A phase 2, randomized, double-blind, placebo- controlled study of chemo-immunotherapy combination using motolimod with pegylated liposomal doxorubicin in recurrent or persistent ovarian cancer: a Gynecologic Oncology Group partners study.

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Version: Final published version
Serval ID
serval:BIB_B4FD453E2DFC
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
A phase 2, randomized, double-blind, placebo- controlled study of chemo-immunotherapy combination using motolimod with pegylated liposomal doxorubicin in recurrent or persistent ovarian cancer: a Gynecologic Oncology Group partners study.
Journal
Annals of oncology
Author(s)
Monk B.J., Brady M.F., Aghajanian C., Lankes H.A., Rizack T., Leach J., Fowler J.M., Higgins R., Hanjani P., Morgan M., Edwards R., Bradley W., Kolevska T., Foukas P., Swisher E.M., Anderson K.S., Gottardo R., Bryan J.K., Newkirk M., Manjarrez K.L., Mannel R.S., Hershberg R.M., Coukos G.
ISSN
1569-8041 (Electronic)
ISSN-L
0923-7534
Publication state
Published
Issued date
01/05/2017
Peer-reviewed
Oui
Volume
28
Number
5
Pages
996-1004
Language
english
Notes
Publication types: Clinical Trial, Phase II ; Journal Article ; Multicenter Study ; Randomized Controlled Trial
Publication Status: ppublish
Abstract
A phase 2, randomized, placebo-controlled trial was conducted in women with recurrent epithelial ovarian carcinoma to evaluate the efficacy and safety of motolimod-a Toll-like receptor 8 (TLR8) agonist that stimulates robust innate immune responses-combined with pegylated liposomal doxorubicin (PLD), a chemotherapeutic that induces immunogenic cell death.
Women with ovarian, fallopian tube, or primary peritoneal carcinoma were randomized 1 : 1 to receive PLD in combination with blinded motolimod or placebo. Randomization was stratified by platinum-free interval (≤6 versus >6-12 months) and Gynecologic Oncology Group (GOG) performance status (0 versus 1). Treatment cycles were repeated every 28 days until disease progression.
The addition of motolimod to PLD did not significantly improve overall survival (OS; log rank one-sided P = 0.923, HR = 1.22) or progression-free survival (PFS; log rank one-sided P = 0.943, HR = 1.21). The combination was well tolerated, with no synergistic or unexpected serious toxicity. Most patients experienced adverse events of fatigue, anemia, nausea, decreased white blood cells, and constipation. In pre-specified subgroup analyses, motolimod-treated patients who experienced injection site reactions (ISR) had a lower risk of death compared with those who did not experience ISR. Additionally, pre-treatment in vitro responses of immune biomarkers to TLR8 stimulation predicted OS outcomes in patients receiving motolimod on study. Immune score (tumor infiltrating lymphocytes; TIL), TLR8 single-nucleotide polymorphisms, mutational status in BRCA and other DNA repair genes, and autoantibody biomarkers did not correlate with OS or PFS.
The addition of motolimod to PLD did not improve clinical outcomes compared with placebo. However, subset analyses identified statistically significant differences in the OS of motolimod-treated patients on the basis of ISR and in vitro immune responses. Collectively, these data may provide important clues for identifying patients for treatment with immunomodulatory agents in novel combinations and/or delivery approaches.
Clinicaltrials.gov, NCT 01666444.

Keywords
Adjuvants, Immunologic/administration & dosage, Adult, Aged, Aged, 80 and over, Antineoplastic Combined Chemotherapy Protocols/pharmacology, Antineoplastic Combined Chemotherapy Protocols/therapeutic use, Benzazepines/administration & dosage, Disease-Free Survival, Double-Blind Method, Doxorubicin/administration & dosage, Doxorubicin/analogs & derivatives, Humans, Immunity, Innate/drug effects, Kaplan-Meier Estimate, Middle Aged, Neoplasm Recurrence, Local/drug therapy, Neoplasm Recurrence, Local/mortality, Neoplasms, Glandular and Epithelial/drug therapy, Neoplasms, Glandular and Epithelial/mortality, Ovarian Neoplasms/drug therapy, Ovarian Neoplasms/mortality, Polyethylene Glycols/administration & dosage, Proportional Hazards Models, Treatment Outcome, Toll-like receptor 8, biomarkers, immunotherapy, motolimod, oncology, ovarian cancer
Pubmed
Web of science
Create date
09/05/2017 17:37
Last modification date
20/08/2019 15:23
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