title: Cyclophosphamide and tucotuzumab (huKS-IL2) following first-line chemotherapy in responding patients with extensive-disease small-cell lung cancer.
abstract: The humanized KS-interleukin-2, tucotuzumab (huKS-IL2; EMD 273066), is an EpCAM-specific immunocytokine with reported immunologic activity in combination with cyclophosphamide. This Phase 2, randomized, open-label study compared tucotuzumab/cyclophosphamide, administered as maintenance, with best supportive care (BSC) in patients with extensive-disease small-cell lung cancer (ED-SCLC) who responded to first-line platinum-based chemotherapy with/without prophylactic cranial irradiation (PCI). Patients received cyclophosphamide (300 mg/m, Day 1 of every 3-week cycle), followed by tucotuzumab (1.5 mg/m, Days 2-4) until disease progression. The primary endpoint was 6-month progression-free survival (PFS); the secondary objectives included overall survival (OS), treatment response, and safety. The 6-month PFS rate was lower in the tucotuzumab/cyclophosphamide group (n=64) than in the BSC group (n=44): 6.4 versus 12.2% [hazard ratio (HR): 0.98; 80% confidence interval (CI): 0.74-1.31]. HRs for PFS, time to progression, and OS indicated a similar risk of disease progression and death in both groups and best overall responses were generally comparable. For patients with previous PCI (n=26), there was a nonsignificant trend toward prolonged median PFS (1.7 vs. 1.5 months; HR: 0.60; 80% CI: 0.33-1.11) and OS (21.5 vs. 14.3 months; HR: 0.58; 80% CI: 0.31-1.05) in the tucotuzumab/cyclophosphamide group. Adverse events were more frequent with tucotuzumab/cyclophosphamide (92.2%) than with BSC (47.7%). Tucotuzumab/cyclophosphamide was well tolerated in ED-SCLC patients, but did not show PFS or OS benefits compared with BSC. The observed trend toward prolonged PFS and OS in the subgroup of patients receiving previous PCI may support further confirmation in a larger population.
authors: aChelyabinsk Regional Clinical Oncology Dispensary, Chelyabinsk, Russia bDepartment and Clinic of Oncology, Poznan University of Medical Sciences, Poznan cDepartment of Chemotherapy, Alfred Sokolowski Specialized Hospital, Szczecin dDepartment of Pulmonology, Oncology and Allergology, Medical University of Lublin, Lublin eDepartment of Pulmonary Diseases, Lower Silesian Center for Pulmonary Diseases, Wroclaw fDepartment of Lung and Chest Cancers, Maria Sklodowska-Curie Institute of Oncology, Warsaw, Poland gEMD Serono Inc., GEDU - Oncology, Rockland, Massachusetts, USA hMerck Serono Research and Development, Institute of Drug Metabolism and Pharmacokinetics, Grafing, Germany.
authors: Oleg
authors: O
authors: Gladkov
authors: Rodryg
authors: R
authors: Ramlau
authors: Piotr
authors: P
authors: Serwatowski
authors: Janusz
authors: J
authors: Milanowski
authors: Janusz
authors: J
authors: Tomeczko
authors: Philip B
authors: PB
authors: Komarnitsky
authors: Daniel
authors: D
authors: Kramer
authors: Maciej J
authors: MJ
authors: Krzakowski
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D003520:Cyclophosphamide / Q000008:administration & dosage; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007376:Interleukin-2 / Q000008:administration & dosage / Q000031:analogs & derivatives; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000473:pathology; D060046:Maintenance Chemotherapy; D008297:Male; D008875:Middle Aged; D010166:Palliative Care; D055752:Small Cell Lung Carcinoma / Q000188:drug therapy* / Q000473:pathology
chemical_list: D007376:Interleukin-2; C494047:tucotuzumab celmoleukin; D003520:Cyclophosphamide