Triple combination of bevacizumab, gemcitabine and platinum salt in metastatic collecting duct carcinoma
2013; Elsevier BV; Volume: 24; Issue: 12 Linguagem: Inglês
10.1093/annonc/mdt423
ISSN1569-8041
AutoresNicolas Pécuchet, Frédéric Bigot, Julie Gachet, Christophe Massard, Laurence Albigès, Corine Teghom, Yves Allory, Arnaud Méjean, Bernard Escudier, Stéphane Oudard,
Tópico(s)Urinary and Genital Oncology Studies
ResumoBackgroundCollecting duct carcinoma (CDC) is a rare and aggressive subtype of kidney cancer that responds to platinum-based chemotherapy. Recent phase II trials have established enhanced antitumor activity on combining bevacizumab with chemotherapy in patients with metastatic urothelial carcinoma, a tumor that shares many features with CDC. Our aim was to investigate whether combining bevacizumab with platinum-based chemotherapy might not also show promise in metastatic CDC (mCDC) patients.Patients and methodsFive previously untreated patients diagnosed with mCDC received bevacizumab (15 mg/kg) in combination with gemcitabine (1250 mg/m2, D1–D8) and platinum salt (cisplatin 80 mg/m2 or carboplatin AUC 5 mg/ml/min) every 3 weeks for up to six cycles. This was followed by bevacizumab maintenance therapy (15 mg/kg).ResultsAll five patients (median age, 62 years; range 45–66 years) had an Eastern Cooperative Oncology Group PS of 0–1. They received the triple-drug combination for a median of four cycles (range, 2–6) and bevacizumab maintenance therapy for a median of three cycles (range, 0–17). There were three cases of partial response, one case of stable disease (20 months) and one case of complete remission after surgery of the only metastatic site. Median progression-free survival (PFS) was 15.1 months [95% confidence interval (CI) 5.6–20.4]. Median overall survival (OS) was 27.8 months (95% CI 12.4–unreached). Grades 3 or 4 adverse events were pulmonary embolism (n = 2), neutropenia (n = 2), thrombopenia (n = 1), asthenia (n = 1) and hypertension (n = 1).ConclusionsThe addition of bevacizumab to platinum-based chemotherapy resulted in a longer PFS and longer OS than recorded in an earlier clinical trial of platinum-based chemotherapy alone. The triple combination was manageable. The French Collaborative Group (Groupe d'Etudes des Tumeurs Uro-Génitales) is planning a prospective multicenter phase II clinical trial of the triple combination in mCDC patients.Clinical TrialBEVABEL/MO28644 (EudraCT: 2013-001179-19).
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