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Kumar G, DSouza H, Menon N, Srinivas S, Vallathol DH, Boppana M, Rajpurohit A, Mahajan A, Janu A, Chatterjee A, Krishnatry R, Gupta T, Jalali R, Patil VM. Safety and efficacy of bevacizumab biosimilar in recurrent/ progressive glioblastoma. Ecancermedicalscience 2021; 15:1166. [PMID: 33680080 PMCID: PMC7929766 DOI: 10.3332/ecancer.2021.1166] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2020] [Indexed: 02/05/2023] Open
Abstract
Background Multiple low-cost biosimilars of bevacizumab are now available but their clinical efficacy has never been compared against the original (innovator) molecule in glioblastoma. The aim of the current analysis is to compare the overall survival (OS) in recurrent/progressive glioblastoma patients between the biosimilar and innovator molecules. Materials and methods Adult recurrent/progressive glioblastoma patients treated with bevacizumab from 1 July 2015 to 30 July 2019 were identified. These patients were either offered Bevacizumab innovator (Avastin, Roche) or biosimilar (BevaciRel: Reliance Life sciences or Bryxta: Zydus Oncosciences) depending upon the financial status and affordability of the patients. The primary endpoint of the study was OS, while progression-free survival (PFS) and adverse events were the secondary endpoints. Results There were 82 patients, out of which 57 received innovator and 25 received biosimilar bevacizumab. At median follow-up of 26 months, the median PFS was 3.66 (95% confidence interval (CI) 2.08 to 5.25) and 3.3 months (95% CI 2.38 to 4.21) in innovator and biosimilar group, respectively (Log-rank test p-value = 0.072). The hazard ratio (HR) for progression was 0.61 (95% CI 0.35 to 1.05; p-value = 0.075). At the time of data cut-off, the median OS was 5.53 (95% CI, 5.07 to 5.99) versus 7.33 months (95% CI, 5.63 to 9.03) in innovator and biosimilar group, respectively (Log-rank test p-value = 0.51). The HR for death was 1.21 (95% CI, 0.67 to 2.17; p-value = 0.51). The adverse events and safety profiles were comparable between the two groups. Conclusion In the recurrent/progressive glioblastoma patients, both innovator and biosimilar bevacizumab seem to have similar safety and clinical efficacy.
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Affiliation(s)
- Gunjesh Kumar
- Department of Medical Oncology, Tata Memorial Hospital, Parel 400012 Mumbai, India.,Co-first authorship
| | - Hollis DSouza
- Department of Medical Oncology, Tata Memorial Hospital, Parel 400012 Mumbai, India.,Co-first authorship
| | - Nandini Menon
- Department of Medical Oncology, Tata Memorial Hospital, Parel 400012 Mumbai, India
| | - Sujay Srinivas
- Department of Medical Oncology, Tata Memorial Hospital, Parel 400012 Mumbai, India
| | | | - Mounika Boppana
- Department of Medical Oncology, Tata Memorial Hospital, Parel 400012 Mumbai, India
| | - Annu Rajpurohit
- Department of Medical Oncology, Tata Memorial Hospital, Parel 400012 Mumbai, India
| | - Abhishek Mahajan
- Department of Radiodiagnosis, Tata Memorial Hospital, Parel 400012 Mumbai, India
| | - Amit Janu
- Department of Radiodiagnosis, Tata Memorial Hospital, Parel 400012 Mumbai, India
| | - Abhishek Chatterjee
- Department of Radiation Oncology, Tata Memorial Hospital, Parel 400012 Mumbai, India
| | - Rahul Krishnatry
- Department of Radiation Oncology, Tata Memorial Hospital, Parel 400012 Mumbai, India
| | - Tejpal Gupta
- Department of Radiation Oncology, Tata Memorial Hospital, Parel 400012 Mumbai, India
| | - Rakesh Jalali
- Department of Radiation Oncology, Tata Memorial Hospital, Parel 400012 Mumbai, India
| | - Vijay M Patil
- Department of Medical Oncology, Tata Memorial Hospital, Parel 400012 Mumbai, India
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Singh GK, Menon N, Jadhav MM, Walavalkar R, DSouza H, Roy S, Das S, Srinivas S, Vallathol DH, Patil VM. Thromboembolic events in brain tumour patients on bevacizumab. Acta Oncol 2020; 59:1543-1546. [PMID: 32897111 DOI: 10.1080/0284186x.2020.1815834] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
| | - Nandini Menon
- Department of Medical Oncology, Tata Memorial Hospital, Mumbai, India
| | | | - Rutuja Walavalkar
- Department of Medical Oncology, Tata Memorial Hospital, Mumbai, India
| | - Hollis DSouza
- Department of Medical Oncology, Tata Memorial Hospital, Mumbai, India
| | - Somnath Roy
- Department of Medical Oncology, Tata Memorial Hospital, Mumbai, India
| | - Sudeep Das
- Department of Medical Oncology, Tata Memorial Hospital, Mumbai, India
| | - Sujay Srinivas
- Department of Medical Oncology, Tata Memorial Hospital, Mumbai, India
| | | | - Vijay M. Patil
- Department of Medical Oncology, Tata Memorial Hospital, Mumbai, India
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Patil VM, Noronha V, Joshi A, Dhumal S, Mahimkar M, Bhattacharjee A, Gota V, Pandey M, Menon N, Mahajan A, Sable N, Kumar S, Nawale K, Mukadam S, Solanki B, Das S, Simha V, Abraham G, Chandrasekharan A, Talreja V, DSouza H, Srinivas S, Kashyap L, Banavali S, Prabhash K. Phase I/II Study of Palliative Triple Metronomic Chemotherapy in Platinum-Refractory/Early-Failure Oral Cancer. J Clin Oncol 2019; 37:3032-3041. [PMID: 31539316 DOI: 10.1200/jco.19.01076] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
PURPOSE Platinum-resistant oral cancer has a dismal outcome with limited treatment options. We conducted a phase I/II study to identify the optimal biologic dose (OBD) of methotrexate when given along with erlotinib and celecoxib and to assess the efficacy of this three-drug regimen in advanced oral cancer. METHODS Patients with platinum-resistant or early-failure squamous cell carcinoma of the oral cavity were eligible for this study. They were orally administered erlotinib 150 mg once per day, celecoxib 200 mg twice per day, and methotrexate per week. The primary end point of phase I was to determine the OBD of methotrexate, and that of phase II was to determine the 3-month progression-free survival. The OBD of methotrexate was determined on the basis of the clinical benefit rate at 2 months and circulating endothelial cell level at day 8, using a de-escalation model. Pharmacokinetic evaluation was performed during phase I. Phase II consisted of an expansion cohort of 76 patients. RESULTS Fifteen patients were recruited in phase I, and 9 mg/m2 methotrexate was identified as the OBD. A total of 91 patients were recruited, and the median follow-up was 6.8 months (range, 0 to 16.8 months). The 3-month progression-free survival rate was 71.1% (95% CI, 60.5% to 79.3%), the 6-month overall survival rate was 61.2% (95% CI, 49.2% to 67.8%), and the response rate was 42.9% (95% CI, 33.2% to 53.1%; n = 39). The mean Functional Assessment of Cancer Therapy-Head and Neck Trial Outcome Index score at day 8 was improved by 6.1 units (standard deviation, 13.6 units) and was maintained around this magnitude ( P = .001). CONCLUSION Triple oral metronomic chemotherapy with erlotinib, methotrexate, and celecoxib is efficacious in platinum-refractory oral cavity cancers and represents a new therapeutic option in patients with poor prognosis.
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Joshi A, Patil V, Noronha V, Dhumal S, Pande N, Chandrasekharan A, Turkar S, DSouza H, Shrirangwar S, Mahajan A, Arya S, Juvekar S, BhattaCharjee A, Prabhash K. Results of a phase II randomized controlled clinical trial comparing efficacy of Cabazitaxel versus Docetaxel as second line or above therapy in recurrent head and neck cancer. Oral Oncol 2017; 75:54-60. [PMID: 29224823 DOI: 10.1016/j.oraloncology.2017.10.018] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2017] [Revised: 10/02/2017] [Accepted: 10/23/2017] [Indexed: 02/08/2023]
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