Comment
Jim West/Science Photo Library
Trebananib: an alternative anti-angiogenic strategy
Published Online June 18, 2014 http://dx.doi.org/10.1016/ S1470-2045(14)70283-9 See Articles page 799
776
Phase 3 clinical trials have shown a significant benefit for anti-angiogenic treatment in ovarian cancer either in the first line1–4 or relapsed disease settings.5–7 Results of the first-line studies have generally shown a modest progression-free survival benefit, with the exception of AGO-OVAR164 in which a 5·6-month improvement was more impressive, but came at the expense of marked toxic effects.4 So far, the only study to show a significant overall survival benefit was the ICON6 study,7 in which patients with platinum-sensitive, relapsed ovarian cancer were given concomitant and maintenance cediranib. The proportion of patients given anti-angiogenic agents who achieved a tumour response was consistently between 15–21% in these studies,2,5,6 and these findings, in addition to the welldocumented single-agent activity, further emphasise the validity of this approach. In this issue of The Lancet Oncology, Bradley Monk and colleagues8 show once again the benefit of the antiangiogenic strategy in the treatment of epithelial ovarian cancer by doing a phase 3 trial of trebananib in patients with platinum-resistant and partially platinum-sensitive relapsed ovarian cancer, in whom there is a major need for new treatments. The importance of this study relates to the unique mechanism of action of the experimental agent (trebananib), which unlike other anti-angiogenic drugs tested in the phase 3 ovarian cancer setting, targets the binding of angiopoietins 1 and 2 to the Tie 2 receptor rather than the VEGF pathway. Median progression-free survival was significantly longer in the trebananib group than in the placebo group (7·2 months [95% CI 5·8–7·4] vs 5·4 months [4·3–5·5], respectively, HR 0·66, 95% CI 0·57–0·77; p
Jim West/Science Photo Library
Trebananib: an alternative anti-angiogenic strategy
Published Online June 18, 2014 http://dx.doi.org/10.1016/ S1470-2045(14)70283-9 See Articles page 799
776
Phase 3 clinical trials have shown a significant benefit for anti-angiogenic treatment in ovarian cancer either in the first line1–4 or relapsed disease settings.5–7 Results of the first-line studies have generally shown a modest progression-free survival benefit, with the exception of AGO-OVAR164 in which a 5·6-month improvement was more impressive, but came at the expense of marked toxic effects.4 So far, the only study to show a significant overall survival benefit was the ICON6 study,7 in which patients with platinum-sensitive, relapsed ovarian cancer were given concomitant and maintenance cediranib. The proportion of patients given anti-angiogenic agents who achieved a tumour response was consistently between 15–21% in these studies,2,5,6 and these findings, in addition to the welldocumented single-agent activity, further emphasise the validity of this approach. In this issue of The Lancet Oncology, Bradley Monk and colleagues8 show once again the benefit of the antiangiogenic strategy in the treatment of epithelial ovarian cancer by doing a phase 3 trial of trebananib in patients with platinum-resistant and partially platinum-sensitive relapsed ovarian cancer, in whom there is a major need for new treatments. The importance of this study relates to the unique mechanism of action of the experimental agent (trebananib), which unlike other anti-angiogenic drugs tested in the phase 3 ovarian cancer setting, targets the binding of angiopoietins 1 and 2 to the Tie 2 receptor rather than the VEGF pathway. Median progression-free survival was significantly longer in the trebananib group than in the placebo group (7·2 months [95% CI 5·8–7·4] vs 5·4 months [4·3–5·5], respectively, HR 0·66, 95% CI 0·57–0·77; p
