A phase II trial of trebananib (AMG 386; IND#111071), a selective angiopoietin 1/2 neutralizing peptibody, in patients with persistent/recurrent carcinoma of the endometrium: An NRG/Gynecologic Oncology Group trial

Gynecol Oncol. 2015 Sep;138(3):513-8. doi: 10.1016/j.ygyno.2015.07.006. Epub 2015 Jul 11.

Abstract

Objectives: Ang1 & 2 (angiopoietin-1; -2) interact with Tie2 receptors on endothelial cells to mediate vascular remodeling in an angiogenesis signaling pathway distinct from the VEGF axis. Trebananib is a peptide Fc fusion protein that binds Ang1 and 2 and prevents interaction with Tie2. The efficacy of trebananib in recurrent/persistent endometrial cancer (EC) was studied.

Methods: The primary objective was to determine the frequency of patients with objective tumor responses (ORR) and event-free survival for ≥6months (6-month EFS) and determine toxicity of trebananib at a dose and schedule of 15mg/kg, IV QW. Recurrent/persistent EC, measurable disease, and ≤2 prior chemotherapy lines were required.

Results: Thirty-two patients were eligible and treated. The most common histologies were G1/2 endometrioid (31%), G3 endometrioid (28%) and serous (31.3%). 78% of patients had 1 prior regimen. Patients received 1-9+ cycles of trebananib; 24 patients (75%) received ≤2cycles. One patient had a partial response (3.1%); 8 patients had stable disease (25%) and 5 patients (15.6%) had 6 month EFS. Median progression-free survival and overall-survival were 1.97 months (90% CI 1.77-2.1) and 6.6 months (90% CI 4.01-14.75), respectively. Most common adverse events (AEs) were fatigue, anemia, and GI issues. Grade 3 and 4 AEs were: GI 31 and 0%; vascular 22 and 0%; metabolism/nutrition 19 and 3%; and general (including edema) 16 and 0%.

Conclusions: Trebananib has insufficient single agent activity in recurrent EC to warrant further investigation at this dose/schedule.

Keywords: Angiogenesis; Endometrial cancer; NCT01210222; Trebananib.

Publication types

  • Clinical Trial, Phase II
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Aged
  • Angiogenesis Inhibitors / adverse effects
  • Angiogenesis Inhibitors / therapeutic use*
  • Angiopoietin-1 / antagonists & inhibitors
  • Angiopoietin-1 / metabolism
  • Angiopoietin-2 / antagonists & inhibitors
  • Angiopoietin-2 / metabolism
  • Endometrial Neoplasms / blood supply
  • Endometrial Neoplasms / drug therapy*
  • Endometrial Neoplasms / metabolism
  • Female
  • Humans
  • Middle Aged
  • Recombinant Fusion Proteins / adverse effects
  • Recombinant Fusion Proteins / therapeutic use*

Substances

  • ANGPT1 protein, human
  • ANGPT2 protein, human
  • Angiogenesis Inhibitors
  • Angiopoietin-1
  • Angiopoietin-2
  • Recombinant Fusion Proteins
  • trebananib