Erlotinib, bevacizumab yield negligible outcome in metastatic melanoma
NEW YORK — The combination of erlotinib and bevacizumab was tolerable yet displayed minimal clinical activity in patients with metastatic melanoma, according to phase 2 study results presented at the HemOnc Today Melanoma and Cutaneous Malignancies meeting in New York.
Tejaswi V. Mudigonda, BS, a medical student at Vanderbilt University, and colleagues sought to evaluate the combination of erlotinib (Tarceva; Genentech, Astellas Pharma) and bevacizumab (Avastin, Genentech) because each of the agents inhibit signaling pathways critical to tumorigenesis, according to study background. Researchers thought the combination would be effective in metastatic melanoma based on the overexpression of VEGF and expression of epidermal growth factor receptor in patients with the disease.
Mudigonda and colleagues evaluated data from 28 patients with advanced melanoma, nine of whom (32%) were previously treated for metastatic disease. A majority of the patients (61%) were male and had stage M1c disease (64%). Five patients had uveal melanoma and 10 patients (36%) had elevated lactate dehydrogenase.
All patients received 150 mg oral erlotinib daily and 10 mg/kg IV bevacizumab every 2 weeks.
Response rate, response duration and PFS (> 6 months) served as the study’s primary endpoints.
Two patients (7%) achieved partial responses which lasted longer than 5 months and 11 patients (39%) achieved stable disease as best response. Median PFS was 2 months (95% CI, 0.2-3.8) and median OS was 6.7 months (95% CI, 1.5-12.2).
Grade 3 adverse events occurred in 13 patients, the most common of which were pain, fatigue and diarrhea. Grade 4 adverse events occurred in two patients and included myocardial infarction and bowel perforation.
“Although moderately well tolerated, bevacizumab and erlotinib had minimal clinical activity in advanced melanoma,” Mudigonda and colleagues concluded. “With the advent of more effective targeted and immune therapies for advanced melanoma, further investigation of erlotinib plus bevacizumab is not warranted.” – by Cameron Kelsall
Mudigonda TV, et al. A Phase II trial of erlotinib and bevacizumab for patients with metastatic melanoma. Presented at: HemOnc Today Melanoma and Cutaneous Malignancies; April 10-11, 2015; New York.
Disclosure: Mudigonda reports no relevant financial disclosures.