Lancet Oncol: Efficacy and safety of the ADC drug Anetumab ravtansine in the treatment of malignant pleural mesothelioma

Before the approval of ipilimumab and nivolumab as first-line combination immunotherapy for malignant pleural mesothelioma in October 2020 , pemetrexed and platinum-based chemotherapy were the only first-line treatment options
.
To date, there are few second-line treatment options for malignant pleural mesothelioma

This study is an international, multicenter, randomized, open-label phase 2 trial to evaluate the antibody-drug conjugate Anetumab ravtansine, a fully human anti-mesothelin antibody composed of the toxic group DM4.
ADC drug) compared with vinorelbine in patients with malignant pleural mesothelioma
.

Patients 18 years of age and older with unresectable locally advanced or metastatic mesothelin-overexpressing malignant pleural mesothelioma who progressed on first-line platinum + pemetrexed ± bevacizumab therapy were recruited, randomized 2:1 The group received intravenous Anetumab ravtansine (6.
5 mg/kg, day 1 of every 21-day cycle) or intravenous vinorelbine (30 mg/m2 weekly) until disease progression, unacceptable toxicity, or death
.
The primary endpoint was progression-free survival

Progression-free survival and overall survival in the two groups

Between December 3, 2015, and May 31, 2017, a total of 589 patients were enrolled, of which 248 patients with mesothelin overexpression were randomized into two groups: 155 in the anetumab ravtansine group and 82 in the vinorelbine group bit
.
Disease progression occurred in 105 (63%) and 43 (52%) patients in the anetumab ravtansine and vinorelbine groups, respectively, at a median follow-up of 4.
0 months and 3.
9 months in the anetumab ravtansine and vinorelbine groups, respectively.
or death, the median progression-free survival was 4.

In conclusion, although Anetumab ravtansine showed a manageable safety profile in patients with malignant pleural mesothelioma, it was not superior to vinorelbine
.

Original source:

Hedy L Kindler, et al.
A netumab ravtansine versus vinorelbine in patients with relapsed, mesothelin-positive malignant pleural mesothelioma (ARCS-M): a randomised, open-label phase 2 trial .
The Lancet Oncology.