Phase II study of panitumumab, 5-fluorouracil, mitomycin-c and radiotherapy treatment in patients with non-metastatic squamous cell carcinoma of the anal canal: safety and efficacy results (VITAL study)—GEMCAD 09-02.

Authors

null

Jaime Feliu

Hospital Universitario La Paz, Madrid, Spain

Jaime Feliu , Rocio Garcia-Carbonero , Jaume Capdevila , Inmaculada Guasch , Vicente Alonso , Carlos López-López , Pilar Garcia Alfonso , Carmen Castañon Lopez , Isabel Sevilla , Joan Maurel

Organizations

Hospital Universitario La Paz, Madrid, Spain, Hospital Universitario Virgen del Rocio, Sevilla, Spain, Medical Oncology Department, Vall d’Hebron University Hospital; Vall d’Hebron Institute of Oncology (VHIO)., Barcelona, Spain, Hospital Althaia- Manresa, Barcelona, Spain, Hospital Universitario Miguel Servet, Zaragoza, Spain, Hospital Universitario Marqués de Valdecilla, Santander, Spain, Hospital General Universitario Gregorio Marañón, Madrid, Spain, Hospital Virgen Blanca de León, Leon, Spain, Hospital Universitario Virgen de la Victoria, Málaga, Spain, Hospital Clinic de Barcelona, Barcelona, Spain

Research Funding

Pharmaceutical/Biotech Company

Background: More than 80% of squamous cell carcinoma of the anal canal (SCCAC) express epidermal growth factor receptor protein (EGFR). VITAL was a phase II, multicentre, single arm study, which aimed to evaluate efficacy and safety of the addition of panitumumab (Pmab) to fluorouracil (5-FU), mitomycin C (M) and radiotherapy (RT) standard treatment in patients with SCCAC (NCT01285778). Methods: Treatment naïve patients ≥ 18 years old, with SCCAC (Stage T2-T4, any N, M0 defined by MRI) with ≤ 2 ECOG performance status, received Pmab (6 mg/kg, day 1 and q2w during 8 weeks), 5-FU (1000 mg/m2/day; IV infusion, days 1-4 and 29-32) and M (10mg/m2, days 1 and 29) plus RT 45 Gy (1.8 Gy/fraction) to the primary tumour and mesorectal, iliac and inguinal lymph nodes, plus boost dose of 10-15 Gy to primary tumour and affected lymph nodes. The primary objective was disease free survival (DFS) at 3 years (anticipated DFS: 73.7% ± 12%) estimated by Kaplan-Meier. Multivariable analysis of efficacy variables adjusting for key baseline covariates will be presented. Results: A total of 58 patients (31 women; median age: 59 years; ECOG performance status: 0 [41%] / 1 [57%] / 2 [2%]; TNM II [29%] / IIIA [21%] / IIIB [47%]/ non-evaluable [NE] [4%]) were evaluated. The 3-year DFS rate was 61.1% (95%CI 47.1 - 72.4). The median follow-up was 45 months. The 3-year overall survival rate and progression free survival rate were 78.4% (95%CI 65.1-87.1) and 57.5% (95%CI 43.6 - 69.2) respectively. Eighteen patients (31.0%) had a colostomy within the first 2 years post-treatment. Grade 3-4 toxicities were experienced by 53 (91%) patients. Radiation skin injury (19%), diarrhoea (10%), neutropenia (9%) and leukopenia (19%) were the most common ( > 10%) grade 3-4 adverse events associated with Pmab. There were no toxic deaths. Potential predictive efficacy and safety biomarkers are currently being assessed. Conclusions: The overall 3-year DFS rate does not reach the anticipated level for the main objective of the study. The multivariable analysis will determine if any subgroup of patients may benefit from this treatment scheme. Financed by Amgen S.A. Clinical trial information: NCT01285778

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Abstract Details

Meeting

2018 ASCO Annual Meeting

Session Type

Poster Session

Session Title

Gastrointestinal (Colorectal) Cancer

Track

Gastrointestinal Cancer—Colorectal and Anal

Sub Track

Anal Cancer

Clinical Trial Registration Number

NCT01285778

Citation

J Clin Oncol 36, 2018 (suppl; abstr 3566)

DOI

10.1200/JCO.2018.36.15_suppl.3566

Abstract #

3566

Poster Bd #

59

Abstract Disclosures