Oncol 31, 2013 (suppl; abstr 2023^)

DOI

10.1200/jco.2013.31.15_suppl.2023

Abstract #

2023^

Poster Bd #

12

Abstract Disclosures