Gastric (stomach) cancer kills over 865,000 people every year, and its incidence in young people is increasing. Anti-angiogenesis agents can be effective in stomach cancer but until now there have been no biomarkers to predict outcomes. According to research at the AACR-NCI-EORTC International Conference, levels of the soluble form of VEGFR2 could predict length of improvement for patients treated with the anti-angiogenesis drug telatinib.
Telatinib has orphan drug status for stomach cancer, is an oral inhibitor of the vascular endothelial growth factor receptor (VEGFR) and acts by blocking VEGFR and platelet derived growth factor receptor (PDGFR), inhibiting the growth of new blood vessels and therefore starving tumors. In a Phase II trial, patients with stomach cancer were treated with telatinib, capecitabine and cisplatin and their levels of the soluble form of VEGFR2 (sVEGFR2), a marker of angiogenesis, were measured. Those patients whose levels of this biomarker fell by more than a third had a lower risk of disease progression and death, with progression-free survival of around 12 months compared with around 5 months in patients with a lower decrease in sVEGFR2.
"The importance of angiogenesis in metastatic disease and poor outcome in stomach cancer is well documented. However, to date, a biomarker that correlates with anti-angiogenic treatment outcome has not been identified," said Lori Kunkel, M.D., chief medical officer for ACT Biotech and lead author of the study. "In our study, we saw a marked decrease in sVEGFR2 in response to telatinib treatment and hence, sVEGFR2 may be a quantitative biomarker that will allow us to identify patients that achieve the best response to telatinib. We intend to integrate this biomarker in upcoming trials of telatinib."
Because stomach cancer is often detected late, it is hard to treat, and many people do not respond to standard chemotherapy. Finding a biomarker for angiogenesis-targeted treatment could improve outcomes for these patients by selecting those who would be most likely to respond. Biomarkers like this may also help speed up drug development by allowing biopharma companies to conduct more targeted trials. However, as with all targeted therapies, these do leave an unmet need for those patients who will not respond.
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