Bemarituzumab plus mFOLFOX6 as first-line treatment in East Asian patients with FGFR2b-overexpressing locally advanced or metastatic gastric/gastroesophageal junction cancer: subgroup of FIGHT final analysis

Gastric Cancer. 2024 Sep;27(5):1046-1057. doi: 10.1007/s10120-024-01516-3. Epub 2024 Jun 11.

Abstract

Background: In the FIGHT study (NCT03694522) bemarituzumab, a humanized monoclonal antibody selective for fibroblast growth factor receptor 2b (FGFR2b), plus mFOLFOX6 showed clinically meaningful efficacy in patients with FGFR2b-positive (2+/3+ membranous staining by immunohistochemistry) locally advanced unresectable/metastatic gastric/gastroesophageal cancer (G/GEJC). A meaningful proportion of patients in FIGHT were enrolled in East Asia, reflecting global epidemiology of G/GEJC.

Methods: This subgroup analysis of the global, phase 2, double-blind FIGHT study included all patients enrolled in East Asian sites. Patients were randomized 1:1 to bemarituzumab-mFOLFOX6 (15 mg/kg and one 7.5 mg/kg dose on cycle 1, day 8) or matching placebo-mFOLFOX6. The primary endpoint was investigator-assessed progression-free survival (PFS). Secondary endpoints included overall survival (OS), objective response rate, and safety. Efficacy was evaluated after a minimum follow-up of 24 months.

Results: The East Asian subgroup comprised 89 patients (57% of overall study population); 45 were randomized to bemarituzumab-mFOLFOX6 and 44 to placebo-mFOLFOX6. Median PFS (95% confidence interval [CI]) was 12.9 months (8.8-17.9) with bemarituzumab-mFOLFOX6 and 8.2 months (5.6-10.3) with placebo-mFOLFOX6 (HR 0.50, 95% CI 0.29-0.87); median OS (95% CI) was 24.7 months (13.8-33.1) vs 12.9 months (9.3-21.4), respectively (HR 0.56, 95% CI 0.32-0.96). Treatment benefit was more pronounced in patients with FGFR2b-positive G/GEJC in ≥ 10% of tumor cells. No new safety signals were reported.

Conclusion: In East Asian patients with FGFR2b-positive advanced/metastatic G/GEJC enrolled in the global FIGHT study, bemarituzumab-mFOLFOX6 showed clinically meaningful outcomes over placebo-mFOLFOX6.

Keywords: Bemarituzumab; FGFR2b; Gastric cancer; Targeted therapy; mFOLFOX6.

Publication types

  • Randomized Controlled Trial
  • Clinical Trial, Phase II
  • Multicenter Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Antibodies, Monoclonal, Humanized* / therapeutic use
  • Antineoplastic Combined Chemotherapy Protocols* / therapeutic use
  • Asia, Eastern
  • Double-Blind Method
  • East Asian People
  • Esophageal Neoplasms / drug therapy
  • Esophageal Neoplasms / pathology
  • Esophagogastric Junction* / pathology
  • Female
  • Fluorouracil* / administration & dosage
  • Fluorouracil* / therapeutic use
  • Humans
  • Leucovorin* / administration & dosage
  • Leucovorin* / therapeutic use
  • Male
  • Middle Aged
  • Organoplatinum Compounds* / administration & dosage
  • Organoplatinum Compounds* / therapeutic use
  • Receptor, Fibroblast Growth Factor, Type 2*
  • Stomach Neoplasms* / drug therapy
  • Stomach Neoplasms* / mortality
  • Stomach Neoplasms* / pathology
  • Survival Rate

Substances

  • Receptor, Fibroblast Growth Factor, Type 2
  • Fluorouracil
  • Leucovorin
  • Antibodies, Monoclonal, Humanized
  • Organoplatinum Compounds
  • FGFR2 protein, human

Supplementary concepts

  • Folfox protocol