Evidence map›Paper›PMID 25057173›Full record

Trial reportAnnals of oncology : official journal of the European Society for Medical Oncology2014

EGFR biomarkers predict benefit from vandetanib in combination with docetaxel in a randomized phase III study of second-line treatment of patients with advanced non-small cell lung cancer.

J V Heymach, S J Lockwood, R S Herbst, B E Johnson, A J Ryan

Registry-linked trialOpen access · bronzeAbstract readClinical Trial, Phase IIIRandomized Controlled Trial
In one paragraph

Trial report in Annals of oncology : official journal of the European Society for Medical Oncology, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00312377 (A Phase III, Randomized, Double-Blinded, Multi-Center, Study to Assess the Efficacy of Docetaxel), which is not on this map. Cited by 10 papers.

0numbers the graph read from it
0cells of the map it votes in
10citing papers in PubMed
3.6field-weighted citation impact, top 7% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT00312377 phase3completednot on this map

A Phase III, Randomized, Double-Blinded, Multi-Center, Study to Assess the Efficacy of Docetaxel (TAXOTERE™) in Combination With ZD6474 (ZACTIMA™) Versus Docetaxel (TAXOTERE™) With Placebo in Subjects With Locally Advanced or Metastatic NSCLC

TypeinterventionalSponsorGenzyme, a Sanofi CompanyRan2006 to 2014Enrolled1,690ConditionsNon-small Cell Lung Cancer, Lung CancerArmsDocetaxel, Vandetanib
3 · Its place in the literature

Who cites it

10 citing papers in PubMed, 22 citations in OpenAlex.

  1. Review
  2. Article
  3. Article
  4. Article
  5. Article
  6. Article
  7. Article
  8. Review
  9. Second-line combination therapies in nonsmall cell lung cancer without known driver mutations.European respiratory review : an official journal of the European Respiratory Society · 2015
    Review
  10. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 5 institutions in 2 countries.

J V HeymachDivision of Cancer Medicine, Department of Thoracic/Head and Neck Medical Oncology, University of Texas M.D. Anderson Cancer Center, Houston, USA.
S J LockwoodOncology iMED, AstraZeneca, Macclesfield, UK.
R S HerbstSection of Medical Oncology, Yale Cancer Center and Smilow Cancer Hospital, Yale, New Haven.
B E JohnsonDepartment of Medical Oncology, Dana-Farber Cancer Institute and Brigham and Women's Hospital, Boston, USA; Department of Medicine, Dana-Farber Cancer Institute and Brigham and Women's Hospital, Boston, USA.
A J RyanDepartment of Oncology, University of Oxford, Oxford, UK. Electronic address: anderson.ryan@oncology.ox.ac.uk.
AstraZeneca (United Kingdom) · GBDana-Farber Brigham Cancer Center · USThe University of Texas MD Anderson Cancer Center · USUniversity of Oxford · GBYale Cancer Center · US

Funding

Tumor Evolution and Metastasis ProgramP30CA016672 · NCI · UNIVERSITY OF TX MD ANDERSON CAN CTR · PI Scott Kopetz · 1985 to 2026
$290.8M
Medical Research Council MC_PC_12006NCI NIH HHS P30 CA016672
6 · The paper itself

Abstract

backgroundZODIAC was a randomized phase III study of second-line treatment in patients with advanced non-small cell lung cancer (NSCLC) that evaluated the addition of vandetanib to docetaxel. The study showed a statistically significant improvement in progression-free survival and objective response rate, but not in overall survival for unselected patients. This study evaluated epidermal growth factor receptor (EGFR) gene mutation, copy number gain, and protein expression, and KRAS gene mutation, in pretreatment tumor samples as potential biomarkers predicting benefit from vandetanib as second-line treatment of NSCLC. PATIENTS AND

methodsAfter progression following first-line chemotherapy, 1391 patients with locally advanced or metastatic (stage IIIB/IV) NSCLC were randomized 1 : 1 to receive vandetanib (100 mg/day) plus docetaxel (75 mg/m(2) every 21 days) or placebo plus docetaxel in the ZODIAC study. Archival tumor samples (n = 570) were collected from consenting patients (n = 958) for predefined, prospective biomarker analyses.

resultsOf evaluable samples, 14% were EGFR mutation positive, 35% were EGFR FISH positive, 88% were EGFR protein expression positive, and 13% were KRAS mutation positive. Compared with the overall study population, in which progression-free survival (PFS) [hazard ratio (HR) = 0.79] but not OS (HR = 0.91) were significantly improved with vandetanib, there was greater relative clinical benefit for patients with EGFR mutation-positive tumors [PFS HR 0.51, confidence interval (CI) 0.25-1.06 and OS HR 0.46, CI 0.14-1.57] and EGFR FISH-positive tumors (PFS HR 0.61, CI 0.39-0.94 and OS HR 0.48, CI 0.28-0.84). Similarly, patients with EGFR mutation or FISH-positive tumor samples who received vandetanib had an increased chance of objective tumor response (odds ratios 3.34, CI 0.8-13.89, and 3.90, CI 1.02-14.82, respectively). There did not appear to be benefit for vandetanib in patients with KRAS mutation-positive tumors.

conclusionsHigh EGFR gene copy number or activating EGFR mutations may identify patient subgroups who receive increased clinical benefit from vandetanib in combination with docetaxel in second-line NSCLC. CLINICALTRIALSGOV: NCT00312377.

Indexed as

Antineoplastic Combined Chemotherapy ProtocolsBiomarkers, TumorCarcinoma, Non-Small-Cell LungDisease-Free SurvivalDocetaxelErbB ReceptorsFemaleGene DosageHumansMaleMutationPiperidinesPrognosisProto-Oncogene ProteinsProto-Oncogene Proteins p21(ras)QuinazolinesBiomarkers, TumorDocetaxelEGFR protein, humanErbB ReceptorsKRAS protein, humanPiperidinesProto-Oncogene ProteinsProto-Oncogene Proteins p21(ras)Quinazolinesras ProteinsTaxoidsvandetanibdocetaxelEGFRKRASlung cancervandetanib

Identifiers

PMID25057173
PMCPMC4176452
OpenAlexW2119002966

What OpenQuestion holds

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.