547P - Updated report: A randomized, double-blind, placebo-controlled phase II study of prophylactic dexamethasone (dex) therapy for fatigue and malaise d...

Date 08 October 2016
Event ESMO 2016 Congress
Session Poster Display
Topics Colon and Rectal Cancer
Presenter Satoshi Yuki
Citation Annals of Oncology (2016) 27 (6): 149-206. 10.1093/annonc/mdw370
Authors S. Yuki1, Y. Komatsu2, H. Satake3, Y. Miyamoto4, H. Tanioka5, A. Tsuji3, M. Asayama6, T. Shiraishi7, M. Kotaka8, A. Makiyama9, T. Kashiwada10, N. Takeuchi11, M. Shimokawa12, H. Saeki13, E. Oki13, Y. Emi14, H. Baba15, Y. Maehara13
  • 1Gastroenterology And Hepatology, Hokkaido University Hospital, 060-8638 - Sapporo/JP
  • 2Cancer Center, Hokkaido University Hospital, 060-8638 - Sapporo/JP
  • 3Medical Oncology, Kobe City Medical Center General Hospital, 650-0047 - Kobe/JP
  • 4Gastroenterological Surgery, Graduate School Of Medical Sciences, Kumamoto University, Kumamoto/JP
  • 5Medical Oncology, Okayama Rosai Hospital, 702-8055 - Okayama/JP
  • 6Gastroenterology, Saitama Cancer Center, Saitama/JP
  • 7Clinical Oncology, Matsuyama Red Cross Hospital, Matsuyama/JP
  • 8Gastrointestinal Cancer Center, Sano Hospital, Kobe/JP
  • 9Hematology And Oncology, Japan Community Health care Organization Kyushu Hospital, Kitakyushu/JP
  • 10Hematology, Respiratory Medicine And Oncology, Saga University Cancer Center, Saga/JP
  • 11Medical Oncology, Ina Central Hospital, Ina/JP
  • 12Clinical Research Institute, Cancer Biostatistics Laboratory, National Kyushu Cancer Center, 811-1395 - Fukuoka/JP
  • 13Surgery And Science, Graduate School Of Medical Sciences, Kyushu University, Fukuoka/JP
  • 14Surgery, Saiseikai Fukuoka General Hospital, Fukuoka/JP
  • 15Gastroenterological Surgery, Graduate School Of Medical Sciences, Kumamoto University, 860-8556 - Kumamoto/JP

Abstract

Background

Regorafenib (REG) is an oral multikinase inhibitor with survival benefit in salvage line therapy for metastatic colorectal cancer (mCRC); fatigue and malaise which are common adverse events (AEs) cause REG treatment discontinuation. Oral steroids are empirically used for treatment of cancer related fatigue, although there is only a few evidence. KSCC1402/HGCSG1402 is a phase II, randomized, double-blind, placebo-controlled study evaluating the prophylactic effects of oral dex on REG-related fatigue and malaise for pts with mCRC.

Methods

Eligibility included mCRC, objective failure of standard therapy, ECOG performance status 0 or 1. ≤Grade 1 fatigue or malaise was allowed to be enrolled in this study. Pts were 1:1 randomly assigned to an oral steroids group (dex 2 mg/day, 4 weeks) or a placebo (PLC) group with REG (160 mg/day, 3 weeks on/1 week off). The protocol period was scheduled for first 28 days of REG treatment. The primary endpoint was incidence of fatigue or malaise (CTCAE ver. 4, all grades) during the protocol period. Secondary endpoints included patient-reported outcome (PRO) (CTCAE and the Brief Fatigue Inventory), AEs, relative dose intensity of REG. Response, progression free survival and overall survival were also evaluated as exploratory endpoints.

Results

Between October 2014 and December 2015, 74 pts were enrolled and randomized (dex: 37, PLC: 37). Baseline characteristics were balanced between the two arms. The incidence of all grade of malaise and/or fatigue based on CTCAE for dex group was 55.6% and 58.3% for PLC group (p = 0.8119), that based on PRO CTCAE for dex was 47.2% and 58.3% for PLC (p = 0.3450). The incidence of ≥ grade 2 of malaise and/or fatigue based on CTCAE for dex group was 19.4% and 38.9% for PLC group (p = 0.0695), that based on PRO for dex was 27.8% and 52.8% for PLC (p = 0.0306). The most common AE during protocol period was hand foot skin reaction in both groups (75.0 % vs. 86.1%).

Conclusions

The KSCC1402/HGCSG1402 study provided promising results that improve the supportive therapy for pts with REG-related fatigue and malaise. (NCT02288078)

Clinical trial identification

UMIN000015131 Release date: 2014/09/11; NCT02288078 Release date: 2014/10/28

Legal entity responsible for the study

Clinical Research Support Center Kyushu

Funding

Bayer Yakuhin, Ltd

Disclosure

S. Yuki: Honoraria: Taiho Pharmaceutical, Merck Serono, Bristol-Myers Squibb, Takeda Pharmaceutical, Chugai Pharmaceutical, Bayer Yakuhin, Eli Lilly Japan. Y. Komatsu: Taiho Pharmaceutical, Yakult Honsha, Chugai Pharmaceutical, Merck Serono, Pfizer Japan, Novartis Pharma, Ono Pharmaceutical, Daiichi Sankyo, Takeda Pharmaceutical, Eli Lilly Japan, Novartis Pharma, Daiichi Sankyo, Kureha Corporation. E. Oki: Honoraria: Bayer Yakuhin. H. Baba: Honoraria: Bayer Yakuhin. All other authors have declared no conflicts of interest.