Selumetinib in combination with dacarbazine in patients with metastatic uveal melanoma: A Phase III, Multicenter, Randomized Trial (SUMIT)

Carvajal RD, Piperno-Neumann S, Kapiteijn E, Chapman PB, Frank S, Joshua AM, Piulats JM, Wolter P, Cocquyt V, Chmielowski B, Evans TRJ, Gastaud L, Linette G, Berking C, Schachter J, Rodrigues MJ, Shoushtari AN, Clemett D, Ghiorghiu D, Mariani G, Spratt S, Lovick S, Barker P, Kilgour E, Lai Z, Schwartz GK, Nathan P (2018)

Publication Type: Journal article

Publication year: 2018

Journal

Book Volume: 36

Pages Range: 1232-1239

Journal Issue: 12

DOI: 10.1200/JCO.2017.74.1090

Abstract

Purpose Uveal melanoma is the most common primary intraocular malignancy in adults with no effective systemic treatment option in the metastatic setting. Selumetinib (AZD6244, ARRY-142886) is an oral, potent, and selective MEK1/2 inhibitor with a short half-life, which demonstrated single-agent activity in patients with metastatic uveal melanoma in a randomized phase II trial. Methods The Selumetinib (AZD6244: ARRY-142886) (Hyd-Sulfate) in Metastatic Uveal Melanoma (SUMIT) study was a phase III, double-blind trial (ClinicalTrial.gov identifier: NCT01974752) in which patients with metastatic uveal melanoma and no prior systemic therapy were randomly assigned (3:1) to selumetinib (75 mg twice daily) plus dacarbazine (1,000 mg/m2 intravenously on day 1 of every 21- day cycle) or placebo plus dacarbazine. The primary end point was progression-free survival (PFS) by blinded independent central radiologic review. Secondary end points included overall survival and objective response rate. Results A total of 129 patients were randomly assigned to receive selumetinib plus dacarbazine (n = 97) or placebo plus dacarbazine (n = 32). In the selumetinib plus dacarbazine group, 82 patients (85%) experienced a PFS event, compared with 24 (75%) in the placebo plus dacarbazine group (median, 2.8 v 1.8 months); the hazard ratio for PFS was 0.78 (95% CI, 0.48 to 1.27; two-sided P =.32). The objective response rate was 3% with selumetinib plus dacarbazine and 0% with placebo plus dacarbazine (two-sided P =.36). At 37% maturity (n = 48 deaths), analysis of overall survival gave a hazard ratio of 0.75 (95% CI, 0.39 to 1.46; two-sided P =.40). The most frequently reported adverse events (selumetinib plus dacarbazine v placebo plus dacarbazine) were nausea (62% v 19%), rash (57% v 6%), fatigue (44% v 47%), diarrhea (44% v 22%), and peripheral edema (43% v 6%). Conclusion In patients with metastatic uveal melanoma, the combination of selumetinib plus dacarbazine had a tolerable safety profile but did not significantly improve PFS comparedwith placebo plus dacarbazine.

Authors with CRIS profile

Involved external institutions

Columbia University United States (USA) (US) Klinikum der Universität München (Großhadern und Innenstadt) Germany (DE) Chaim Sheba Medical Center at Tel HaShomer / המרכז הרפואי עש חיים שיבא – תל השומר‎‎ Israel (IL) Institut Curie France (FR) Memorial Sloan Kettering Cancer Center United States (USA) (US) AstraZeneca UK Limited United Kingdom (GB) Leiden University Netherlands (NL) Hebrew University of Jerusalem Israel (IL) University of Toronto Canada (CA) Catalan Institute of Oncology / Institut Català d'Oncologia (ICO) Spain (ES) University Hospital Leuven (UZ) / Universitaire ziekenhuizen Leuven Belgium (BE) University Hospital Ghent Belgium (BE) University of California Los Angeles (UCLA) United States (USA) (US) University of Glasgow United Kingdom (GB) Centre Antoine Lacassagne (UNICANCER) France (FR) Washington University United States (USA) (US) Mount Vernon Cancer Centre United Kingdom (GB)

How to cite

APA:

Carvajal, R.D., Piperno-Neumann, S., Kapiteijn, E., Chapman, P.B., Frank, S., Joshua, A.M.,... Nathan, P. (2018). Selumetinib in combination with dacarbazine in patients with metastatic uveal melanoma: A Phase III, Multicenter, Randomized Trial (SUMIT). Journal of Clinical Oncology, 36(12), 1232-1239. https://doi.org/10.1200/JCO.2017.74.1090

MLA:

Carvajal, Richard D., et al. "Selumetinib in combination with dacarbazine in patients with metastatic uveal melanoma: A Phase III, Multicenter, Randomized Trial (SUMIT)." Journal of Clinical Oncology 36.12 (2018): 1232-1239.

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