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Lee EQ , Kaley TJ , Duda DG , Schiff D , Lassman AB , Wong ET , Mikkelsen T , Purow BW , Muzikansky A , Ancukiewicz M , Huse JT , Ramkissoon S , Drappatz J , Norden AD , Beroukhim R , Weiss SE , Alexander BM , McCluskey CS , Gerard M , Smith KH , Jain RK , Batchelor TT , Ligon KL , Wen PY
A Multicenter, Phase II, Randomized, Noncomparative Clinical Trial of Radiation and Temozolomide with or without Vandetanib in Newly Diagnosed Glioblastoma Patients
Clin Cancer Res. 2015 Aug 15;21(16) :3610-8
PMID: 25910950    PMCID: PMC4790106    URL: http://www.ncbi.nlm.nih.gov/pubmed/25910950
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PURPOSE: Vandetanib, a tyrosine kinase inhibitor of KDR (VEGFR2), EGFR, and RET, may enhance sensitivity to chemotherapy and radiation. We conducted a randomized, noncomparative, phase II study of radiation (RT) and temozolomide with or without vandetanib in patients with newly diagnosed glioblastoma (GBM). EXPERIMENTAL DESIGN: We planned to randomize a total of 114 newly diagnosed GBM patients in a ratio of 2:1 to standard RT and temozolomide with (76 patients) or without (38 patients) vandetanib 100 mg daily. Patients with age >/= 18 years, Karnofsky performance status (KPS) >/= 60, and not on enzyme-inducing antiepileptics were eligible. Primary endpoint was median overall survival (OS) from the date of randomization. Secondary endpoints included median progression-free survival (PFS), 12-month PFS, and safety. Correlative studies included pharmacokinetics as well as tissue and serum biomarker analysis. RESULTS: The study was terminated early for futility based on the results of an interim analysis. We enrolled 106 patients (36 in the RT/temozolomide arm and 70 in the vandetanib/RT/temozolomide arm). Median OS was 15.9 months [95% confidence interval (CI), 11.0-22.5 months] in the RT/temozolomide arm and 16.6 months (95% CI, 14.9-20.1 months) in the vandetanib/RT/temozolomide (log-rank P = 0.75). CONCLUSIONS: The addition of vandetanib at a dose of 100 mg daily to standard chemoradiation in patients with newly diagnosed GBM or gliosarcoma was associated with potential pharmacodynamic biomarker changes and was reasonably well tolerated. However, the regimen did not significantly prolong OS compared with the parallel control arm, leading to early termination of the study. Clin Cancer Res; 21(16); 3610-8. (c)2015 AACR.
Lee, Eudocia Q Kaley, Thomas J Duda, Dan G Schiff, David Lassman, Andrew B Wong, Eric T Mikkelsen, Tom Purow, Benjamin W Muzikansky, Alona Ancukiewicz, Marek Huse, Jason T Ramkissoon, Shakti Drappatz, Jan Norden, Andrew D Beroukhim, Rameen Weiss, Stephanie E Alexander, Brian M McCluskey, Christine S Gerard, Mary Smith, Katrina H Jain, Rakesh K Batchelor, Tracy T Ligon, Keith L Wen, Patrick Y United States Clin Cancer Res. 2015 Aug 15;21(16):3610-8. doi: 10.1158/1078-0432.CCR-14-3220. Epub 2015 Apr 24.