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Cyclophosphamide and tucotuzumab (huKS-IL2) following first-line chemotherapy in responding patients with extensive-disease small-cell lung cancer

Gladkov, Olega; Ramlau, Rodrygb; Serwatowski, Piotrc; Milanowski, Januszd; Tomeczko, Janusze; Komarnitsky, Philip B.g; Kramer, Danielh; Krzakowski, Maciej J.f

doi: 10.1097/CAD.0000000000000281

The humanized KS-interleukin-2, tucotuzumab (huKS-IL2; EMD 273066), is an EpCAM-specific immunocytokine with reported immunologic activity in combination with cyclophosphamide. This Phase 2, randomized, open-label study compared tucotuzumab/cyclophosphamide, administered as maintenance, with best supportive care (BSC) in patients with extensive-disease small-cell lung cancer (ED-SCLC) who responded to first-line platinum-based chemotherapy with/without prophylactic cranial irradiation (PCI). Patients received cyclophosphamide (300 mg/m2, Day 1 of every 3-week cycle), followed by tucotuzumab (1.5 mg/m2, Days 2–4) until disease progression. The primary endpoint was 6-month progression-free survival (PFS); the secondary objectives included overall survival (OS), treatment response, and safety. The 6-month PFS rate was lower in the tucotuzumab/cyclophosphamide group (n=64) than in the BSC group (n=44): 6.4 versus 12.2% [hazard ratio (HR): 0.98; 80% confidence interval (CI): 0.74–1.31]. HRs for PFS, time to progression, and OS indicated a similar risk of disease progression and death in both groups and best overall responses were generally comparable. For patients with previous PCI (n=26), there was a nonsignificant trend toward prolonged median PFS (1.7 vs. 1.5 months; HR: 0.60; 80% CI: 0.33–1.11) and OS (21.5 vs. 14.3 months; HR: 0.58; 80% CI: 0.31–1.05) in the tucotuzumab/cyclophosphamide group. Adverse events were more frequent with tucotuzumab/cyclophosphamide (92.2%) than with BSC (47.7%). Tucotuzumab/cyclophosphamide was well tolerated in ED-SCLC patients, but did not show PFS or OS benefits compared with BSC. The observed trend toward prolonged PFS and OS in the subgroup of patients receiving previous PCI may support further confirmation in a larger population.

aChelyabinsk Regional Clinical Oncology Dispensary, Chelyabinsk, Russia

bDepartment and Clinic of Oncology, Poznan University of Medical Sciences, Poznan

cDepartment of Chemotherapy, Alfred Sokolowski Specialized Hospital, Szczecin

dDepartment of Pulmonology, Oncology and Allergology, Medical University of Lublin, Lublin

eDepartment of Pulmonary Diseases, Lower Silesian Center for Pulmonary Diseases, Wroclaw

fDepartment of Lung and Chest Cancers, Maria Sklodowska-Curie Institute of Oncology, Warsaw, Poland

gEMD Serono Inc., GEDU – Oncology, Rockland, Massachusetts, USA

hMerck Serono Research and Development, Institute of Drug Metabolism and Pharmacokinetics, Grafing, Germany

Correspondence to Maciej J. Krzakowski, Department of Lung and Chest Cancers, Maria Sklodowska-Curie Institute of Oncology, 5 Roentgen Street, 02-781 Warsaw, Poland Tel: +48 225 462 169; fax: +48 225 462 982; e-mail:

Received March 18, 2015

Accepted July 20, 2015

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