Selumetinib in Combination With Dacarbazine in Patients With Metastatic Uveal Melanoma: A Phase III, Multicenter, Randomized Trial (SUMIT)

被引：215

作者：

Carvajal, Richard D. ^{[1
]}

Piperno-Neumann, Sophie ^{[3
]}

Kapiteijn, Ellen ^{[5
]}

Chapman, Paul B. ^{[2
]}

Frank, Stephen ^{[6
]}

Joshua, Anthony M. ^{[9
]}

Piulats, Josep M. ^{[10
]}

Wolter, Pascal ^{[11
]}

Cocquyt, Veronique ^{[12
]}

Chmielowski, Bartosz ^{[13
]}

Evans, T. R. Jeffry ^{[14
]}

Gastaud, Lauris ^{[4
]}

Linette, Gerald ^{[18
]}

Berking, Carola ^{[19
]}

Schachter, Jacob ^{[7
,8
]}

Rodrigues, Manuel J. ^{[3
]}

Shoushtari, Alexander N. ^{[2
]}

Clemett, Delyth ^{[15
]}

Ghiorghiu, Dana ^{[16
]}

Mariani, Gabriella ^{[16
]}

Spratt, Shirley ^{[15
]}

Lovick, Susan ^{[15
]}

Barker, Peter ^{[20
]}

Kilgour, Elaine ^{[15
]}

Lai, Zhongwu ^{[21
]}

Schwartz, Gary K. ^{[1
]}

Nathan, Paul ^{[17
]}

机构：

[1] Columbia Univ, Med Ctr, New York, NY 10032 USA

[2] Mem Sloan Kettering Canc Ctr, 1275 York Ave, New York, NY 10021 USA

[3] Inst Curie, Paris, France

[4] Ctr Antoine Lacassagne, Nice, France

[5] Leiden Univ, Med Ctr, Leiden, Netherlands

[6] Hebrew Univ Jerusalem, Hadassah Med Sch, Sharett Inst Oncol, Jerusalem, Israel

[7] Sheba Med Ctr, Tel Hashomer, Israel

[8] Tel Aviv Univ, Sch Med, Tel Aviv, Israel

[9] Princess Margaret Canc Ctr, Toronto, ON, Canada

[10] Inst Catala Oncol LHosp, Barcelona, Spain

[11] Univ Hosp Leuven, Leuven, Belgium

[12] Ghent Univ Hosp, Ghent, Belgium

[13] Univ Calif Los Angeles, Jonsson Comprehens Canc Ctr, Los Angeles, CA 90024 USA

[14] Univ Glasgow, Glasgow, Lanark, Scotland

[15] AstraZeneca, Macclesfield, Cheshire, England

[16] AstraZeneca, Cambridge, England

[17] Mt Vernon Canc Ctr, Northwood, Middx, England

[18] Washington Univ, Sch Med, St Louis, MO USA

[19] Univ Hosp Munich, Munich, Germany

[20] AstraZeneca, Gaithersburg, MD USA

[21] AstraZeneca, Waltham, MA USA

来源：

JOURNAL OF CLINICAL ONCOLOGY | 2018年 / 36卷 / 12期

关键词：

AZD6244; ARRY-142886; MUTATIONS; CANCER; GNAQ; INHIBITOR; GROWTH;

D O I：

10.1200/JCO.2017.74.1090

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 [肿瘤学];

摘要：

PurposeUveal melanoma is the most common primary intraocular malignancy in adults with no effective systemic treatment option in the metastatic setting. Selumetinib (AZD6244, ARRY-142886) is an oral, potent, and selective MEK1/2 inhibitor with a short half-life, which demonstrated single-agent activity in patients with metastatic uveal melanoma in a randomized phase II trial.MethodsThe Selumetinib (AZD6244: ARRY-142886) (Hyd-Sulfate) in Metastatic Uveal Melanoma (SUMIT) study was a phase III, double-blind trial (ClinicalTrial.gov identifier: NCT01974752) in which patients with metastatic uveal melanoma and no prior systemic therapy were randomly assigned (3:1) to selumetinib (75 mg twice daily) plus dacarbazine (1,000 mg/m(2) intravenously on day 1 of every 21-day cycle) or placebo plus dacarbazine. The primary end point was progression-free survival (PFS) by blinded independent central radiologic review. Secondary end points included overall survival and objective response rate.ResultsA total of 129 patients were randomly assigned to receive selumetinib plus dacarbazine (n = 97) or placebo plus dacarbazine (n = 32). In the selumetinib plus dacarbazine group, 82 patients (85%) experienced a PFS event, compared with 24 (75%) in the placebo plus dacarbazine group (median, 2.8 v 1.8 months); the hazard ratio for PFS was 0.78 (95% CI, 0.48 to 1.27; two-sided P = .32). The objective response rate was 3% with selumetinib plus dacarbazine and 0% with placebo plus dacarbazine (two-sided P = .36). At 37% maturity (n = 48 deaths), analysis of overall survival gave a hazard ratio of 0.75 (95% CI, 0.39 to 1.46; two-sided P = .40). The most frequently reported adverse events (selumetinib plus dacarbazine v placebo plus dacarbazine) were nausea (62% v 19%), rash (57% v 6%), fatigue (44% v 47%), diarrhea (44% v 22%), and peripheral edema (43% v 6%).ConclusionIn patients with metastatic uveal melanoma, the combination of selumetinib plus dacarbazine had a tolerable safety profile but did not significantly improve PFS compared with placebo plus dacarbazine. (c) 2018 by American Society of Clinical Oncology

引用

页码：1232 / +

页数：10

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