Anti-Angiopoietin Therapy With Trebananib for Recurrent Ovarian Cancer (TRINOVA-1): A Randomised, Multicentre, Double-blind, Placebo-Controlled Phase 3 Trial

摘要

Angiogenesis has become an important target for treatment of epithelial ovarian cancer. The growth of new blood vessels iscritical for cancer growth, metastases, and progression. Vascular endothelial growth factor (VEGF) plays a key role in epithelial ovarian cancer. Adding anti-VEGF treatment to first-line chemotherapy, to maintenance therapy, or at the time of recurrence significantly prolongs progression-free survival. However, these agents have several adverse effects, including hypertension, thrombosis, emboli, bleeding, impaired wound healing, proteinuria, and bowel perforation. As many as a third of patients with epithelial ovarian cancer discontinue anti-VEGF treatment because of these adverse events.Trebananib has a mechanism of action and toxicity profile different from other antiangiogenesis agents. It inhibits angiogenesis by preventing the binding of angiopoietins 1 and 2 to the Tie2 receptor. In a randomized phase 2 trial, trebananib prolonged progression-free survival in patients with recurrent epithelial ovarian cancer. This agent has mild and reversible adverse events. Edema is a unique adverse effect.