Table 4.
Drug | Indication | Pivotal study | Primary endpoint | Study phase | Control | Design | Performance status [16] | No. of patients | OS effect in months | QoL effect |
---|---|---|---|---|---|---|---|---|---|---|
Imatinib | GIST | Demetri 2002 [36] DeMatteo 2009 [21] |
ORR RFS |
II III |
Imatinib (different dose) Placebo |
Rand. OL Rand. DB |
ECOG ≤3 ECOG ≤2 |
147 713 |
n/a n/a |
NE NE |
Imatinib | DFSP | Heinrich 2008 [39] | ORR | II | None | Single-arm | ECOG ≤2 | 18 | NE | NS |
Mitotane | Adrenocortical carcinoma | Several pivotal studies | OS, PFS, ORR | n/a | n/a | n/a | n/a | > 500 | n/a | n/a |
Sunitiniba | GIST | Demetri 2006 [22] | TTP | III | Placebo | Rand. DB | ECOG ≤1 | 312 | n/a | NE |
Sunitinib | RCC | Motzer 2006 [40] Motzer 2007 [31] |
ORR PFS |
II III |
None IFN-α |
Single-arm Rand. OL |
ECOG ≤1 ECOG ≤1 |
106 750 |
n/a n/a |
NE Improved |
Sorafeniba | RCC | Escudier 2007 [24] | OS | III | Placebo | Rand. DB | ECOG ≤1 | 903 | n/a | NS |
Sorafenib | HCC | Llovet 2008 29 | OS, TTP | III | Placebo | Rand. DB | ECOG ≤2 | 602 | 2.8 | NE |
Sorafenib | Thyroid carcinoma | Brose 2014 [20] (DECISION) | PFS | III | Placebo | Rand. DB | ECOG ≤2 | 417 | n/a | NS |
Temsirolimus | RCC | Hudes 2007 [26] (ARCC) |
OS | III | IFN-α | Rand. OL | Karnofsky ≥60 (ECOG 1) | 626 | 3.6 | NS |
Trabectedin | STS | Demetri 2009 [35] | TTP | II | Trabectedin (different dose) | Rand. OL | ECOG ≤1 | 266 | 2.1 (NS) | NE |
Trabectedin | Ovarian cancer | Monk 2010 [29] | PFS | III | Single-agent PLD | Rand. OL | ECOG ≤2 | 672 | n/a | NS |
Mifamurtide | Osteosarcoma | Meyers 2005 [28] | EFS | III | Ifosfamide | Rand. OL (factorial) | Not reported | 678 | n/a | NE |
Everolimusa | RCC | Motzer 2008 [30] | PFS | III | Placebo | Rand. DB | Karnofsky ≥70 (ECOG 1) | 416 | n/a | NS |
Cabozantinib | Medullary thyroid cancer | Elisei 2013 [23] | PFS | III | Placebo | Rand. DB | ECOG ≤2 | 330 | n/a | NE |
Olaparib | Ovarian cancer | Ledermann 2012 [37] | PFS | II | Placebo | Rand. DB | ECOG ≤2 | 265 | n/a | NS |
Ramucirumab | Gastric cancer | Wilke 2014 [34] (RAINBOW) Fuchs 2014 [25] (REGARD) |
OS OS |
III III |
Placebo Placebo |
Rand. DB Rand. DB |
ECOG ≤1 ECOG ≤2 |
665 355 |
2.2 1.4 |
NS NS |
Dinutuximaba | Neuroblastoma | Study not yet published [19] | EFS | III | Isotretinoin | Rand. OL | Karnofsky ≥50 (ECOG 2) | 230 | n/a | NE |
Lenvatinib | Thyroid cancer | Schlumberger 2015 [32] | PFS | III | Placebo | Rand. DB | ECOG ≤3 | 392 | n/a | NE |
Olaratumab | STS | Tap 2016 [38] | PFS | Ib/II | Doxorubicin | Rand. OL | ECOG ≤2 | 133 | 11.8 | NE |
Nanoliposomal irinotecan | Pancreatic cancer | Wang-Gillam 2016 [33] | OS | III | Fluorouracil and folinic acid | Rand. OL | Karnofsky ≥70(ECOG 1) | 417 | 1.9 | NS |
COMPASS Clinical Evidence of Orphan Medicinal Products – an ASSessment tool, DB double-blind, DFSP Dermatofibrosarcoma protuberans, ECOG Eastern Cooperative Oncology Group, EFS event-free survival, GIST gastrointestinal stromal tumor, HCC hepatocellular carcinoma, IFN-α interferon alfa, NE not evaluated, NS no significant improvement, ORR overall response rate, OS overall survival, PFS progression-free survival, PLD pegylated liposomal doxorubicin, pNET pancreatic neuroendocrine tumor, PLD pegylated liposomal doxorubicin, Rand DB randomized double-blind, Rand OL randomized open-label, RCC renal cell carcinoma, STS soft tissue sarcoma, TTP time to tumor progression
a Pivotal study was terminated early