학술논문
Randomized Phase II Study of Gemcitabine With or Without ATR Inhibitor Berzosertib in Platinum-Resistant Ovarian Cancer: Final Overall Survival and Biomarker Analyses.
Document Type
Article
Author
Konstantinopoulos, Panagiotis A.; Cheng, Su-Chun; Lee, Elizabeth K.; da Costa, Alexandre André B.A.; Gulhan, Doga; Wahner Hendrickson, Andrea E.; Kochupurakkal, Bose; Kolin, David L.; Kohn, Elise C.; Liu, Joyce F.; Penson, Richard T.; Stover, Elizabeth H.; Curtis, Jennifer; Sawyer, Hannah; Polak, Madeline; Chowdhury, Dipanjan; D'Andrea, Alan D.; Färkkilä, Anniina; Shapiro, Geoffrey I.; Matulonis, Ursula A.
Source
Subject
*OVERALL survival
*OVARIAN cancer
*GEMCITABINE
*CA 125 test
*PROGRESSION-free survival
*SAMPLE size (Statistics)
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Language
ISSN
2473-4284
Abstract
PURPOSE: The multicenter, open-label, randomized phase 2 NCI-9944 study (NCT02595892) demonstrated that addition of ATR inhibitor (ATRi) berzosertib to gemcitabine increased progression-free survival (PFS) compared to gemcitabine alone (hazard ratio [HR]=0.57, one-sided log-rank P =.044, which met the one-sided significance level of 0.1 used for sample size calculation). METHODS: We report here the final overall survival (OS) analysis and biomarker correlations (ATM expression by immunohistochemistry, mutational signature 3 and a genomic biomarker of replication stress) along with post-hoc exploratory analyses to adjust for crossover from gemcitabine to gemcitabine/berzosertib. RESULTS: At the data cutoff of January 27, 2023 (>30 months of additional follow-up from the primary analysis), median OS was 59.4 weeks with gemcitabine/berzosertib versus 43.0 weeks with gemcitabine alone (HR 0.79, 90% CI 0.52 to 1.2, one-sided log-rank P =.18). An OS benefit with addition of berzosertib to gemcitabine was suggested in patients stratified into the platinum-free interval ≤3 months (N = 26) subgroup (HR, 0.48, 90% CI 0.22 to 1.01, one-sided log-rank P =.04) and in patients with ATM-negative/low (N = 24) tumors (HR, 0.50, 90% CI 0.23 to 1.08, one-sided log-rank P =.06). CONCLUSION: The results of this follow-up analysis continue to support the promise of combined gemcitabine/ATRi therapy in platinum resistant ovarian cancer, an active area of investigation with several ongoing clinical trials. Final OS and biomarker analysis support the promise of gemcitabine with ATR inhibitor therapy in platinum resistant ovarian cancer [ABSTRACT FROM AUTHOR]