Pexidartinib improves physical functioning and stiffness in patients with tenosynovial giant cell tumor: Results from the ENLIVEN randomized clinical trial Journal Article


Authors: Van De Sande, M.; Tap, W. D.; Gelhorn, H. L.; Ye, X.; Speck, R. M.; Palmerini, E.; Stacchiotti, S.; Desai, J.; Wagner, A. J.; Alcindor, T.; Ganjoo, K.; Martín-Broto, J.; Wang, Q.; Shuster, D.; Gelderblom, H.; Healey, J. H.
Article Title: Pexidartinib improves physical functioning and stiffness in patients with tenosynovial giant cell tumor: Results from the ENLIVEN randomized clinical trial
Abstract: Background and purpose — The ENLIVEN trial showed that, after 25 weeks, pexidartinib statistically significantly reduced tumor size more than placebo in patients with symptomatic, advanced tenosynovial giant cell tumor (TGCT) for whom surgery was not recommended. Here, we detail the effect of pexidartinib on patient-reported physical function and stiffness in ENLIVEN. Patients and methods — This was a planned analysis of patient-reported outcome data from ENLIVEN, a double-blinded, randomized phase 3 trial of adults with symptomatic, advanced TGCT treated with pexidartinib or placebo. Physical function was assessed using the Patient-Reported Outcomes Measurement Information System (PROMIS)-physical function (PF), and worst stiffness was assessed using a numerical rating scale (NRS). A mixed model for repeated measures was used to compare changes in PROMIS-PF and worst stiffness NRS scores from baseline to week 25 between treatment groups. Response rates for the PROMIS-PF and worst stiffness NRS at week 25 were calculated based on threshold estimates from reliable change index and anchor-based methods. Results — Between baseline and week 25, greater improvements in physical function and stiffness were experienced by patients receiving pexidartinib than patients receiving placebo (change in PROMIS-PF = 4.1 [95% confidence interval (CI) 1.8–6.3] vs. –0.9 [CI −3.0 to 1.2]; change in worst stiffness NRS = –2.5 [CI −3.0 to −1.9] vs. –0.3 [CI −0.9 to 0.3]). Patients receiving pexidartinib had higher response rates than patients receiving placebo for meaningful improvements in physical function and stiffness. Improvements were sustained after 50 weeks of pexidartinib treatment. Interpretation — Pexidartinib treatment provided sustained, meaningful improvements in physical function and stiffness for patients with symptomatic, advanced TGCT. © 2021 The Author(s). Published by Taylor & Francis on behalf of the Nordic Orthopedic Federation.
Journal Title: Acta Orthopaedica
Volume: 92
Issue: 4
ISSN: 1745-3674
Publisher: Informa Healthcare  
Date Published: 2021-01-01
Start Page: 493
End Page: 499
Language: English
DOI: 10.1080/17453674.2021.1922161
PUBMED: 33977825
PROVIDER: scopus
PMCID: PMC8382018
DOI/URL:
Notes: Article -- Export Date: 1 September 2021 -- Source: Scopus
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  1. John H Healey
    547 Healey
  2. William Douglas Tap
    372 Tap