Phase III randomized trial of second-line ixabepilone versus paclitaxel or doxorubicin in women with advanced endometrial cancer.
OBJECTIVE
The purpose of this multicenter, open label, randomized phase III study was to determine whether ixabepilone resulted in improved overall survival (OS) compared with commonly used single-agent chemotherapy (doxorubicin or paclitaxel) in women with locally advanced, recurrent, or metastatic endometrial cancer with at least one failed prior platinum-based chemotherapeutic regimen.


METHODS
Patients were randomized 1:1 to ixabepilone (40mg/m(2)), or either paclitaxel (175mg/m(2)) or doxorubicin (60mg/m(2)), every 21days. Patients that had previously received an anthracycline were randomized to ixabepilone or paclitaxel; all other patients were randomized to ixabepilone or doxorubicin. An interim analysis of futility for OS was planned.


RESULTS
At the time of database lock, 496 patients were randomized to receive ixabepilone (n=248) or control (n=248); nine patients in the control arm were not treated. The interim analysis of futility for OS (219 events) favored the control chemotherapy arm (hazard ratio=1.3 [95% confidence interval: 1.0-1.7], stratified log rank test P=0.0397), indicating that the study would not meet its primary objective. The study was discontinued based on the interim OS results. The frequency of adverse events was comparable between the treatment arms.


CONCLUSIONS
The study did not meet its primary objective of improving OS in the ixabepilone arm compared to the control chemotherapy arm. A favorable risk/benefit ratio was not observed for ixabepilone versus control at the time of the interim analysis. The safety results were consistent with the known safety profiles of ixabepilone and control.
Stephenson Cancer Center, University of Oklahoma, Oklahoma City, OK, USA. Electronic address: scott-mcmeekin@ouhsc.edu.
Scott
S
McMeekin
Medical Gynecologic Oncology, Gillette Center for Women's Cancers, Massachusetts General Hospital, Boston, MA, USA.
Don
D
Dizon
Women's Health Specialists, Rockville, MD, USA.
James
J
Barter
Policlinico Universitario A. Gemelli, Rome, Italy.
Giovanni
G
Scambia
Russian Oncology Research Center Named After Blokhin N.N., Moscow, Russia.
Lyudmila
L
Manzyuk
City Clinical Oncology Dispensary, St Petersburg, Russia.
Alla
A
Lisyanskaya
Vall D'Hebron University Hospital, Barcelona, Spain.
Ana
A
Oaknin
Bristol-Myers Squibb, Wallingford, CT, USA.
Sarah
S
Ringuette
Bristol-Myers Squibb, Wallingford, CT, USA.
Pralay
P
Mukhopadhyay
Bayer HealthCare, Montville, NJ, USA.
Julie
J
Rosenberg
University Hospital Leuven, Leuven Cancer Institute, Department of Oncology, KU Leuven, Belgium.
Ignace
I
Vergote
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D004317:Doxorubicin / Q000627:therapeutic use*; D016889:Endometrial Neoplasms / Q000188:drug therapy*; D034261:Epothilones / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008875:Middle Aged; D017239:Paclitaxel / Q000627:therapeutic use*; D015996:Survival Rate
D000970:Antineoplastic Agents; D034261:Epothilones; D004317:Doxorubicin; C430592:ixabepilone; D017239:Paclitaxel
Advanced; Chemotherapy; Endometrial cancer; Ixabepilone; Metastatic; Second-line; Single-agent