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LTBK-06. IMPACT OF VORASIDENIB TREATMENT ON MUTANT IDH1 OR IDH2 DIFFUSE GLIOMA TUMOR GROWTH RATE: RESULTS FROM THE RANDOMIZED, DOUBLE-BLIND, PHASE 3 INDIGO STUDY

Abstract INTRODUCTION The INDIGO study (NCT04164901) showed that vorasidenib, an oral, brain-penetrant, dual inhibitor of mutant isocitrate dehydrogenase (mIDH) 1/2, significantly improved imaging-based progression-free survival and time-to-next-intervention compared with placebo in patients with gr...

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Published in:Neuro-oncology (Charlottesville, Va.) Va.), 2023-11, Vol.25 (Supplement_5), p.v310-v311
Main Authors: Wen, Patrick, Mellinghoff, Ingo, van den Bent, Martin, Blumenthal, Deborah, Touat, Mehdi, Peters, Katherine, Clarke, Jennifer, Mendez, Joe, Yust-Katz, Shlomit, Mason, Warren, Ducray, Francois, Umemura, Yoshie, Nabors, L Burt, Holdhoff, Matthias, Hottinger, Andreas, Arakawa, Yoshiki, Sepúlveda, Juan, Wick, Wolfgang, Soffietti, Riccardo, Perry, James, Giglio, Pierre, de la Fuente, Macarena, Maher, Elizabeth, Zhao, Dan, Pandya, Shuchi, Steelman, Lori, Hassan, Islam, Cloughesy, Timothy, Ellingson, Benjamin
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container_end_page v311
container_issue Supplement_5
container_start_page v310
container_title Neuro-oncology (Charlottesville, Va.)
container_volume 25
creator Wen, Patrick
Mellinghoff, Ingo
van den Bent, Martin
Blumenthal, Deborah
Touat, Mehdi
Peters, Katherine
Clarke, Jennifer
Mendez, Joe
Yust-Katz, Shlomit
Mason, Warren
Ducray, Francois
Umemura, Yoshie
Nabors, L Burt
Holdhoff, Matthias
Hottinger, Andreas
Arakawa, Yoshiki
Sepúlveda, Juan
Wick, Wolfgang
Soffietti, Riccardo
Perry, James
Giglio, Pierre
de la Fuente, Macarena
Maher, Elizabeth
Zhao, Dan
Pandya, Shuchi
Steelman, Lori
Hassan, Islam
Cloughesy, Timothy
Ellingson, Benjamin
description Abstract INTRODUCTION The INDIGO study (NCT04164901) showed that vorasidenib, an oral, brain-penetrant, dual inhibitor of mutant isocitrate dehydrogenase (mIDH) 1/2, significantly improved imaging-based progression-free survival and time-to-next-intervention compared with placebo in patients with grade 2 mIDH1/2 glioma previously treated with surgery only. Given the limitations of traditional bi-dimensional measurements, evaluating volumetry and tumor growth rate (TGR) is an additional method of measuring treatment effect in these diffuse growing tumors. METHODS Magnetic resonance imaging (MRI) scans were performed at baseline and every 12 weeks on-treatment; up to three pre-treatment MRI scans were requested when available. Tumor volumes were derived per blinded independent review committee using a semi-automated approach. TGR was defined as percentage change in tumor volume every 6 months. Patients with evaluable baseline and ≥ 1 MRI during the corresponding period were included in the analysis. The difference in TGR in each arm was assessed by slope of tumor growth over time using a linear mixed model. RESULTS 331 patients were randomized to vorasidenib (n=168) or placebo (n=163). Median follow-up was 14.2 months. On-treatment TGR was −2.5% (95% CI, −4.7, −0.2) with vorasidenib (n=167) and 13.9% (95% CI, 11.1, 16.8) with placebo (n=161). In patients with available imaging data, TGR pre- and post-treatment with vorasidenib (n=56) was 13.2% (95% CI, 10.3, 16.3) and −3.3% (95% CI, −5.2, −1.2), respectively, while placebo (n=67) was 18.3% (95% CI, 15.0, 21.7) and 12.2% (95% CI, 9.5, 14.9), respectively. In patients who crossed over from placebo with available imaging data (n=38), TGR pre- and post-crossover was 22.4% (95% CI, 15.7, 29.4) and 5.2% (95% CI, −3.8, 15.0), respectively. CONCLUSIONS Tumor growth was observed in patients with mIDH1/2 gliomas before receiving vorasidenib or placebo. Treatment with vorasidenib reduced the TGR and shrunk tumor volume, whereas continued growth in tumor volume was observed in patients receiving placebo.
doi_str_mv 10.1093/neuonc/noad179.1202
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IMPACT OF VORASIDENIB TREATMENT ON MUTANT IDH1 OR IDH2 DIFFUSE GLIOMA TUMOR GROWTH RATE: RESULTS FROM THE RANDOMIZED, DOUBLE-BLIND, PHASE 3 INDIGO STUDY</title><source>Oxford Journals Online</source><creator>Wen, Patrick ; Mellinghoff, Ingo ; van den Bent, Martin ; Blumenthal, Deborah ; Touat, Mehdi ; Peters, Katherine ; Clarke, Jennifer ; Mendez, Joe ; Yust-Katz, Shlomit ; Mason, Warren ; Ducray, Francois ; Umemura, Yoshie ; Nabors, L Burt ; Holdhoff, Matthias ; Hottinger, Andreas ; Arakawa, Yoshiki ; Sepúlveda, Juan ; Wick, Wolfgang ; Soffietti, Riccardo ; Perry, James ; Giglio, Pierre ; de la Fuente, Macarena ; Maher, Elizabeth ; Zhao, Dan ; Pandya, Shuchi ; Steelman, Lori ; Hassan, Islam ; Cloughesy, Timothy ; Ellingson, Benjamin</creator><creatorcontrib>Wen, Patrick ; Mellinghoff, Ingo ; van den Bent, Martin ; Blumenthal, Deborah ; Touat, Mehdi ; Peters, Katherine ; Clarke, Jennifer ; Mendez, Joe ; Yust-Katz, Shlomit ; Mason, Warren ; Ducray, Francois ; Umemura, Yoshie ; Nabors, L Burt ; Holdhoff, Matthias ; Hottinger, Andreas ; Arakawa, Yoshiki ; Sepúlveda, Juan ; Wick, Wolfgang ; Soffietti, Riccardo ; Perry, James ; Giglio, Pierre ; de la Fuente, Macarena ; Maher, Elizabeth ; Zhao, Dan ; Pandya, Shuchi ; Steelman, Lori ; Hassan, Islam ; Cloughesy, Timothy ; Ellingson, Benjamin</creatorcontrib><description>Abstract INTRODUCTION The INDIGO study (NCT04164901) showed that vorasidenib, an oral, brain-penetrant, dual inhibitor of mutant isocitrate dehydrogenase (mIDH) 1/2, significantly improved imaging-based progression-free survival and time-to-next-intervention compared with placebo in patients with grade 2 mIDH1/2 glioma previously treated with surgery only. Given the limitations of traditional bi-dimensional measurements, evaluating volumetry and tumor growth rate (TGR) is an additional method of measuring treatment effect in these diffuse growing tumors. METHODS Magnetic resonance imaging (MRI) scans were performed at baseline and every 12 weeks on-treatment; up to three pre-treatment MRI scans were requested when available. Tumor volumes were derived per blinded independent review committee using a semi-automated approach. TGR was defined as percentage change in tumor volume every 6 months. Patients with evaluable baseline and ≥ 1 MRI during the corresponding period were included in the analysis. The difference in TGR in each arm was assessed by slope of tumor growth over time using a linear mixed model. RESULTS 331 patients were randomized to vorasidenib (n=168) or placebo (n=163). Median follow-up was 14.2 months. On-treatment TGR was −2.5% (95% CI, −4.7, −0.2) with vorasidenib (n=167) and 13.9% (95% CI, 11.1, 16.8) with placebo (n=161). In patients with available imaging data, TGR pre- and post-treatment with vorasidenib (n=56) was 13.2% (95% CI, 10.3, 16.3) and −3.3% (95% CI, −5.2, −1.2), respectively, while placebo (n=67) was 18.3% (95% CI, 15.0, 21.7) and 12.2% (95% CI, 9.5, 14.9), respectively. In patients who crossed over from placebo with available imaging data (n=38), TGR pre- and post-crossover was 22.4% (95% CI, 15.7, 29.4) and 5.2% (95% CI, −3.8, 15.0), respectively. CONCLUSIONS Tumor growth was observed in patients with mIDH1/2 gliomas before receiving vorasidenib or placebo. Treatment with vorasidenib reduced the TGR and shrunk tumor volume, whereas continued growth in tumor volume was observed in patients receiving placebo.</description><identifier>ISSN: 1522-8517</identifier><identifier>EISSN: 1523-5866</identifier><identifier>DOI: 10.1093/neuonc/noad179.1202</identifier><language>eng</language><publisher>US: Oxford University Press</publisher><ispartof>Neuro-oncology (Charlottesville, Va.), 2023-11, Vol.25 (Supplement_5), p.v310-v311</ispartof><rights>The Author(s) 2023. Published by Oxford University Press on behalf of the Society for Neuro-Oncology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com. 2023</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c1332-e4120f0e8b0ae0067924ac6949cecef8a99229e454e7eec00b4beeaa19a7449f3</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>315,786,790,27957,27958</link.rule.ids></links><search><creatorcontrib>Wen, Patrick</creatorcontrib><creatorcontrib>Mellinghoff, Ingo</creatorcontrib><creatorcontrib>van den Bent, Martin</creatorcontrib><creatorcontrib>Blumenthal, Deborah</creatorcontrib><creatorcontrib>Touat, Mehdi</creatorcontrib><creatorcontrib>Peters, Katherine</creatorcontrib><creatorcontrib>Clarke, Jennifer</creatorcontrib><creatorcontrib>Mendez, Joe</creatorcontrib><creatorcontrib>Yust-Katz, Shlomit</creatorcontrib><creatorcontrib>Mason, Warren</creatorcontrib><creatorcontrib>Ducray, Francois</creatorcontrib><creatorcontrib>Umemura, Yoshie</creatorcontrib><creatorcontrib>Nabors, L Burt</creatorcontrib><creatorcontrib>Holdhoff, Matthias</creatorcontrib><creatorcontrib>Hottinger, Andreas</creatorcontrib><creatorcontrib>Arakawa, Yoshiki</creatorcontrib><creatorcontrib>Sepúlveda, Juan</creatorcontrib><creatorcontrib>Wick, Wolfgang</creatorcontrib><creatorcontrib>Soffietti, Riccardo</creatorcontrib><creatorcontrib>Perry, James</creatorcontrib><creatorcontrib>Giglio, Pierre</creatorcontrib><creatorcontrib>de la Fuente, Macarena</creatorcontrib><creatorcontrib>Maher, Elizabeth</creatorcontrib><creatorcontrib>Zhao, Dan</creatorcontrib><creatorcontrib>Pandya, Shuchi</creatorcontrib><creatorcontrib>Steelman, Lori</creatorcontrib><creatorcontrib>Hassan, Islam</creatorcontrib><creatorcontrib>Cloughesy, Timothy</creatorcontrib><creatorcontrib>Ellingson, Benjamin</creatorcontrib><title>LTBK-06. IMPACT OF VORASIDENIB TREATMENT ON MUTANT IDH1 OR IDH2 DIFFUSE GLIOMA TUMOR GROWTH RATE: RESULTS FROM THE RANDOMIZED, DOUBLE-BLIND, PHASE 3 INDIGO STUDY</title><title>Neuro-oncology (Charlottesville, Va.)</title><description>Abstract INTRODUCTION The INDIGO study (NCT04164901) showed that vorasidenib, an oral, brain-penetrant, dual inhibitor of mutant isocitrate dehydrogenase (mIDH) 1/2, significantly improved imaging-based progression-free survival and time-to-next-intervention compared with placebo in patients with grade 2 mIDH1/2 glioma previously treated with surgery only. Given the limitations of traditional bi-dimensional measurements, evaluating volumetry and tumor growth rate (TGR) is an additional method of measuring treatment effect in these diffuse growing tumors. METHODS Magnetic resonance imaging (MRI) scans were performed at baseline and every 12 weeks on-treatment; up to three pre-treatment MRI scans were requested when available. Tumor volumes were derived per blinded independent review committee using a semi-automated approach. TGR was defined as percentage change in tumor volume every 6 months. Patients with evaluable baseline and ≥ 1 MRI during the corresponding period were included in the analysis. The difference in TGR in each arm was assessed by slope of tumor growth over time using a linear mixed model. RESULTS 331 patients were randomized to vorasidenib (n=168) or placebo (n=163). Median follow-up was 14.2 months. On-treatment TGR was −2.5% (95% CI, −4.7, −0.2) with vorasidenib (n=167) and 13.9% (95% CI, 11.1, 16.8) with placebo (n=161). In patients with available imaging data, TGR pre- and post-treatment with vorasidenib (n=56) was 13.2% (95% CI, 10.3, 16.3) and −3.3% (95% CI, −5.2, −1.2), respectively, while placebo (n=67) was 18.3% (95% CI, 15.0, 21.7) and 12.2% (95% CI, 9.5, 14.9), respectively. In patients who crossed over from placebo with available imaging data (n=38), TGR pre- and post-crossover was 22.4% (95% CI, 15.7, 29.4) and 5.2% (95% CI, −3.8, 15.0), respectively. CONCLUSIONS Tumor growth was observed in patients with mIDH1/2 gliomas before receiving vorasidenib or placebo. Treatment with vorasidenib reduced the TGR and shrunk tumor volume, whereas continued growth in tumor volume was observed in patients receiving placebo.</description><issn>1522-8517</issn><issn>1523-5866</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><recordid>eNqNUM1OhDAYJEYTdfUJvPQBhG3Lb72VpUAj0A0UjV5IF0ui0WUD2YOP45vadfcBPM3MN5lJvrGsOwQdBIm73Or9uO2X21G9oZA4CEN8Zl0hH7u2HwXB-R_HduSj8NK6nucPCDHyA3Rl_RQyfrRh4ABerulKApGCJ1HThies4jGQNaOyZJUxKlC2khrGkxwBUR8Qg4SnadswkBVclBTItjROVotnmYOaSvYAata0hWxAWosSyJyZc5WIkr-y5B4koo0LZscFr4xa59RUucAIngnQyDZ5ubEuBvU569sTLqw2ZXKV24XI-IoWdo9cF9vaM18PUEcbqDSEQUiwp_qAeKTXvR4iRQjGRHu-p0Otewg33kZrpRBRoeeRwV1Y7rG3n8Z5nvTQ7ab3LzV9dwh2h5W748rdaeXusLJJOcfUuN_9K_ALol92CQ</recordid><startdate>20231110</startdate><enddate>20231110</enddate><creator>Wen, Patrick</creator><creator>Mellinghoff, Ingo</creator><creator>van den Bent, Martin</creator><creator>Blumenthal, Deborah</creator><creator>Touat, Mehdi</creator><creator>Peters, Katherine</creator><creator>Clarke, Jennifer</creator><creator>Mendez, Joe</creator><creator>Yust-Katz, Shlomit</creator><creator>Mason, Warren</creator><creator>Ducray, Francois</creator><creator>Umemura, Yoshie</creator><creator>Nabors, L Burt</creator><creator>Holdhoff, Matthias</creator><creator>Hottinger, Andreas</creator><creator>Arakawa, Yoshiki</creator><creator>Sepúlveda, Juan</creator><creator>Wick, Wolfgang</creator><creator>Soffietti, Riccardo</creator><creator>Perry, James</creator><creator>Giglio, Pierre</creator><creator>de la Fuente, Macarena</creator><creator>Maher, Elizabeth</creator><creator>Zhao, Dan</creator><creator>Pandya, Shuchi</creator><creator>Steelman, Lori</creator><creator>Hassan, Islam</creator><creator>Cloughesy, Timothy</creator><creator>Ellingson, Benjamin</creator><general>Oxford University Press</general><scope>AAYXX</scope><scope>CITATION</scope></search><sort><creationdate>20231110</creationdate><title>LTBK-06. 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IMPACT OF VORASIDENIB TREATMENT ON MUTANT IDH1 OR IDH2 DIFFUSE GLIOMA TUMOR GROWTH RATE: RESULTS FROM THE RANDOMIZED, DOUBLE-BLIND, PHASE 3 INDIGO STUDY</atitle><jtitle>Neuro-oncology (Charlottesville, Va.)</jtitle><date>2023-11-10</date><risdate>2023</risdate><volume>25</volume><issue>Supplement_5</issue><spage>v310</spage><epage>v311</epage><pages>v310-v311</pages><issn>1522-8517</issn><eissn>1523-5866</eissn><abstract>Abstract INTRODUCTION The INDIGO study (NCT04164901) showed that vorasidenib, an oral, brain-penetrant, dual inhibitor of mutant isocitrate dehydrogenase (mIDH) 1/2, significantly improved imaging-based progression-free survival and time-to-next-intervention compared with placebo in patients with grade 2 mIDH1/2 glioma previously treated with surgery only. Given the limitations of traditional bi-dimensional measurements, evaluating volumetry and tumor growth rate (TGR) is an additional method of measuring treatment effect in these diffuse growing tumors. METHODS Magnetic resonance imaging (MRI) scans were performed at baseline and every 12 weeks on-treatment; up to three pre-treatment MRI scans were requested when available. Tumor volumes were derived per blinded independent review committee using a semi-automated approach. TGR was defined as percentage change in tumor volume every 6 months. Patients with evaluable baseline and ≥ 1 MRI during the corresponding period were included in the analysis. The difference in TGR in each arm was assessed by slope of tumor growth over time using a linear mixed model. RESULTS 331 patients were randomized to vorasidenib (n=168) or placebo (n=163). Median follow-up was 14.2 months. On-treatment TGR was −2.5% (95% CI, −4.7, −0.2) with vorasidenib (n=167) and 13.9% (95% CI, 11.1, 16.8) with placebo (n=161). In patients with available imaging data, TGR pre- and post-treatment with vorasidenib (n=56) was 13.2% (95% CI, 10.3, 16.3) and −3.3% (95% CI, −5.2, −1.2), respectively, while placebo (n=67) was 18.3% (95% CI, 15.0, 21.7) and 12.2% (95% CI, 9.5, 14.9), respectively. In patients who crossed over from placebo with available imaging data (n=38), TGR pre- and post-crossover was 22.4% (95% CI, 15.7, 29.4) and 5.2% (95% CI, −3.8, 15.0), respectively. CONCLUSIONS Tumor growth was observed in patients with mIDH1/2 gliomas before receiving vorasidenib or placebo. Treatment with vorasidenib reduced the TGR and shrunk tumor volume, whereas continued growth in tumor volume was observed in patients receiving placebo.</abstract><cop>US</cop><pub>Oxford University Press</pub><doi>10.1093/neuonc/noad179.1202</doi></addata></record>
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title LTBK-06. IMPACT OF VORASIDENIB TREATMENT ON MUTANT IDH1 OR IDH2 DIFFUSE GLIOMA TUMOR GROWTH RATE: RESULTS FROM THE RANDOMIZED, DOUBLE-BLIND, PHASE 3 INDIGO STUDY
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