Veliparib in combination with whole-brain radiation therapy for patients with brain metastases from non-small cell lung cancer: results of a randomized, global, placebo-controlled study

Veliparib in combination with whole-brain radiation therapy for patients with brain metastases from non-small cell lung cancer: results of a randomized, global, placebo-controlled study

Veliparib is a potent, orally bioavailable, poly (adenosine diphosphate-ribose) polymerase (PARP) inhibitor that crosses the blood–brain barrier and has been shown to potentiate the effects of radiation in preclinical and early clinical studies. This phase 2, randomized, global study evaluated the e...

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Bibliographic Details
Published in:Journal of neuro-oncology Vol. 131; no. 1; pp. 105 - 115
Main Authors: Chabot, Pierre, Hsia, Te-Chun, Ryu, Jeong-Seon, Gorbunova, Vera, Belda-Iniesta, Cristobal, Ball, David, Kio, Ebenezer, Mehta, Minesh, Papp, Katherine, Qin, Qin, Qian, Jane, Holen, Kyle D., Giranda, Vince, Suh, John H.
Format: Journal Article
Language:English
Published: New York Springer US 01-01-2017
Springer Nature B.V
Subjects:
Adult
Aged
Aged, 80 and over
Antineoplastic Agents - therapeutic use
Benzimidazoles - therapeutic use
Brain Neoplasms - drug therapy
Brain Neoplasms - radiotherapy
Brain Neoplasms - secondary
Carcinoma, Non-Small-Cell Lung - pathology
Clinical Study
Cranial Irradiation - methods
Double-Blind Method
Female
Humans
Longitudinal Studies
Lung Neoplasms - pathology
Male
Medicine
Medicine & Public Health
Middle Aged
Neurology
Oncology
Treatment Outcome
Whole-brain radiation therapy
Brain metastases
Randomized clinical trial
Veliparib
PARP inhibitor
Non-small cell lung cancer
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Summary:Veliparib is a potent, orally bioavailable, poly (adenosine diphosphate-ribose) polymerase (PARP) inhibitor that crosses the blood–brain barrier and has been shown to potentiate the effects of radiation in preclinical and early clinical studies. This phase 2, randomized, global study evaluated the efficacy and safety of veliparib in combination with whole-brain radiation therapy (WBRT) in patients with brain metastases from non-small cell lung cancer (NSCLC). Three-hundred and seven patients with brain metastases from NSCLC were randomized 1:1:1 to WBRT (30 Gy in 10 fractions) plus 50 mg veliparib twice daily (BID; n  = 103), 200 mg veliparib BID ( n  = 102), or placebo BID ( n  = 102). Treatment began within 28 days of diagnosis. Tumor response and safety were assessed; the primary endpoint was overall survival (OS). Patients who received ≥1 dose of treatment were included in the safety analysis. All randomized patients were included in the efficacy endpoint analyses. Patient characteristics were well balanced between treatment arms. Median OS was 185 days for patients treated with WBRT plus placebo and 209 days for WBRT plus veliparib (50 or 200 mg). No statistically significant differences in OS, intracranial response rate, and time to clinical or radiographic progression between any of the treatment arms were noted. No differences were observed in adverse events (all grades) across treatment arms; nausea, fatigue, alopecia, and headache were the most commonly reported. No new safety signals were identified for veliparib. A significant unmet need for therapies that improve the outcomes of patients with brain metastases from NSCLC remains.
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ISSN:0167-594X
1573-7373
DOI:10.1007/s11060-016-2275-x