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Barnes DJ, Dutton P, Bruland Ø, Gelderblom H, Faleti A, Bühnemann C, van Maldegem A, Johnson H, Poulton L, Love S, Tiemeier G, van Beelen E, Herbschleb K, Haddon C, Billingham L, Bradley K, Ferrari S, Palmerini E, Picci P, Dirksen U, Strauss SJ, Hogendoorn PCW, Buddingh E, Blay JY, Cleton-Jansen AM, Hassan AB. Outcomes from a mechanistic biomarker multi-arm and randomised study of liposomal MTP-PE (Mifamurtide) in metastatic and/or recurrent osteosarcoma (EuroSarc-Memos trial). BMC Cancer 2022; 22:629. [PMID: 35672690 PMCID: PMC9175372 DOI: 10.1186/s12885-022-09697-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Accepted: 05/19/2022] [Indexed: 11/17/2022] Open
Abstract
The phase III clinical study of adjuvant liposomal muramyl tripeptide (MTP-PE) in resected high-grade osteosarcoma (OS) documented positive results that have been translated into regulatory approval, supporting initial promise for innate immune therapies in OS. There remains, however, no new approved treatment such as MTP-PE for either metastatic or recurrent OS. Whilst the addition of different agents, including liposomal MTP-PE, to surgery for metastatic or recurrent high-grade osteosarcoma has tried to improve response rates, a mechanistic hiatus exists in terms of a detailed understanding the therapeutic strategies required in advanced disease. Here we report a Bayesian designed multi-arm, multi-centre, open-label phase II study with randomisation in patients with metastatic and/or recurrent OS, designed to investigate how patients with OS might respond to liposomal MTP-PE, either given alone or in combination with ifosfamide. Despite the trial closing because of poor recruitment within the allocated funding period, with no objective responses in eight patients, we report the design and feasibility outcomes for patients registered into the trial. We demonstrate the feasibility of the Bayesian design, European collaboration, tissue collection with genomic analysis and serum cytokine characterisation. Further mechanistic investigation of liposomal MTP-PE alone and in combination with other agents remains warranted in metastatic OS.
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Affiliation(s)
- David J Barnes
- Oxford Molecular Pathology Institute, Sir William Dunn School of Pathology, University of Oxford, South Parks Road, and Oxford University Hospital NHS Trust, Oxford, OX1 3RE, UK
| | - Peter Dutton
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences and Centre for Statistics in Medicine (CSM), University of Oxford, Botnar Research Centre, Windmill Road, Oxford, OX3 7LD, UK
| | - Øyvind Bruland
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo and Department of Oncology-Norwegian Radium Hospital, Oslo University Hospital, Oslo, Norway
| | - Hans Gelderblom
- Leiden University Medical Center, P.O. Box 9600, Postzone K1-P, 2300RC, Leiden, The Netherlands
| | - Ade Faleti
- Department of Oncology Early Phase trials unit and Oncology Clinical Trials Office (OCTO), University of Oxford, Old Road Campus Research Building, Oxford, OX3 7DQ, UK
| | - Claudia Bühnemann
- Oxford Molecular Pathology Institute, Sir William Dunn School of Pathology, University of Oxford, South Parks Road, and Oxford University Hospital NHS Trust, Oxford, OX1 3RE, UK
| | - Annemiek van Maldegem
- Oxford Molecular Pathology Institute, Sir William Dunn School of Pathology, University of Oxford, South Parks Road, and Oxford University Hospital NHS Trust, Oxford, OX1 3RE, UK
- Leiden University Medical Center, P.O. Box 9600, Postzone K1-P, 2300RC, Leiden, The Netherlands
| | - Hannah Johnson
- Department of Oncology Early Phase trials unit and Oncology Clinical Trials Office (OCTO), University of Oxford, Old Road Campus Research Building, Oxford, OX3 7DQ, UK
| | - Lisa Poulton
- Department of Oncology Early Phase trials unit and Oncology Clinical Trials Office (OCTO), University of Oxford, Old Road Campus Research Building, Oxford, OX3 7DQ, UK
| | - Sharon Love
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences and Centre for Statistics in Medicine (CSM), University of Oxford, Botnar Research Centre, Windmill Road, Oxford, OX3 7LD, UK
| | - Gesa Tiemeier
- Oxford Molecular Pathology Institute, Sir William Dunn School of Pathology, University of Oxford, South Parks Road, and Oxford University Hospital NHS Trust, Oxford, OX1 3RE, UK
- Leiden University Medical Center, P.O. Box 9600, Postzone K1-P, 2300RC, Leiden, The Netherlands
| | - Els van Beelen
- Leiden University Medical Center, P.O. Box 9600, Postzone K1-P, 2300RC, Leiden, The Netherlands
| | - Karin Herbschleb
- Department of Oncology Early Phase trials unit and Oncology Clinical Trials Office (OCTO), University of Oxford, Old Road Campus Research Building, Oxford, OX3 7DQ, UK
| | - Caroline Haddon
- Department of Oncology Early Phase trials unit and Oncology Clinical Trials Office (OCTO), University of Oxford, Old Road Campus Research Building, Oxford, OX3 7DQ, UK
| | - Lucinda Billingham
- Cancer Research Clinical Trials Unit (Cancer Sciences), Institute of Cancer and Genomic Sciences, Robert Aitken Building, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK
| | - Kevin Bradley
- Department of Radiology, Churchill Hospital, Oxford University Hospitals Foundation Trust, Oxford, OX3 7LJ, UK
| | - Stefano Ferrari
- Istituti Ortopedici Rizzoli, Via C. Pupilli 1, 40136, Bologna, Italy
| | | | - Piero Picci
- Istituti Ortopedici Rizzoli, Via C. Pupilli 1, 40136, Bologna, Italy
| | - Uta Dirksen
- Pediatrics III, West German Cancer Centre Network Essen-Muenster, University Hospital Essen, Hufelanstr 55, Essen, 45147, Germany
| | - Sandra J Strauss
- Department of Oncology, UCLH NHS Foundation Trust, 250 Euston Road, London, NW1 2PG, UK
| | - Pancras C W Hogendoorn
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences and Centre for Statistics in Medicine (CSM), University of Oxford, Botnar Research Centre, Windmill Road, Oxford, OX3 7LD, UK
- Leiden University Medical Center, P.O. Box 9600, Postzone K1-P, 2300RC, Leiden, The Netherlands
| | - Emmeline Buddingh
- Leiden University Medical Center, P.O. Box 9600, Postzone K1-P, 2300RC, Leiden, The Netherlands
| | | | | | - Andrew Bassim Hassan
- Oxford Molecular Pathology Institute, Sir William Dunn School of Pathology, University of Oxford, South Parks Road, and Oxford University Hospital NHS Trust, Oxford, OX1 3RE, UK.
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences and Centre for Statistics in Medicine (CSM), University of Oxford, Botnar Research Centre, Windmill Road, Oxford, OX3 7LD, UK.
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