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Schmitz S, Kaminsky-Forrett MC, Henry S, Zanetta S, Geoffrois L, Bompas E, Moxhon A, Mignion L, Guigay J, Knoops L, Hamoir M, Machiels JP. Phase II study of figitumumab in patients with recurrent and/or metastatic squamous cell carcinoma of the head and neck: clinical activity and molecular response (GORTEC 2008-02). Ann Oncol 2012; 23:2153-2161. [PMID: 22234739 DOI: 10.1093/annonc/mdr574] [Citation(s) in RCA: 55] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/06/2023] Open
Abstract
BACKGROUND Preclinical studies suggest that insulin-like growth factor-1 receptor (IGF-1R) blockage could be a promising therapeutic target in squamous cell carcinoma of the head and neck (SCCHN). Therefore, we investigated the efficacy and toxicity of figitumumab, an anti-IGF-1R monoclonal antibody, in palliative SCCHN. PATIENTS AND METHODS Patients with palliative SCCHN progressing after platinum-based therapy were treated with figitumumab i.v. 20 mg/kg, every 3 weeks. The primary end point was the disease control rate at 6-8 weeks after treatment initiation. Tumor biopsies and plasma samples were collected before and after figitumumab administration to monitor the molecular response. RESULTS Seventeen patients were included. Only two patients achieved stable disease at 6-8 weeks. Median overall survival and progression-free survival were 63 and 52 days, respectively. The main grade 3-4 adverse event was hyperglycemia (41%). Translational research showed that figitumumab downregulated IGF-1R at the surface of tumor cells with activation of the epidermal growth factor receptor (EGFR) pathway, as shown by the upregulation of p-EGFR in tumor cells (P=0.016), and an increase in the plasma level of tumor growth factor-alpha (P=0.006). CONCLUSION Figitumumab monotherapy has no clinically significant activity in unselected palliative SCCHN.
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MESH Headings
- Antibodies, Monoclonal
- Biopsy
- Carcinoma, Squamous Cell/blood
- Carcinoma, Squamous Cell/drug therapy
- Carcinoma, Squamous Cell/genetics
- Carcinoma, Squamous Cell/pathology
- Gene Expression Profiling
- Head and Neck Neoplasms/blood
- Head and Neck Neoplasms/drug therapy
- Head and Neck Neoplasms/genetics
- Head and Neck Neoplasms/pathology
- Humans
- Immunoglobulins, Intravenous/adverse effects
- Immunoglobulins, Intravenous/immunology
- Immunoglobulins, Intravenous/therapeutic use
- Receptor, IGF Type 1/antagonists & inhibitors
- Receptor, IGF Type 1/immunology
- Reverse Transcriptase Polymerase Chain Reaction
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Affiliation(s)
- S Schmitz
- Cancer Center; Department of Medical Oncology, University Hospital St-Luc, Catholic University Louvain, Brussels, Belgium; Head and Neck Surgery, University Hospital St-Luc, Catholic University Louvain, Brussels, Belgium
| | | | - S Henry
- Department of Medical Oncology, Catholic University Louvain, Mont-Godinne and St-Elisabeth, Namur, Belgium
| | - S Zanetta
- Department of Medical Oncology, Center G-F Leclerc, Dijon
| | - L Geoffrois
- Department of Medical Oncology, Center Alexis Vautrin, Nancy, France
| | - E Bompas
- Department of Medical Oncology, Center René Gauducheau, Nantes
| | - A Moxhon
- Cancer Center; Department of Medical Oncology, University Hospital St-Luc, Catholic University Louvain, Brussels, Belgium
| | - L Mignion
- Cancer Center; Department of Medical Oncology, University Hospital St-Luc, Catholic University Louvain, Brussels, Belgium
| | - J Guigay
- Department of Medical Oncology, Gustave Roussy Institut, Villejuif, France
| | - L Knoops
- Cancer Center; Ludwig Institute for Cancer Research; Department of Hematology, University Hospital St-Luc, Catholic University Louvain, Brussels, Belgium
| | - M Hamoir
- Cancer Center; Head and Neck Surgery, University Hospital St-Luc, Catholic University Louvain, Brussels, Belgium
| | - J-P Machiels
- Cancer Center; Department of Medical Oncology, University Hospital St-Luc, Catholic University Louvain, Brussels, Belgium; Head and Neck Surgery, University Hospital St-Luc, Catholic University Louvain, Brussels, Belgium.
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