Efficacy of regorafenib (REG) in patients with hepatocellular carcinoma (HCC) in the phase III RESORCE trial according to alpha-fetoprotein (AFP) and c-Met levels as predictors of poor prognosis.

Authors

null

Michael Teufel

Bayer HealthCare Pharmaceuticals Inc., Whippany, NJ

Michael Teufel , Karl Köchert , Gerold Meinhardt , Jordi Bruix

Organizations

Bayer HealthCare Pharmaceuticals Inc., Whippany, NJ, Bayer AG, Berlin, Germany, BCLC Group, Liver Unit, Hospital Clinic, University of Barcelona, Barcelona, Spain

Research Funding

Pharmaceutical/Biotech Company

Background: REG is a multikinase inhibitor which improved overall survival (OS; HR 0.63, 95% CI 0.50, 0.79; P<0.0001) and time to progression (TTP; HR 0.44, 95% CI 0.36, 0.55; P<0.0001) compared with placebo in patients with HCC who progressed during prior sorafenib treatment in the RESORCE trial. This exploratory analysis evaluated the impact of baseline AFP and c-Met on REG treatment benefit (OS and TTP) in the RESORCE trial. Methods: Circulating AFP and c-Met protein (shed ectodomain) levels were quantified by a Luminex assay (Myriad RBM) in plasma samples collected at baseline from patients enrolled in the RESORCE trial. Valid biomarker data were available from 497 (AFP) and 499 (c-Met) out of 573 patients. Patients were subgrouped according to the median protein concentration (high vs low), and the treatment effect HR and its 95% CI were evaluated using a Cox proportional hazards model. The predictive effect was modeledas a protein–treatment interaction effect and subjected to Akaike information criterion (AIC)-based selection to assess its association with OS and TTP. Results: Baseline characteristics of patients were balanced across protein subgroups. While increased levels of both AFP (HR 1.09, 95% CI 1.07, 1.12; P<0.001) and c-Met (HR 1.32, CI 95% 1.06, 1.63; P=0.011) were associated with a worse prognosis for OS, increased AFP levels were also associated with poor prognosis for TTP (HR 1.05, 95% CI 1.03, 1.07; P<0.001). REG treatment benefit for both OS and TTP was independent of AFP and c-Met protein expression (Table). The protein–treatment interaction effect was not statistically significant. Conclusions: The treatment benefit of REG in patients with HCC was independent of AFP and c-MET protein expression at baseline. So far, no single protein has been associated with REG clinical benefit. Clinical trial information: NCT01774344

Protein, expressionOS
HR (95% CI)
OS
P-value
TTP
HR (95% CI)
TTP
P-value
AFP, low0.62 (0.44, 0.87)0.0060.39 (0.28, 0.52)<0.001
AFP, high0.58 (0.42, 0.79)<0.0010.46 (0.34, 0.62)<0.001
c-Met, low0.55 (0.39, 0.76)<0.0010.37 (0.27, 0.50)<0.001
c-Met, high0.65 (0.47, 0.90)<0.010.48 (0.36, 0.65)<0.001

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Abstract Details

Meeting

2017 ASCO Annual Meeting

Session Type

Poster Session

Session Title

Gastrointestinal (Noncolorectal) Cancer

Track

Gastrointestinal Cancer—Gastroesophageal, Pancreatic, and Hepatobiliary

Sub Track

Hepatobiliary Cancer

Clinical Trial Registration Number

NCT01774344

Citation

J Clin Oncol 35, 2017 (suppl; abstr 4078)

DOI

10.1200/JCO.2017.35.15_suppl.4078

Abstract #

4078

Poster Bd #

70

Abstract Disclosures