Novartis Study of Afinitor in Advanced Liver Cancer Does Not Meet Primary Endpoint of Overall Survival

Novartis has announced that results of a global Phase III study showed that Afinitor (everolimus) did not extend overall survival compared to placebo in patients with locally advanced or metastatic hepatocellular carcinoma (HCC) after progression on or intolerance to sorafenib[1]. Hepatocellular carcinoma, an aggressive and debilitating cancer, is the most common type of liver cancer[2].Novartis will not proceed with regulatory filings of Afinitor in this indication.

"While we are disappointed with these results, Novartis remains committed to studying everolimus through a robust research and development programme to address unmet needs in different types of cancer," said Alessandro Riva, Global Head, Oncology Development & Medical Affairs, Novartis Oncology. "To date, Afinitor has proven efficacy in a number of tumour types, including hormone receptor positive advanced breast cancer, advanced pancreatic neuroendocrine tumours and advanced renal cell carcinoma."

The results of the HCC trial do not affect the worldwide approvals of Afinitor for these other indications. Everolimus is also in Phase III development in other diseases, including gastrointestinal and lung neuroendocrine tumors (NET), HER2 positive breast cancer, lymphoma and tuberous sclerosis complex (TSC). Results of these trials are expected during 2014 and 2015.

Study Details
The Phase III study, EVOLVE-1 (EVerOlimus for LiVer cancer Evaluation-1), is a randomised, double-blind, placebo-controlled trial examining the efficacy and safety of everolimus versus placebo, plus best supportive care (BSC), in adult patients with advanced HCC whose disease progressed after treatment with or who were intolerant to sorafenib, a targeted therapy[3]. The study results continue to be evaluated and will be presented at an upcoming medical conference.

EVOLVE-1 involved 546 patients and was conducted at 156 sites worldwide. Patients in the trial were randomised (2:1) to receive therapy with everolimus 7.5 mg/day orally plus BSC or placebo plus BSC. The primary endpoint was overall survival. Secondary endpoints included time to tumour progression, disease control rate,time to deterioration of performance status, safety and quality of life[1][3].

References
[1] Data on file.

[2] Faloppi L. et al. Evolving strategies for the treatment of hepatocellular carcinoma: from clinical-guided to molecularly-tailored therapeutic options. Cancer Treat Rev. 2011; 37(3):169-77.

[3] US National Institutes of Health. Global Study Looking at the Combination of RAD001 Plus Best Supportive Care (BSC) and Placebo Plus BSC to Treat Patients With Advanced Hepatocellular Carcinoma (EVOLVE-1). Available at https://clinicaltrials.gov/ct2/show/NCT01035229?term=EVOLVE-1&rank=1. Accessed August 2013.