Does Adding Motesanib to Paclitaxel/Carboplatin Improve Outcomes in East Asian Patients With Lung Cancer?
Three oncology drugs in combination were not more effective than placebo plus two of the chemotherapy drugs in East Asian patients with stage IV recurrent nonsquamous, non–small cell lung cancer (NSCLC). Kaoru Kubota, MD, of the Nippon Medical School, Tokyo, and colleagues reported in the Journal of Clinical Oncology that paclitaxel and carboplatin (P/C) plus motesanib (AMG-706) compared with P/C and placebo was associated with a higher incidence of grade ≥ 3 adverse events leading to treatment discontinuation and did not significantly improve survival outcomes.
In this phase III double-blind trial, approximately 400 East Asian patients with advanced (stage IV/recurrent) nonsquamous NSCLC were treated with either motesanib plus P/C or placebo plus P/C. Motesanib is a small-molecule inhibitor of vascular endothelial growth factor receptors 1, 2, and 3; platelet-derived growth factor receptor; and Kit receptor.
The median progression-free survival was 6.1 months in those who received motesanib and 5.6 months in those who did not. More grade ≥ 3 adverse events were reported in those treated with motesanib (86.7% vs. 67.6%), and more adverse events led to treatment discontinuation with motesanib than with placebo (32.7% vs. 14.2%). However, the objective response rate favored the triplet therapy (60.1% vs. 41.6%), and the investigators consider this response rate and the duration of response as “hypothesis-generating efficacy signals.”