Evidence mapPaperPMID 33451345Full record

Trial reportBreast cancer research : BCR2021

A phase Ib/II study of xentuzumab, an IGF-neutralising antibody, combined with exemestane and everolimus in hormone receptor-positive, HER2-negative locally advanced/metastatic breast cancer.

Peter Schmid, Marie-Paule Sablin, Jonas Bergh, Seock-Ah Im, Yen-Shen Lu, Noelia Martínez, Patrick Neven, Keun Seok Lee, Serafín Morales, J Alejandro Pérez-Fidalgo and 10 more

2 registry-linked trialsOpen access · goldAbstract readClinical Trial, Phase IClinical Trial, Phase II
In one paragraph

Trial report in Breast cancer research : BCR, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 15 papers.

0numbers the graph read from it
0cells of the map it votes in
15citing papers in PubMed
3.2field-weighted citation impact, top 7% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT02123823 phase1completednot on this map

A Phase Ib/II Randomized Study of BI 836845 in Combination With Exemestane and Everolimus Versus Exemestane and Everolimus Alone in Women With Locally Advanced or Metastatic Breast Cancer

TypeinterventionalSponsorBoehringer IngelheimRan2014 to 2021Enrolled164ConditionsNeoplasmsArmsEverolimus, Exemestane, BI 836845
NCT03659136 phase2completednot on this map

XENERA™1: A Multi-centre, Double-blind, Placebo-controlled, Randomised Phase II Trial to Compare Efficacy of Xentuzumab in Combination With Everolimus and Exemestane Versus Everolimus and Exemestane in Women With HR+ / HER2- Metastatic Breast Cancer and Non-visceral Disease

TypeinterventionalSponsorBoehringer IngelheimRan2018 to 2022Enrolled103ConditionsBreast NeoplasmsArmsXentuzumab, Placebo, Everolimus, Exemestane
3 · Its place in the literature

Who cites it

15 citing papers in PubMed, 27 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

20 authors at 20 institutions in 11 countries.

Peter SchmidCentre for Experimental Cancer Medicine, Barts Cancer Institute, Queen Mary University of London, London, UK. p.schmid@qmul.ac.uk.
Marie-Paule SablinDepartment of Drug Development and Innovation, Institut Curie, Paris, France.
Jonas BerghDepartment of Oncology-Pathology, Karolinska Institutet and Breast Cancer Centre, Cancer Theme, Karolinska University Hospital, Stockholm, Sweden.
Seock-Ah ImDepartment of Internal Medicine, Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine, Seoul, South Korea.
Yen-Shen LuDepartment of Oncology, National Taiwan University Hospital, Taipei, Taiwan.
Noelia MartínezDepartment of Oncology, Ramon y Cajal University Hospital, Madrid, Spain.
Patrick NevenDepartment of Oncology, UZ Leuven, Campus Gasthuisberg, Leuven, Belgium.
Keun Seok LeeDepartment of Internal Medicine, National Cancer Center, Goyang, South Korea.
Serafín MoralesDepartment of Medical Oncology, Hospital Universitario Arnau de Vilanova de Lleida, Lleida, Spain.
J Alejandro Pérez-FidalgoMedical Oncology Unit, Hospital Clinico Universitario Valencia, Biomedical Research Institute INCLIVA, CIBERONC, Valencia, Spain.
Douglas AdamsonDepartment of Medical Oncology, Ninewells Hospital, Tayside Cancer Centre, Dundee, UK.
Anthony GonçalvesDepartment of Medical Oncology, Institut Paoli Calmettes, Aix-Marseille University, CRCM, CNRS, INSERM, Marseille, France.
Aleix PratTranslational Genomics and Targeted Therapeutics in Solid Tumors, IDIBAPS, Hospital Clínic of Barcelona, Barcelona, Spain.
Guy JerusalemDepartment of Medical Oncology, Centre Hospitalier Universitaire de Liège, and Liège University, Liège, Belgium.
Laura SchliekerExternal statistician on behalf of Boehringer Ingelheim Pharma GmbH & Co. KG., Staburo GmbH & Co. KG., Munich, Germany.
Rosa-Maria EspaderoMedical Department (Clinical Operations), Boehringer Ingelheim España S.A, Barcelona, Spain.
Thomas BogenriederMedical Department, Boehringer Ingelheim, RCV, Vienna, Austria.
Dennis Chin-Lun HuangMedical Department, Boehringer Ingelheim Taiwan Limited, Taipei, Taiwan.
John Crown *Department of Medical Oncology, St Vincent's University Hospital, Dublin, Ireland.
Javier Cortés *Breast Cancer Group, Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain.
Aix-Marseille Université · FRBoehringer Ingelheim (Austria) · ATBoehringer Ingelheim (Germany) · DEBoehringer Ingelheim (Spain) · ESBoehringer Ingelheim (Taiwan) · TWCentre Hospitalier Universitaire de Liège · BEConsorci Institut D'Investigacions Biomediques August Pi I Sunyer · ESHospital Universitari Arnau de Vilanova · ESINCLIVA Health Research Institute · ESInstitut Curie · FRInstituto Cajal · ESKarolinska Institutet · SENational Cancer Center · KRNational Taiwan University Hospital · TWNinewells Hospital · GBQueen Mary University of London · GBSeoul National University Hospital · KRSt. Vincent's University Hospital · IEUniversitair Ziekenhuis Leuven · BEVall d'Hebron Institute of Oncology

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundXentuzumab-a humanised IgG1 monoclonal antibody-binds IGF-1 and IGF-2, inhibiting their growth-promoting signalling and suppressing AKT activation by everolimus. This phase Ib/II exploratory trial evaluated xentuzumab plus everolimus and exemestane in hormone receptor-positive, locally advanced and/or metastatic breast cancer (LA/MBC).

methodsPatients with hormone receptor-positive/HER2-negative LA/MBC resistant to non-steroidal aromatase inhibitors were enrolled. Maximum tolerated dose (MTD) and recommended phase II dose (RP2D) of xentuzumab/everolimus/exemestane were determined in phase I (single-arm, dose-escalation). In phase II (open-label), patients were randomised 1:1 to the RP2D of xentuzumab/everolimus/exemestane or everolimus/exemestane alone. Randomisation was stratified by the presence of visceral metastases. Primary endpoint was progression-free survival (PFS).

resultsMTD was determined as xentuzumab 1000 mg weekly plus everolimus 10 mg/day and exemestane 25 mg/day. A total of 140 patients were enrolled in phase II (70 to each arm). Further recruitment was stopped following an unfavourable benefit-risk assessment by the internal Data Monitoring Committee appointed by the sponsor. Xentuzumab was discontinued; patients could receive everolimus/exemestane if clinically indicated. Median PFS was 7.3 months (95% CI 3.3-not calculable) in the xentuzumab/everolimus/exemestane group and 5.6 months (3.7-9.1) in the everolimus/exemestane group (hazard ratio 0.97, 95% CI 0.57-1.65; P = 0.9057). In a pre-specified subgroup of patients without visceral metastases at screening, xentuzumab/everolimus/exemestane showed evidence of PFS benefit versus everolimus/exemestane (hazard ratio 0.21 [0.05-0.98]; P = 0.0293). Most common any-cause adverse events in phase II were diarrhoea (29 [41.4%] in the xentuzumab/everolimus/exemestane group versus 20 [29.0%] in the everolimus/exemestane group), mucosal inflammation (27 [38.6%] versus 21 [30.4%]), stomatitis (24 [34.3%] versus 24 [34.8%]), and asthenia (21 [30.0%] versus 24 [34.8%]).

conclusionsAddition of xentuzumab to everolimus/exemestane did not improve PFS in the overall population, leading to early discontinuation of the trial. Evidence of PFS benefit was observed in patients without visceral metastases when treated with xentuzumab/everolimus/exemestane, leading to initiation of the phase II XENERA™-1 trial (NCT03659136).

trial registrationClinicalTrials.gov, NCT02123823 . Prospectively registered, 8 March 2013.

Indexed as

AdultAgedAged, 80 and overAndrostadienesAntibodies, Monoclonal, HumanizedAntineoplastic Combined Chemotherapy ProtocolsBiomarkers, TumorBreast NeoplasmsDisease ManagementErb-b2 Receptor Tyrosine KinasesEverolimusFemaleHumansMaximum Tolerated DoseMiddle AgedNeoplasm MetastasisAndrostadienesAntibodies, Monoclonal, HumanizedBiomarkers, TumorErb-b2 Receptor Tyrosine KinasesEverolimusexemestaneReceptors, EstrogenReceptors, ProgesteronexentuzumabBreast cancerHER2-negativeHormone receptor-positiveInsulin-like growth factorXentuzumab

Identifiers

PMID33451345
PMCPMC7811234
OpenAlexW3124214822

What Socratic holds

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LicenceCC BY
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.