Prognostic and predictive role of circulating angiopoietin-2 in multiple solid tumors: An analysis of approximately 500 patients treated with lenvatinib across tumor types.

Authors

Ignace Vergote

Ignace Vergote

Department of Oncology,University Hospitals Leuven and Katholieke Universiteit Leuven, Leuven, Belgium

Ignace Vergote , Douglas Wilmot Ball , Masatoshi Kudo , Pallavi Sachdev , Mark Matijevic , Tadashi Kadowaki , Yasuhiro Funahashi , Keith Flaherty

Organizations

Department of Oncology,University Hospitals Leuven and Katholieke Universiteit Leuven, Leuven, Belgium, Division of Endocrinology, Diabetes, and Metabolism at The Johns Hopkins University, Baltimore, MD, Department of Gastroenterology and Hepatology, Kinki University School of Medicine, Osaka, Japan, Eisai, Woodcliff Lake, NJ, Massachusetts General Hospital Cancer Center,Harvard Medical School, Boston, MA

Research Funding

Pharmaceutical/Biotech Company

Background: Lenvatinib is an oral tyrosine kinase inhibitor targeting VEGFR1-3, FGFR1-4, RET, KIT, and PDGFRα. Two phase 3 trials in differentiated thyroid cancer [DTC] and hepatocellular cancer [HCC] are ongoing. Baseline levels (BL) of circulating cytokines and angiogenic factors (CAFs) were evaluated across multiple phase 2 trials in 6 different types of solid tumors. Methods: BL serum or plasma samples from a total of approximately 500 patients were analyzed for about 50 CAFs using ELISA and multiplex assay platforms* in 5 phase 2 trials of lenvatinib for thyroid cancer (DTC and medullary thyroid cancer [MTC]), HCC, glioblastoma, endometrial cancer (EC), and melanoma (with or without BRAF V600E). Correlation with clinical outcomes (objective response rate [ORR], overall survival [OS]) was performed using Wilcoxon signed-rank test and univariate Cox proportional hazard model, respectively, whereas correlation with tumor size prior to lenvatinib treatment was performed using the Spearman's rank correlation test. Results: Among 50 CAFs, BL angiopoietin-2 (Ang-2) correlated with tumor size (p) in DTC (0.004), MTC (0.004), EC (<0.001), melanoma [WT (<0.001), MU (<0.001)] and HCC (0.046) among multiple phase 2 trials. BL Ang-2 levels showed consistent correlation with clinical outcomes per tumor types across trials and with OS (p/hazard ratio per standard deviation) in DTC (0.001/3.2), MTC (<0.001/3.2), EC (<0.001/1.8), and melanoma [WT (0.001/1.5), MU (<0.001/2.0)]. Correlation with ORR was observed only for a minor subset of analyzed CAFs; only BL Ang-2 levels correlated with ORR in >1 tumor type, specifically in DTC (0.034*), MTC (0.025) and EC (0.001). In EC, almost 50% of BL CAFs showed a significant correlation with tumor size, potentially suggestive of an EC-specific tumor micro-environment and the contribution of Ang-2 to tumor angiogenesis in EC. Conclusions: BL Ang-2 levels correlated with tumor size and OS across majority of solid tumors in multiple lenvatinib phase 2 trials. Only BL Ang-2 levels also correlated with ORR in a subset of tumors including EC. Clinical trial information: NCT00784303,NCT01111461,NCT01136967,NCT00946153,NCT01433991,.

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Abstract Details

Meeting

2014 ASCO Annual Meeting

Session Type

Poster Session

Session Title

Tumor Biology

Track

Tumor Biology

Sub Track

Genomic and Epigenomic Biomarkers

Clinical Trial Registration Number

NCT00784303,NCT01111461,NCT01136967,NCT00946153,NCT01433991,

Citation

J Clin Oncol 32:5s, 2014 (suppl; abstr 11061)

DOI

10.1200/jco.2014.32.15_suppl.11061

Abstract #

11061

Poster Bd #

343

Abstract Disclosures