Anetumab ravtansine versus vinorelbine in relapsed mesothelin-positive pleural mesothelioma
The first randomised test of an antibody-drug conjugate in mesothelioma: no better than vinorelbine, which is why no ADC is approved for this cancer.
Overview
589 patients were screened and 248 with mesothelin over-expression were randomised 2:1 to anetumab ravtansine or vinorelbine. Median progression-free survival was 4.3 months with the conjugate and 4.5 months with vinorelbine (hazard ratio 1.22, 95% CI 0.85 to 1.74). Grade 3 or worse neutropenia was rare with anetumab ravtansine (1% versus 39%), but serious adverse events and treatment-emergent deaths occurred in both arms. Kindler and colleagues reported it in Lancet Oncology in 2022.
- Median 4.3 vs 4.5 months with Anetumab ravtansine compared with Vinorelbine; about 0.2 months shorter for half the group.
- A median is a midpoint: half the people did better than this and half did worse, so it is not a prediction for any one person.
- Put another way, the treated group had about 22 percent higher chance of the event at any given time (hazard ratio 1.22, likely range 0.85 to 1.74).
- The likely range for the hazard ratio crosses 1, so the difference could be due to chance.
- This is a surrogate endpoint: it measures the cancer being controlled or absent on scans and tests, which often, but not always, translates into living longer.
- These results apply to the people the trial enrolled: Second-line, unresectable locally advanced or metastatic malignant pleural mesothelioma over-expressing mesothelin after platinum and pemetrexed, randomised open-label at 76 hospitals in 14 countries. People in a different situation may not see the same effect.
Numbers are from the trial as recorded here; see the source links in the table below. This is orientation, not medical advice: ask your team how closely the trial population matches you.
Similar pages
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