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Poster display session: Breast cancer - early stage, locally advanced & metastatic, CNS tumours, Developmental therapeutics, Genitourinary tumours - prostate & non-prostate, Palliative care, Psycho-oncology, Public health policy, Sarcoma, Supportive care

2722 - Sunitinib tolerance following an initial exposure period: results of longitudinal PRO data from S-TRAC study

Date

22 Oct 2018

Session

Poster display session: Breast cancer - early stage, locally advanced & metastatic, CNS tumours, Developmental therapeutics, Genitourinary tumours - prostate & non-prostate, Palliative care, Psycho-oncology, Public health policy, Sarcoma, Supportive care

Topics

Tumour Site

Urothelial Cancers

Presenters

Daniel George

Citation

Annals of Oncology (2018) 29 (suppl_8): viii303-viii331. 10.1093/annonc/mdy283

Authors

D.J. George1, R. Figlin2, R.J. Motzer3, J. Paty4, M.J. Lechuga Frean5, G. Zanotti6, H. Bhattacharyya7, K. Ramaswamy7, L. Deannuntis8, A. Ravaud9

Author affiliations

  • 1 Medical Oncology, Duke University Medical Center, 27710 - Durham/US
  • 2 Medicine - Hematology Oncology, Cedars-Sinai Medical Center, 90048 - Los Angeles/US
  • 3 Oncology, Memorial Sloan-Kettering Cancer Center, 10065 - New York/US
  • 4 Real World & Analytic Solutions, IQVIA, New York, NY, Pittsburgh/US
  • 5 Oncology, Pfizer - Italy, 20152 - Milan/IT
  • 6 Global Heor, Oncology, Pfizer, Inc., New York/US
  • 7 Oncology, Pfizer Inc., New York/US
  • 8 Worldwide Safety And Regulatory, Pfizer Inc., Collegeville/US
  • 9 Medical Oncology, CHU Bordeaux University Hospital St. André, 33000 - Bordeaux/FR
More

Resources

Abstract 2722

Background

Sunitinib (SU) was FDA-approved for adjuvant treatment of patients (pts) with renal cell carcinoma (RCC) at high risk of recurrence post nephrectomy, based upon a 24% reduction in disease-free survival with up to 1 year of SU treatment vs placebo (PBO) (S-TRAC trial). The analysis of patient-reported outcomes (PRO) data showed a statistically significant difference favoring PBO in most EORTC QLQ-C30 scales, and in the symptoms appetite loss and diarrhea, a clinically meaningful difference (≥ 10 points) favoring PBO was observed. Recognizing that some pts did not tolerate SU early on, with higher discontinuation and dose reduction rates for SU than PBO, we describe a baseline reset analysis to assess the longitudinal PRO profile of pts who were able to tolerate and stay on treatment beyond the first 2 cycles (C).

Methods

After censoring the data from C1 and 2, and resetting a new baseline at C 3, the baseline reset analysis described here used the same statistical analysis done for PRO data in S-TRAC. For each scale, comparison of the two treatment arms was carried out using longitudinal repeated measures mixed effect.

Results

Of the 615 pts enrolled in S-TRAC, 580 were included in the PRO analyses. Of these, 506 pts had PRO data at C 3 and were included in this analysis. The longitudinal between treatment comparison resulted in statistically significant differences favoring PBO in 6 of the 15 scales with no clinically meaningful differences (≥10 points) (see Table). The discontinuation rates of the 2 treatment groups were comparable from C 3 onward.Table: 916P

Summary results: EORTC QLQ-C30: Scores between treatment comparison – intent-to-treat population (cycles 3-9)

Sunitinib (n = 241) Model Estimated MeanPlacebo (n = 265) Model Estimated MeanDifference (Sunitinib – Placebo)
EORTC QLQ-C30
Global Health status/QoL (large values better)69.8772.20-2.32*
Functional scales (large values better)
Physical functioning85.1286.18-1.06
Role functioning80.8483.49-2.65*
Emotional functioning81.5282.49-0.97
Cognitive functioning85.5986.35-0.76
Social functioning83.1085.31-2.22*
Symptom items/scales (large values worse)
Fatigue27.4024.552.85*
Nausea and vomiting6.505.301.21
Pain20.7818.682.10
Dyspnea14.3614.040.32
Insomnia20.7120.89-0.18
Appetite loss12.217.744.47 *
Constipation10.4610.63-0.17
Diarrhea18.6710.678.00 *
Financial difficulties14.1013.530.58

A repeated measures longitudinal analysis with an intercept term, and treatment, time, treatment by time, and baseline as covariate over all cycles.

*

P < 0.05

P-values not adjusted for multiplicity.

Conclusions

These analyses suggest that for pts who are able to tolerate SU for > 2 cycles (3 months), PRO profiles for SU are similar to PBO pts with similar discontinuation rates. Some pts do not tolerate SU early on in the adjuvant setting, but for the majority who do, long term tolerance may be more acceptable than originally thought.

Clinical trial identification

NCT00375674.

Legal entity responsible for the study

Pfizer Inc.

Funding

Pfizer.

Editorial Acknowledgement

Disclosure

D.J. George: Honoraria & Consulting: Sanofi, Exelixis, Bayer; Consulting: Merck, Sanofi; Grants: Genentech/Roche, Novartis, Astellas, Celldex, Acerta; Grants & Consulting: Exelixis, Janssen, Pfizer, Innocrin Pharma, BMS. R. Figlin: Funding: Merck, Pfizer, Peloton, Calithera; Consulting fees: Pfizer. R.J. Motzer: Consulting fees: Pfizer, Eisai, Novartis, Exelixis; Clinical trial support to institution: Pfizer, Eisai, Novartis, Bristol-Myers Squibb, Genentech/Roche, Exelixis. M.J. Lechuga Frean, G. Zanotti, H. Bhattacharyya, K. Ramaswamy, L. Deannuntis: Employee of and owns stock in Pfizer. A. Ravaud: Advisory boards: Pfizer, Novartis, GSK, Roche, BMS; Institutional support grants: Pfizer, Novartis; Housing and transportation for meetings and speeches: Pfizer, Novartis, BMS. All other authors have declared no conflicts of interest.

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