1
|
Adjei AA, Bekaii-Saab TS, Berlin J, Philip PA, Mercade TM, Walter A, Cupit L, Liu R, Fields SZ, Holynskyj A. Phase 1b multi-indication study of the antibody drug conjugate anetumab ravtansine in patients with mesothelin-expressing advanced or recurrent malignancies. J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.15_suppl.tps2607] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
| | | | - Jordan Berlin
- Vanderbilt University Ingram Cancer Center, Nashville, TN
| | | | | | | | - Lisa Cupit
- Bayer HealthCare Pharmaceuticals, Inc., Whippany, NJ
| | - Rong Liu
- Bayer HealthCare Pharmaceuticals, Inc., Whippany, NJ
| | | | | |
Collapse
|
2
|
Dreyling M, Santoro A, Mollica L, Leppä S, Follows GA, Lenz G, Kim WS, Nagler A, Panayiotidis P, Demeter J, Özcan M, Kosinova M, Bouabdallah K, Morschhauser F, Stevens DA, Trevarthen D, Giurescu M, Cupit L, Liu L, Köchert K, Seidel H, Peña C, Yin S, Hiemeyer F, Garcia-Vargas J, Childs BH, Zinzani PL. Phosphatidylinositol 3-Kinase Inhibition by Copanlisib in Relapsed or Refractory Indolent Lymphoma. J Clin Oncol 2017; 35:3898-3905. [DOI: 10.1200/jco.2017.75.4648] [Citation(s) in RCA: 246] [Impact Index Per Article: 35.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Purpose Phosphatidylinositol 3-kinase (PI3K) signaling is critical for the proliferation and survival of malignant B cells. Copanlisib, a pan-class I PI3K inhibitor with predominant activity against PI3K-α and -δ isoforms, has demonstrated efficacy and a manageable safety profile in patients with indolent lymphoma. Patients and Methods In this phase II study, 142 patients with relapsed or refractory indolent lymphoma after two or more lines of therapy were enrolled to receive copanlisib 60 mg intravenously on days 1, 8, and 15 of a 28-day cycle. The primary end point was objective response rate; secondary end points included duration of response, progression-free survival, and overall survival. In addition, safety and gene expression were evaluated. Results Median age was 63 years (range, 25 to 82 years), and patients had received a median of three (range, two to nine) prior regimens. The objective response rate was 59% (84 of 142 patients); 12% of patients achieved a complete response. Median time to response was 53 days. Median duration of response was 22.6 months, median progression-free survival was 11.2 months, and median overall survival had not yet been reached. The most frequent treatment-emergent adverse events were transient hyperglycemia (all grades, 50%; grade 3 or 4, 41%) and transient hypertension (all grades, 30%; grade 3, 24%). Other grade ≥3 events included decreased neutrophil count (24%) and lung infection (15%). High response rates to copanlisib were associated with high expression of PI3K/B-cell receptor signaling pathway genes. Conclusion PI3K-α and -δ inhibition by copanlisib demonstrated significant efficacy and a manageable safety profile in heavily pretreated patients with relapsed or refractory indolent lymphoma.
Collapse
Affiliation(s)
- Martin Dreyling
- Martin Dreyling, Ludwig Maximilians University of Munich, Munich; Georg Lenz, University Hospital Münster, Münster; Marius Giurescu, Karl Köchert, Henrik Seidel, and Florian Hiemeyer, Bayer AG, Berlin, Germany; Armando Santoro, Humanitas Clinical and Research Center, Rozzano; Pier Luigi Zinzani, University of Bologna, Bologna, Italy; Luigina Mollica, Hôpital Maisonneuve-Rosemont, Montreal, Quebec, Canada; Sirpa Leppä, Helsinki University Central Hospital Cancer Center, Helsinki, Finland; George A
| | - Armando Santoro
- Martin Dreyling, Ludwig Maximilians University of Munich, Munich; Georg Lenz, University Hospital Münster, Münster; Marius Giurescu, Karl Köchert, Henrik Seidel, and Florian Hiemeyer, Bayer AG, Berlin, Germany; Armando Santoro, Humanitas Clinical and Research Center, Rozzano; Pier Luigi Zinzani, University of Bologna, Bologna, Italy; Luigina Mollica, Hôpital Maisonneuve-Rosemont, Montreal, Quebec, Canada; Sirpa Leppä, Helsinki University Central Hospital Cancer Center, Helsinki, Finland; George A
| | - Luigina Mollica
- Martin Dreyling, Ludwig Maximilians University of Munich, Munich; Georg Lenz, University Hospital Münster, Münster; Marius Giurescu, Karl Köchert, Henrik Seidel, and Florian Hiemeyer, Bayer AG, Berlin, Germany; Armando Santoro, Humanitas Clinical and Research Center, Rozzano; Pier Luigi Zinzani, University of Bologna, Bologna, Italy; Luigina Mollica, Hôpital Maisonneuve-Rosemont, Montreal, Quebec, Canada; Sirpa Leppä, Helsinki University Central Hospital Cancer Center, Helsinki, Finland; George A
| | - Sirpa Leppä
- Martin Dreyling, Ludwig Maximilians University of Munich, Munich; Georg Lenz, University Hospital Münster, Münster; Marius Giurescu, Karl Köchert, Henrik Seidel, and Florian Hiemeyer, Bayer AG, Berlin, Germany; Armando Santoro, Humanitas Clinical and Research Center, Rozzano; Pier Luigi Zinzani, University of Bologna, Bologna, Italy; Luigina Mollica, Hôpital Maisonneuve-Rosemont, Montreal, Quebec, Canada; Sirpa Leppä, Helsinki University Central Hospital Cancer Center, Helsinki, Finland; George A
| | - George A. Follows
- Martin Dreyling, Ludwig Maximilians University of Munich, Munich; Georg Lenz, University Hospital Münster, Münster; Marius Giurescu, Karl Köchert, Henrik Seidel, and Florian Hiemeyer, Bayer AG, Berlin, Germany; Armando Santoro, Humanitas Clinical and Research Center, Rozzano; Pier Luigi Zinzani, University of Bologna, Bologna, Italy; Luigina Mollica, Hôpital Maisonneuve-Rosemont, Montreal, Quebec, Canada; Sirpa Leppä, Helsinki University Central Hospital Cancer Center, Helsinki, Finland; George A
| | - Georg Lenz
- Martin Dreyling, Ludwig Maximilians University of Munich, Munich; Georg Lenz, University Hospital Münster, Münster; Marius Giurescu, Karl Köchert, Henrik Seidel, and Florian Hiemeyer, Bayer AG, Berlin, Germany; Armando Santoro, Humanitas Clinical and Research Center, Rozzano; Pier Luigi Zinzani, University of Bologna, Bologna, Italy; Luigina Mollica, Hôpital Maisonneuve-Rosemont, Montreal, Quebec, Canada; Sirpa Leppä, Helsinki University Central Hospital Cancer Center, Helsinki, Finland; George A
| | - Won Seog Kim
- Martin Dreyling, Ludwig Maximilians University of Munich, Munich; Georg Lenz, University Hospital Münster, Münster; Marius Giurescu, Karl Köchert, Henrik Seidel, and Florian Hiemeyer, Bayer AG, Berlin, Germany; Armando Santoro, Humanitas Clinical and Research Center, Rozzano; Pier Luigi Zinzani, University of Bologna, Bologna, Italy; Luigina Mollica, Hôpital Maisonneuve-Rosemont, Montreal, Quebec, Canada; Sirpa Leppä, Helsinki University Central Hospital Cancer Center, Helsinki, Finland; George A
| | - Arnon Nagler
- Martin Dreyling, Ludwig Maximilians University of Munich, Munich; Georg Lenz, University Hospital Münster, Münster; Marius Giurescu, Karl Köchert, Henrik Seidel, and Florian Hiemeyer, Bayer AG, Berlin, Germany; Armando Santoro, Humanitas Clinical and Research Center, Rozzano; Pier Luigi Zinzani, University of Bologna, Bologna, Italy; Luigina Mollica, Hôpital Maisonneuve-Rosemont, Montreal, Quebec, Canada; Sirpa Leppä, Helsinki University Central Hospital Cancer Center, Helsinki, Finland; George A
| | - Panayiotis Panayiotidis
- Martin Dreyling, Ludwig Maximilians University of Munich, Munich; Georg Lenz, University Hospital Münster, Münster; Marius Giurescu, Karl Köchert, Henrik Seidel, and Florian Hiemeyer, Bayer AG, Berlin, Germany; Armando Santoro, Humanitas Clinical and Research Center, Rozzano; Pier Luigi Zinzani, University of Bologna, Bologna, Italy; Luigina Mollica, Hôpital Maisonneuve-Rosemont, Montreal, Quebec, Canada; Sirpa Leppä, Helsinki University Central Hospital Cancer Center, Helsinki, Finland; George A
| | - Judit Demeter
- Martin Dreyling, Ludwig Maximilians University of Munich, Munich; Georg Lenz, University Hospital Münster, Münster; Marius Giurescu, Karl Köchert, Henrik Seidel, and Florian Hiemeyer, Bayer AG, Berlin, Germany; Armando Santoro, Humanitas Clinical and Research Center, Rozzano; Pier Luigi Zinzani, University of Bologna, Bologna, Italy; Luigina Mollica, Hôpital Maisonneuve-Rosemont, Montreal, Quebec, Canada; Sirpa Leppä, Helsinki University Central Hospital Cancer Center, Helsinki, Finland; George A
| | - Muhit Özcan
- Martin Dreyling, Ludwig Maximilians University of Munich, Munich; Georg Lenz, University Hospital Münster, Münster; Marius Giurescu, Karl Köchert, Henrik Seidel, and Florian Hiemeyer, Bayer AG, Berlin, Germany; Armando Santoro, Humanitas Clinical and Research Center, Rozzano; Pier Luigi Zinzani, University of Bologna, Bologna, Italy; Luigina Mollica, Hôpital Maisonneuve-Rosemont, Montreal, Quebec, Canada; Sirpa Leppä, Helsinki University Central Hospital Cancer Center, Helsinki, Finland; George A
| | - Marina Kosinova
- Martin Dreyling, Ludwig Maximilians University of Munich, Munich; Georg Lenz, University Hospital Münster, Münster; Marius Giurescu, Karl Köchert, Henrik Seidel, and Florian Hiemeyer, Bayer AG, Berlin, Germany; Armando Santoro, Humanitas Clinical and Research Center, Rozzano; Pier Luigi Zinzani, University of Bologna, Bologna, Italy; Luigina Mollica, Hôpital Maisonneuve-Rosemont, Montreal, Quebec, Canada; Sirpa Leppä, Helsinki University Central Hospital Cancer Center, Helsinki, Finland; George A
| | - Krimo Bouabdallah
- Martin Dreyling, Ludwig Maximilians University of Munich, Munich; Georg Lenz, University Hospital Münster, Münster; Marius Giurescu, Karl Köchert, Henrik Seidel, and Florian Hiemeyer, Bayer AG, Berlin, Germany; Armando Santoro, Humanitas Clinical and Research Center, Rozzano; Pier Luigi Zinzani, University of Bologna, Bologna, Italy; Luigina Mollica, Hôpital Maisonneuve-Rosemont, Montreal, Quebec, Canada; Sirpa Leppä, Helsinki University Central Hospital Cancer Center, Helsinki, Finland; George A
| | - Franck Morschhauser
- Martin Dreyling, Ludwig Maximilians University of Munich, Munich; Georg Lenz, University Hospital Münster, Münster; Marius Giurescu, Karl Köchert, Henrik Seidel, and Florian Hiemeyer, Bayer AG, Berlin, Germany; Armando Santoro, Humanitas Clinical and Research Center, Rozzano; Pier Luigi Zinzani, University of Bologna, Bologna, Italy; Luigina Mollica, Hôpital Maisonneuve-Rosemont, Montreal, Quebec, Canada; Sirpa Leppä, Helsinki University Central Hospital Cancer Center, Helsinki, Finland; George A
| | - Don A. Stevens
- Martin Dreyling, Ludwig Maximilians University of Munich, Munich; Georg Lenz, University Hospital Münster, Münster; Marius Giurescu, Karl Köchert, Henrik Seidel, and Florian Hiemeyer, Bayer AG, Berlin, Germany; Armando Santoro, Humanitas Clinical and Research Center, Rozzano; Pier Luigi Zinzani, University of Bologna, Bologna, Italy; Luigina Mollica, Hôpital Maisonneuve-Rosemont, Montreal, Quebec, Canada; Sirpa Leppä, Helsinki University Central Hospital Cancer Center, Helsinki, Finland; George A
| | - David Trevarthen
- Martin Dreyling, Ludwig Maximilians University of Munich, Munich; Georg Lenz, University Hospital Münster, Münster; Marius Giurescu, Karl Köchert, Henrik Seidel, and Florian Hiemeyer, Bayer AG, Berlin, Germany; Armando Santoro, Humanitas Clinical and Research Center, Rozzano; Pier Luigi Zinzani, University of Bologna, Bologna, Italy; Luigina Mollica, Hôpital Maisonneuve-Rosemont, Montreal, Quebec, Canada; Sirpa Leppä, Helsinki University Central Hospital Cancer Center, Helsinki, Finland; George A
| | - Marius Giurescu
- Martin Dreyling, Ludwig Maximilians University of Munich, Munich; Georg Lenz, University Hospital Münster, Münster; Marius Giurescu, Karl Köchert, Henrik Seidel, and Florian Hiemeyer, Bayer AG, Berlin, Germany; Armando Santoro, Humanitas Clinical and Research Center, Rozzano; Pier Luigi Zinzani, University of Bologna, Bologna, Italy; Luigina Mollica, Hôpital Maisonneuve-Rosemont, Montreal, Quebec, Canada; Sirpa Leppä, Helsinki University Central Hospital Cancer Center, Helsinki, Finland; George A
| | - Lisa Cupit
- Martin Dreyling, Ludwig Maximilians University of Munich, Munich; Georg Lenz, University Hospital Münster, Münster; Marius Giurescu, Karl Köchert, Henrik Seidel, and Florian Hiemeyer, Bayer AG, Berlin, Germany; Armando Santoro, Humanitas Clinical and Research Center, Rozzano; Pier Luigi Zinzani, University of Bologna, Bologna, Italy; Luigina Mollica, Hôpital Maisonneuve-Rosemont, Montreal, Quebec, Canada; Sirpa Leppä, Helsinki University Central Hospital Cancer Center, Helsinki, Finland; George A
| | - Li Liu
- Martin Dreyling, Ludwig Maximilians University of Munich, Munich; Georg Lenz, University Hospital Münster, Münster; Marius Giurescu, Karl Köchert, Henrik Seidel, and Florian Hiemeyer, Bayer AG, Berlin, Germany; Armando Santoro, Humanitas Clinical and Research Center, Rozzano; Pier Luigi Zinzani, University of Bologna, Bologna, Italy; Luigina Mollica, Hôpital Maisonneuve-Rosemont, Montreal, Quebec, Canada; Sirpa Leppä, Helsinki University Central Hospital Cancer Center, Helsinki, Finland; George A
| | - Karl Köchert
- Martin Dreyling, Ludwig Maximilians University of Munich, Munich; Georg Lenz, University Hospital Münster, Münster; Marius Giurescu, Karl Köchert, Henrik Seidel, and Florian Hiemeyer, Bayer AG, Berlin, Germany; Armando Santoro, Humanitas Clinical and Research Center, Rozzano; Pier Luigi Zinzani, University of Bologna, Bologna, Italy; Luigina Mollica, Hôpital Maisonneuve-Rosemont, Montreal, Quebec, Canada; Sirpa Leppä, Helsinki University Central Hospital Cancer Center, Helsinki, Finland; George A
| | - Henrik Seidel
- Martin Dreyling, Ludwig Maximilians University of Munich, Munich; Georg Lenz, University Hospital Münster, Münster; Marius Giurescu, Karl Köchert, Henrik Seidel, and Florian Hiemeyer, Bayer AG, Berlin, Germany; Armando Santoro, Humanitas Clinical and Research Center, Rozzano; Pier Luigi Zinzani, University of Bologna, Bologna, Italy; Luigina Mollica, Hôpital Maisonneuve-Rosemont, Montreal, Quebec, Canada; Sirpa Leppä, Helsinki University Central Hospital Cancer Center, Helsinki, Finland; George A
| | - Carol Peña
- Martin Dreyling, Ludwig Maximilians University of Munich, Munich; Georg Lenz, University Hospital Münster, Münster; Marius Giurescu, Karl Köchert, Henrik Seidel, and Florian Hiemeyer, Bayer AG, Berlin, Germany; Armando Santoro, Humanitas Clinical and Research Center, Rozzano; Pier Luigi Zinzani, University of Bologna, Bologna, Italy; Luigina Mollica, Hôpital Maisonneuve-Rosemont, Montreal, Quebec, Canada; Sirpa Leppä, Helsinki University Central Hospital Cancer Center, Helsinki, Finland; George A
| | - Shuxin Yin
- Martin Dreyling, Ludwig Maximilians University of Munich, Munich; Georg Lenz, University Hospital Münster, Münster; Marius Giurescu, Karl Köchert, Henrik Seidel, and Florian Hiemeyer, Bayer AG, Berlin, Germany; Armando Santoro, Humanitas Clinical and Research Center, Rozzano; Pier Luigi Zinzani, University of Bologna, Bologna, Italy; Luigina Mollica, Hôpital Maisonneuve-Rosemont, Montreal, Quebec, Canada; Sirpa Leppä, Helsinki University Central Hospital Cancer Center, Helsinki, Finland; George A
| | - Florian Hiemeyer
- Martin Dreyling, Ludwig Maximilians University of Munich, Munich; Georg Lenz, University Hospital Münster, Münster; Marius Giurescu, Karl Köchert, Henrik Seidel, and Florian Hiemeyer, Bayer AG, Berlin, Germany; Armando Santoro, Humanitas Clinical and Research Center, Rozzano; Pier Luigi Zinzani, University of Bologna, Bologna, Italy; Luigina Mollica, Hôpital Maisonneuve-Rosemont, Montreal, Quebec, Canada; Sirpa Leppä, Helsinki University Central Hospital Cancer Center, Helsinki, Finland; George A
| | - Jose Garcia-Vargas
- Martin Dreyling, Ludwig Maximilians University of Munich, Munich; Georg Lenz, University Hospital Münster, Münster; Marius Giurescu, Karl Köchert, Henrik Seidel, and Florian Hiemeyer, Bayer AG, Berlin, Germany; Armando Santoro, Humanitas Clinical and Research Center, Rozzano; Pier Luigi Zinzani, University of Bologna, Bologna, Italy; Luigina Mollica, Hôpital Maisonneuve-Rosemont, Montreal, Quebec, Canada; Sirpa Leppä, Helsinki University Central Hospital Cancer Center, Helsinki, Finland; George A
| | - Barrett H. Childs
- Martin Dreyling, Ludwig Maximilians University of Munich, Munich; Georg Lenz, University Hospital Münster, Münster; Marius Giurescu, Karl Köchert, Henrik Seidel, and Florian Hiemeyer, Bayer AG, Berlin, Germany; Armando Santoro, Humanitas Clinical and Research Center, Rozzano; Pier Luigi Zinzani, University of Bologna, Bologna, Italy; Luigina Mollica, Hôpital Maisonneuve-Rosemont, Montreal, Quebec, Canada; Sirpa Leppä, Helsinki University Central Hospital Cancer Center, Helsinki, Finland; George A
| | - Pier Luigi Zinzani
- Martin Dreyling, Ludwig Maximilians University of Munich, Munich; Georg Lenz, University Hospital Münster, Münster; Marius Giurescu, Karl Köchert, Henrik Seidel, and Florian Hiemeyer, Bayer AG, Berlin, Germany; Armando Santoro, Humanitas Clinical and Research Center, Rozzano; Pier Luigi Zinzani, University of Bologna, Bologna, Italy; Luigina Mollica, Hôpital Maisonneuve-Rosemont, Montreal, Quebec, Canada; Sirpa Leppä, Helsinki University Central Hospital Cancer Center, Helsinki, Finland; George A
| |
Collapse
|
3
|
Adjei A, Walter A, Cupit L, Siegel J, Holynskyj A, Childs B, Elbi C. Phase 1b multi-indication study of the antibody drug conjugate anetumab ravtansine in patients with mesothelin-expressing advanced or recurrent malignancies. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx367.057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
|
4
|
Dreyling M, Santoro A, Mollica L, Leppä S, Follows G, Lenz G, Kim W, Nagler A, Panayiotidis P, Demeter J, Özcan M, Kosinova M, Bouabdallah K, Morschhauser F, Stevens D, Trevarthen D, Giurescu M, Liu L, Koechert K, Peña C, Cupit L, Yin S, Hiemeyer F, Garcia-Vargas J, Childs B, Zinzani P. COPANLISIB IN PATIENTS WITH RELAPSED OR REFRACTORY INDOLENT B-CELL LYMPHOMA (CHRONOS-1). Hematol Oncol 2017. [DOI: 10.1002/hon.2437_107] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- M. Dreyling
- Medizinische Klinik und Poliklinik III; Klinikum der Universität München-Grosshadern; Munich Germany
| | - A. Santoro
- Department of Oncology and Hematology, Humanitas Cancer Center; Humanitas Clinical and Research Institute; Rozzano MI Italy
| | - L. Mollica
- Department of Hematology; Hôpital Maisonneuve-Rosemont-Montreal; Montreal Quebec Canada
| | - S. Leppä
- Department of Oncology; Helsinki University Central Hospital Cancer Center; Helsinki Finland
| | - G.A. Follows
- Department of Haematology; Cambridge University Hospitals NHS Foundation Trust Addenbrooke's Hospital; Cambridge UK
| | - G. Lenz
- Translational Oncology; University Hospital Münster; Münster Germany
| | - W. Kim
- Division of Hematology and Oncology, Department of Medicine; Sungkyunkwan University School of Medicine, Samsung Medical Center; Seoul Republic of Korea
| | - A. Nagler
- Hematology Division; Chaim Sheba Medical Center- Tel Aviv University; Tel-Hashomer Israel
| | - P. Panayiotidis
- Division of Hematology; Laikon University Hospital, National and Kapodistrian University of Athens; Athens Greece
| | - J. Demeter
- First Department of Internal Medicine, Division of Haematology; Semmelweis University; Budapest Hungary
| | - M. Özcan
- Department of Hematology; Ankara University School of Medicine; Ankara Turkey
| | - M. Kosinova
- Department of Hematology; Kemerovo Regional Clinical Hospital; Kemerovo Russian Federation
| | - K. Bouabdallah
- Service d'Hématologie et de Thérapie Cellulaire; University Hospital of Bordeaux; Pessac France
| | - F. Morschhauser
- Department of Hematology; CHRU - Hôpital Claude Huriez; Lille France
| | - D.A. Stevens
- Medical Oncology; Norton Cancer Institute; Louisville-KY USA
| | - D. Trevarthen
- Medical Oncology; Comprehensive Cancer Care and Research Institute of Colorado; Englewood-CO USA
| | - M. Giurescu
- Pharmaceutical Division, Bayer AG; Berlin Germany
| | - L. Liu
- Biomarkers; Bayer HealthCare Pharmaceuticals Inc; Whippany-NJ USA
| | - K. Koechert
- Pharmaceutical Division, Bayer AG; Berlin Germany
| | - C. Peña
- Biomarkers; Bayer HealthCare Pharmaceuticals Inc; Whippany-NJ USA
| | - L. Cupit
- Clinical Development; Bayer HealthCare Pharmaceuticals Inc; Whippany-NJ USA
| | - S. Yin
- Clinical Development; Bayer HealthCare Pharmaceuticals Inc; Whippany-NJ USA
| | - F. Hiemeyer
- Pharmaceutical Division, Bayer AG; Berlin Germany
| | - J. Garcia-Vargas
- Clinical Development; Bayer HealthCare Pharmaceuticals Inc; Whippany-NJ USA
| | - B.H. Childs
- Clinical Development; Bayer HealthCare Pharmaceuticals Inc; Whippany-NJ USA
| | - P. Zinzani
- Department of Hematology; Institute of Hematology "L. e A. Seràgnoli"- University of Bologna; Bologna Italy
| |
Collapse
|
5
|
Dreyling MH, Santoro A, Leppa S, Demeter J, Follows G, Lenz G, Kim WS, Mollica L, Nagler A, Diong CP, Provencio M, Stevens DA, Trevarthen D, Magagnoli M, Cupit L, Yin S, Hiemeyer F, Garcia-Vargas JE, Childs BH, Zinzani PL. Copanlisib in patients with relapsed or refractory follicular lymphoma. J Clin Oncol 2017. [DOI: 10.1200/jco.2017.35.15_suppl.7535] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
7535 Background: Follicular lymphoma (FL) is the most common indolent non-Hodgkin lymphoma (iNHL) subtype, yet treatment options in the relapsed/refractory (r/r) setting are limited. Copanlisib is a pan-Class I phosphatidylinositol 3-kinase (PI3K) inhibitor with predominant PI3K-α and PI3K-δ activity. We report results from the FL subset of a large phase II study (n=141) in iNHL patients (pts) (NCT01660451, part B). Methods: A total of 104 pts with indolent FL (grade 1-3a) relapsed/refractory to ≥2 prior lines of treatment were treated with copanlisib (60 mg IV infusion) administered on days 1, 8 and 15 of a 28-day cycle. The primary endpoint was objective tumor response rate (ORR) per independent radiologic review (Cheson et al., JCO 20:579, 2007). Results: Of the 104 pts treated, 62% were refractory; median prior lines 3 (range 2-8), median time from progression 8 wks (range 1-73 wks). 52% were male, 83% white, median age 62 yrs, and 62% ECOG 0. At the time of primary analysis the ORR was 58.7%, comprising 15 pts (14.4%) with complete response (CR) and 46 (44.2%) with partial response. Stable disease was observed in 35 (33.7%) pts and progression of disease as best response in 2 pts. The median duration of response was 370 days (range 0-687), with 43 responders censored at data cut-off. Median duration of treatment was 22 wks (range 1-105); 33 (32%) pts remained on treatment. For all pts, the most common treatment-emergent AEs occurring in >25% of pts included (all grade/grade 3+): diarrhea (34%/5%), reduced neutrophil count (30%/24%), fatigue (30%/2%), and fever (25%/4%). Hyperglycemia (50%/41%) and hypertension (30%/24%) were transient. The incidence of pneumonitis (8%/1.4%), hepatic enzymopathy (AST 28%/1.4%; ALT 23%/1.4%), opportunistic infection (1.4%) and colitis (0.7%) were low. Six deaths were observed, 3 of which were attributed to copanlisib: one lung infection, one respiratory failure, and one thromboembolic event. Conclusions: Copanlisib was highly active as a single agent in heavily pretreated r/r FL pts and resulted in durable responses in the majority of pts. Toxicities were manageable, with a low incidence of severe AEs associated with other PI3K inhibitors, especially hepatic enzymopathy, opportunistic infections, and colitis. Clinical trial information: NCT01660451.
Collapse
Affiliation(s)
| | - Armando Santoro
- Humanitas Cancer Center, Humanitas Clinical and Research Center, Rozzano, Italy
| | - Sirpa Leppa
- Helsinki University Central Hospital Cancer Center, Helsinki, Finland
| | - Judit Demeter
- Semmelweis University, First Department of Internal Medicine, Division of Haematology, Budapest, Hungary
| | - George Follows
- Cambridge University Hospitals, Cambridge, United Kingdom
| | - Georg Lenz
- Translational Oncology Medical Clinic, Münster University Clinic, Münster, Germany
| | - Won Seog Kim
- Sungkyunkwan University School of Medicine, Samsung Medical Center, Division of Hematology and Oncology, Seoul, Republic of Korea
| | | | - Arnon Nagler
- Hematology Division, Chaim Sheba Medical Center, Tel-Hashomer, Israel
| | - Colin Phipps Diong
- Singapore General Hospital, Department of Haematology, Singapore, Singapore
| | - Mariano Provencio
- Health Research Institute, Hospital Universitario Puerta de Hierro, Universidad Autonoma de Madrid, Madrid, Spain
| | | | - David Trevarthen
- Comprehensive Cancer Care and Research Institute of Colorado, Englewood, CO
| | - Massimo Magagnoli
- Humanitas Cancer Center, Humanitas Clinical and Research Center, Rozzano, Italy
| | - Lisa Cupit
- Bayer HealthCare Pharmaceuticals Inc., Whippany, NJ
| | - Shuxin Yin
- Bayer HealthCare Pharmaceuticals Inc., Whippany, NJ
| | | | | | | | - Pier Luigi Zinzani
- Institute of Hematology "L. e A. Seràgnoli", University of Bologna, Bologna, Italy
| |
Collapse
|
6
|
Nowakowski GS, Gorbatchevsky I, Hiemeyer F, Cupit L, Childs BH. Abstract CT084: A randomized, double-blind phase III study of phosphatidylinositol-3 kinase alpha/delta inhibitor copanlisib versus placebo in patients with rituximab-refractory indolent non-Hodgkin's lymphoma (iNHL): CHRONOS-2. Cancer Res 2016. [DOI: 10.1158/1538-7445.am2016-ct084] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Copanlisib is a novel pan-Class I phosphatidylinositol-3-kinase (PI3K) inhibitor with potent preclinical inhibitory activity against both PI3K-δ and PI3K-α isoforms. A phase II study of copanlisib in patients with relapsed/refractory indolent or aggressive lymphoma reported promising activity in the indolent NHL group (Dreyling et al., ENA 2014). The objective of this study is to evaluate the efficacy and safety of copanlisib in patients with indolent B-cell NHL relapsed after or refractory to standard therapy.
Methods: Patients meeting the following criteria are eligible for enrollment: histologically confirmed diagnosis of indolent B-cell NHL, with follicular lymphoma (FL) grade 1-2-3a, marginal zone lymphoma (MZL; splenic, nodal, or extra-nodal), small lymphocytic lymphoma (SLL) with absolute lymphocyte count < 5 × 109/L at the time of diagnosis and at study entry, or lymphoplasmacytoid lymphoma/Waldenström macroglobulinemia (LPL/WM), and who have previously received ? 2 prior lines of therapy with rituximab and an alkylating agent and must be refractory to the last treatment with rituximab (refractory defined as progressing or not responding within 6 months of the last course of treatment). Patients will be randomized in 2:1 manner to receive 60 mg of copanlisib administered intravenously on days 1, 8 and 15 of a 28-day cycle or placebo administered on the same schedule until disease progression or intolerable toxicity. Patients in the placebo arm will be allowed to cross-over to receive follow-up treatment with copanlisib, after confirmed disease progression. Dose reductions due to toxicities will be allowed. Radiologic tumor assessment will be performed every 12, 16 or 24 weeks for years 1, 2, and 3, respectively. The primary endpoint will be progression-free survival (PFS). Secondary objectives include overall objective response rate (ORR), duration of response (DOR), time to progression (TTP), complete response rate (CRR), overall survival (OS), time to deterioration as well as time to improvement in disease-related symptoms. Exploratory objectives will include secondary PFS after first progression in placebo-treated patients who cross over to receive copanlisib and time to improvement and the time to deterioration in disease-related symptoms - physical (DRS-P) of at least 3 points as measured by the FLymSI-18 questionnaire. Approximately 189 patients who meet the eligibility criteria will be randomized 2:1, with approximately 126 patients in the copanlisib monotherapy arm and approximately 63 patients in placebo arm. The study is planned to detect a 132% increase in median PFS in copanlisib versus placebo (i.e. to detect a hazard ratio of 0.43), using a stratified log-rank test. This study is currently enrolling patients (NCT02369016).
Citation Format: Grzegorz S. Nowakowski, Igor Gorbatchevsky, Florian Hiemeyer, Lisa Cupit, Barrett H. Childs. A randomized, double-blind phase III study of phosphatidylinositol-3 kinase alpha/delta inhibitor copanlisib versus placebo in patients with rituximab-refractory indolent non-Hodgkin's lymphoma (iNHL): CHRONOS-2. [abstract]. In: Proceedings of the 107th Annual Meeting of the American Association for Cancer Research; 2016 Apr 16-20; New Orleans, LA. Philadelphia (PA): AACR; Cancer Res 2016;76(14 Suppl):Abstract nr CT084.
Collapse
Affiliation(s)
| | | | | | - Lisa Cupit
- 2Bayer HealthCare Pharmaceuticals, Whippany, NJ
| | | |
Collapse
|
7
|
Nowakowski GS, Gorbatchevsky I, Hiemeyer F, Cupit L, Childs BH. Abstract CT212: CHRONOS-2: A randomized, double-blind phase III study of phosphatidylinositol-3 kinase alpha/delta inhibitor copanlisib versus placebo in patients with rituximab-refractory indolent non-Hodgkin's lymphoma (iNHL). Cancer Res 2015. [DOI: 10.1158/1538-7445.am2015-ct212] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Copanlisib is a novel pan-Class I phosphatidylinositol-3-kinase (PI3K) inhibitor with potent preclinical inhibitory activity against both PI3K-δ and PI3K-α isoforms. A phase II study of copanlisib in patients with relapsed/refractory indolent or aggressive lymphoma reported a promising overall response rate of up to 53% for patients in the indolent NHL group (Dreyling et al., ENA 2014). The objective of this study is to evaluate the efficacy and safety of copanlisib in patients with indolent B-cell NHL relapsed after or refractory to standard therapy.
Methods: In this study, patients meeting the following criteria will be eligible for enrollment: histologically confirmed diagnosis of indolent B-cell NHL, with follicular lymphoma (FL) grade 1-2-3a, marginal zone lymphoma (MZL; splenic, nodal, or extra-nodal), small lymphocytic lymphoma (SLL) with absolute lymphocyte count < 5 × 109/L at the time of diagnosis and at study entry, or lymphoplasmacytoid lymphoma/Waldenström macroglobulinemia (LPL/WM), and who have previously received ≥ 2 prior lines of therapy with rituximab and an alkylating agent and must be refractory to the last treatment with rituximab (refractory defined as not responding or progressing within 6 months of the last course of treatment). Patients will be randomized in 2:1 manner to receive 60 mg of copanlisib administered intravenously on days 1, 8 and 15 of a 28-day cycle or placebo administered on the same schedule. Patients will be treated until disease progression or intolerable toxicity. Patients in the placebo arm will be allowed to cross-over to receive follow-up treatment with copanlisib, after confirmed disease progression. Dose reductions due to toxicities to 45 mg and 30 mg will be allowed. Radiologic tumor assessment will be performed every 12, 16 or 24 weeks for years 1, 2, and 3, respectively. The primary endpoint will be progression-free survival (PFS). Secondary objectives include overall objective response rate (ORR), duration of response (DOR), time to progression (TTP), complete response rate (CRR), overall survival (OS), time to deterioration as well as time to improvement in disease-related symptoms. Exploratory objectives will include secondary PFS after first progression in placebo-treated patients who cross over to receive copanlisib and time to improvement and the time to deterioration in disease-related symptoms-physical (DRS-P) of at least 3 points as measured by the FLymSI-18 questionnaire. Approximately 189 patients who meet the eligibility criteria will be randomized 2:1, with approximately 126 patients in the copanlisib monotherapy arm and approximately 63 patients in placebo arm. The study is planned to detect a 132% increase in median PFS in copanlisib versus placebo (i.e. to detect a hazard ratio of 0.43), using a stratified log-rank test.
Citation Format: Grzegorz S. Nowakowski, Igor Gorbatchevsky, Florian Hiemeyer, Lisa Cupit, Barrett H. Childs. CHRONOS-2: A randomized, double-blind phase III study of phosphatidylinositol-3 kinase alpha/delta inhibitor copanlisib versus placebo in patients with rituximab-refractory indolent non-Hodgkin's lymphoma (iNHL). [abstract]. In: Proceedings of the 106th Annual Meeting of the American Association for Cancer Research; 2015 Apr 18-22; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Res 2015;75(15 Suppl):Abstract nr CT212. doi:10.1158/1538-7445.AM2015-CT212
Collapse
Affiliation(s)
| | | | | | - Lisa Cupit
- 2Bayer HealthCare Pharmaceuticals, Whippany, NJ
| | | |
Collapse
|
8
|
Dreyling M, Giurescu M, Grunert J, Fittipaldi F, Cupit L, Childs BH. Abstract CT215: CHRONOS-1: Open-label, uncontrolled phase II trial of intravenous phosphatidylinositol-3 kinase alpha/delta inhibitor copanlisib in patients with relapsed, indolent Non-Hodgkin's lymphomas (iNHL). Cancer Res 2015. [DOI: 10.1158/1538-7445.am2015-ct215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Copanlisib is a novel pan-Class I phosphatidylinositol-3-kinase (PI3K) inhibitor with potent preclinical inhibitory activity against both PI3K-δ and PI3K-α isoforms. Results from a phase II study of copanlisib in 67 patients with relapsed/refractory indolent or aggressive lymphoma have been reported, with a promising overall response rate for 53% seen for patients in the indolent lymphoma group (Dreyling et al., ASH 2014; Dreyling et al., ENA 2014). Enrollment in an expansion cohort of 120 patients with indolent lymphoma has been initiated. The objective of the study is to evaluate the efficacy and safety of copanlisib in patients with indolent B-cell NHL relapsed after or refractory to standard therapy.
Methods: In this study (NCT01660451), patients meeting the following criteria will be eligible for enrollment: histologically confirmed diagnosis of indolent B-cell NHL, with follicular lymphoma (FL) grade 1-2-3a, marginal zone lymphoma (MZL; splenic, nodal, or extra-nodal), small lymphocytic lymphoma (SLL) with absolute lymphocyte count < 5 × 109/L at the time of diagnosis and at study entry, or lymphoplasmacytoid lymphoma/Waldenström macroglobulinemia (LPL/WM), and who have relapsed or are refractory after ≥ 2 prior lines of therapy (refractory defined as not responding to a standard regimen or progressing within 6 months of the last course of a standard regimen; patients must have received Rituximab and alkylating agents). Patients will receive 60 mg of copanlisib administered intravenously on days 1, 8 and 15 of a 28-day cycle. Dose reductions due to toxicities to 45 mg and 30 mg will be allowed. Patients will be followed until disease progression or intolerable toxicity. Radiologic tumor assessment will be performed every 2 cycles. Adverse events will be collected and graded using NCI-CTCAE v4. The primary endpoint will be overall objective response rate (ORR), defined as a complete response (CR) or partial response (PR) up to 16 weeks after the last patient fully evaluable for the primary endpoint started treatment. Secondary objectives include duration of response (DOR), progression-free survival (PFS), overall survival (OS), and quality of Life questionnaire (FACT-Lym symptoms subscale and total score) at week 16. Assuming a one-sided alpha of 0.025, 90% power and a true ORR of 75%, a total of 120 patients will be required.
The trial is currently enrolling patients.
Citation Format: Martin Dreyling, Marius Giurescu, Julia Grunert, Felipe Fittipaldi, Lisa Cupit, Barrett H. Childs. CHRONOS-1: Open-label, uncontrolled phase II trial of intravenous phosphatidylinositol-3 kinase alpha/delta inhibitor copanlisib in patients with relapsed, indolent Non-Hodgkin's lymphomas (iNHL). [abstract]. In: Proceedings of the 106th Annual Meeting of the American Association for Cancer Research; 2015 Apr 18-22; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Res 2015;75(15 Suppl):Abstract nr CT215. doi:10.1158/1538-7445.AM2015-CT215
Collapse
Affiliation(s)
- Martin Dreyling
- 1Klinikum der Universität München-Grosshadern, Munich, Germany
| | | | | | | | - Lisa Cupit
- 5Bayer HealthCare Pharmaceuticals, Whippany, NJ
| | | |
Collapse
|
9
|
Grothey A, Yoshino T, Xu R, Zalcberg J, Sargent D, Choti M, Rutstein M, Cupit L, Kuss I, Van Cutsem E. Adjuvant Regorafenib (Reg) in Stage Iv Colorectal Cancer (Crc) After Curative Treatment of Liver Metastases: a Phase III Randomized, Placebo (Pbo)-Controlled Trial (Coast). Ann Oncol 2014. [DOI: 10.1093/annonc/mdu333.112] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
|
10
|
Grothey A, Sobrero AF, Siena S, Falcone A, Ychou M, Humblet Y, Bouche O, Mineur L, Barone C, Adenis A, Argiles G, Yoshino T, Lenz HJ, Goldberg RM, Sargent DJ, Cihon F, Wagner A, Cupit L, Laurent D, Van Cutsem E. Time profile of adverse events (AEs) from regorafenib (REG) treatment for metastatic colorectal cancer (mCRC) in the phase III CORRECT study. J Clin Oncol 2013. [DOI: 10.1200/jco.2013.31.15_suppl.3637] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
3637 Background: In the CORRECT phase III trial, the multikinase inhibitor REG demonstrated significant improvement in overall survival and progression-free survival vs placebo (P) in patients with mCRC whose disease had progressed on other standard therapies. The most frequent grade 3 AEs were hand–foot skin reaction (HFSR), fatigue, diarrhea, hypertension, and rash. We examined when these AEs first occurred and what impact they had on REG dosing. Methods: Adults with mCRC progressing after all standard therapies were randomized to receive REG 160 mg (n=505) or P (n=255) orally once daily for the first 3 weeks of each 4-week cycle. AEs were managed with dose modifications (reduction and interruption) according to the protocol. Results: The safety population comprised 753 pts (REG n=500, P n=253). The mean ± SD treatment duration was 12.1 ± 9.7 weeks for REG and 7.8 ± 5.2 weeks for P. Treatment-emergent AEs occurred in 99.6% of REG pts and 96.8% of P pts. AEs occurring in ≥10% more REG than P pts were fatigue, HFSR, anorexia, diarrhea, weight loss, voice changes, hypertension, rash/desquamation, oral mucositis, fever, hyperbilirubinemia, and low platelet count. The incidence of grade ≥3 HFSR, fatigue, hypertension, and rash/desquamation typically peaked in cycle 1 and tapered to a relatively stable lower incidence over later cycles, while the incidence of diarrhea remained relatively constant throughout the study; median time to first occurrence and worst grade of these AEs is shown in the table. AEs led to dose modifications in 66.6% of REG pts and 22.5% of P pts. Conclusions: The most common AEs in the REG group typically occurred early during treatment. Close early monitoring of AEs and proper management by dose modification is recommended. Clinical trial information: NCT01103323. [Table: see text]
Collapse
Affiliation(s)
| | | | | | - Alfredo Falcone
- U.O. Oncologia Medica 2, Azienda Ospedaliero-Universitaria Pisana, Istituto Toscano Tumori, Pisa, Italy
| | - Marc Ychou
- ICM - Val d'Aurelle, Montpellier, France
| | - Yves Humblet
- Saint-Luc University Hospital, Brussels, Belgium
| | - Olivier Bouche
- Centre Hospitalier Universitaire Robert Debré, Reims, France
| | - Laurent Mineur
- Radiotherapy and Oncology GI and Liver Unit, Institut Sainte-Catherine, Avignon, France
| | - Carlo Barone
- Catholic University of Sacred Heart, Rome, Italy
| | | | | | | | - Heinz-Josef Lenz
- University of Southern California Norris Comprehensive Cancer Center, Los Angeles, CA
| | | | | | - Frank Cihon
- Bayer HealthCare Pharmaceuticals, Montville, NJ
| | | | - Lisa Cupit
- Bayer HealthCare Pharmaceuticals, Montville, NJ
| | - Dirk Laurent
- Bayer HealthCare Pharmaceuticals, Berlin, Germany
| | | |
Collapse
|
11
|
van Cutsem E, Sobrero A, Siena S, Falcone A, Ychou M, Humblet Y, Bouche O, Mineur L, Barone C, Adenis A, Argilés G, Yoshino T, Lenz HJ, Goldberg RM, Sargent DJ, Cihon F, Wagner A, Laurent D, Cupit L, Grothey A. Regorafenib (REG) in progressive metastatic colorectal cancer (mCRC): Analysis of age subgroups in the phase III CORRECT trial. J Clin Oncol 2013. [DOI: 10.1200/jco.2013.31.15_suppl.3636] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
3636 Background: In the CORRECT phase III trial, the multikinase inhibitor REG demonstrated significant improvement in overall survival (OS) and progression-free survival vs placebo (Pla) in patients (pts) with mCRC whose disease progressed on other standard therapies. The most frequent REG-related grade ≥3 adverse events (AEs) of interest were hand–foot skin reaction (HFSR), fatigue, diarrhea, hypertension, and rash/desquamation. We explored whether the impact of REG in pts aged ≥65 years differed from that in younger patients. Methods: Pts with mCRC progressing following all other available therapies were randomized 2:1 to receive REG 160 mg once daily (n=505) or Pla (n=255) for the first 3 weeks of each 4-week cycle. The dose could be modified to manage AEs. The primary endpoint was OS. We report efficacy, safety, and dosing data from REG recipients by age. Results: The REG treatment group included 309 pts <65 years (307 evaluable for safety) and 196 pts ≥65 years (193 evaluable for safety). The OS hazard ratio (REG/Pla) was 0.72 (95% confidence interval [CI] 0.56–0.91) in pts <65 years and 0.86 (95% CI 0.61–1.19) in pts ≥65 years (interaction p-value = 0.405). Median OS was 6.7 vs 5 months for REG vs Pla in pts <65 years, and 6.0 vs 5.6 months, respectively, in pts ≥65 years. Most pts experienced drug-related AEs (<65 years: 93.8%; ≥65 years: 91.7%). The rates of grade ≥3 REG-related AEs of interest and dose modifications are shown in the Table. In pts <65 years vs ≥65 years, median (interquartile range [IQR]) duration of REG was 7.6 weeks (6.6–15.4) vs 7.1 weeks (5.1–17.2), median (IQR) daily REG dose was 160.0 mg (134.6–160.0) vs 160.0 mg (137.5–160.0), and median (IQR) proportion of planned REG dose was 83.3% (65.7–100.0) vs 78.6% (66.7–100.0), respectively. Conclusions: In the CORRECT trial, REG demonstrated an OS benefit in pts <65 years and ≥65 years. Safety and tolerability of REG appeared to be similar in both age subgroups. Clinical trial information: NCT01103323. [Table: see text]
Collapse
Affiliation(s)
- Eric van Cutsem
- University Hospital Gasthuisberg, Katholieke Universiteit Leuven, Leuven, Belgium
| | | | - Salvatore Siena
- Falck Division of Medical Oncology, Ospedale Niguarda Ca’ Granda, Milano, Italy
| | - Alfredo Falcone
- U.O. Oncologia Medica 2, Azienda Ospedaliero-Universitaria Pisana, Istituto Toscano Tumori, Pisa, Italy
| | - Marc Ychou
- ICM - Val d'Aurelle, Montpellier, France
| | - Yves Humblet
- Centre du Cancer de l'Universite Catholique de Louvain, Brussels, Belgium
| | - Olivier Bouche
- Centre Hospitalier Universitaire Robert Debré, Reims, France
| | - Laurent Mineur
- Radiotherapy and Oncology GI and Liver Unit, Institut Sainte-Catherine, Avignon, France
| | - Carlo Barone
- Catholic University of Sacred Heart, Rome, Italy
| | | | - Guillem Argilés
- Department of Medical Oncology, Vall d'Hebron University Hospital, Barcelona, Spain
| | | | - Heinz-Josef Lenz
- University of Southern California Norris Comprehensive Cancer Center, Los Angeles, CA
| | | | | | - Frank Cihon
- Bayer HealthCare Pharmaceuticals, Montville, NJ
| | | | - Dirk Laurent
- Bayer HealthCare Pharmaceuticals, Berlin, Germany
| | - Lisa Cupit
- Bayer HealthCare Pharmaceuticals, Montville, NJ
| | | |
Collapse
|
12
|
Grothey A, Van Cutsem E, Sobrero AF, Siena S, Falcone A, Ychou M, Humblet Y, Bouche O, Mineur L, Barone C, Adenis A, Tabernero J, Yoshino T, Lenz HJ, Goldberg RM, Sargent DJ, Cihon F, Wagner A, Laurent D, Cupit L. Time course of regorafenib-associated adverse events in the phase III CORRECT study. J Clin Oncol 2013. [DOI: 10.1200/jco.2013.31.4_suppl.467] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
467 Background: Regorafenib (REG) is an oral multikinase inhibitor that has recently demonstrated significant overall survival benefit vs placebo in the randomized phase III CORRECT study. We examined the time course of adverse events (AEs) in the CORRECT study. Methods: Regorafenib (REG) is an oral multikinase inhibitor that has recently demonstrated significant overall survival benefit vs placebo in the randomized phase III CORRECT study. We examined the time course of adverse events (AEs) in the CORRECT study. Results: The safety population comprised 753 patients (pts): REG n=500; placebo n=253. The mean treatment duration was 12.1 ± 9.7 weeks in the REG group and 7.8 ± 5.2 weeks in the placebo group. Treatment-emergent AEs occurred at any grade in 99.6% of REG pts and 96.8% of placebo pts, at grade 1/2 in 21.6% and 47.8%, respectively, at grade 3 in 56.0% and 26.5%, respectively, and at grade 4/5 in 22.0% and 22.5%, respectively. AEs occurring in ≥10% more REG than placebo pts were fatigue, hand–foot skin reaction (HFSR), anorexia, diarrhea, weight loss, voice changes, hypertension, rash/desquamation, oral mucositis, fever, hyperbilirubinemia, low platelet count. The most frequent AEs deemed to be regorafenib related were HFSR, fatigue, diarrhea, hypertension, and rash/desquamation. The frequency of these AEs over time is shown in the Table. The incidence of HFSR, fatigue, hypertension, and rash/desquamation peaked in cycle 1 and tapered to a relatively stable lower incidence over later cycles. The incidence of diarrhea remained relatively constant throughout treatment. AEs led to dose modification in 66.6% of pts in the REG group and 22.5% in the placebo group. Data on dose intensity across treatment cycles will be presented. Conclusions: In the CORRECT trial, the incidences of the most common AEs in the REG group peaked early during treatment. There appeared to be no evidence for cumulative toxicity of REG. Clinical trial information: NCT01103323. [Table: see text]
Collapse
Affiliation(s)
| | - Eric Van Cutsem
- Digestive Oncology Unit, Leuven Cancer Institute, University Hospital Gasthuisberg, Leuven, Belgium
| | | | - Salvatore Siena
- Department of Oncology, Ospedale Niguarda Ca' Granda, Milan, Italy
| | - Alfredo Falcone
- Dipartimento di Oncologia dei Trapianti e delle Nuove Tecnologie in Medicina, Università di Pisa, Pisa, Italy
| | | | - Yves Humblet
- Centre du Cancer de l'Universite Catholique de Louvain, Brussels, Belgium
| | | | - Laurent Mineur
- Radiotherapy and Oncology GI and Liver Unit, Institut Sainte-Catherine, Avignon, France
| | | | | | - Josep Tabernero
- Vall d'Hebron University Hospital, Vall d'Hebron Institute of Oncology, Barcelona, Spain
| | | | | | | | | | - Frank Cihon
- Bayer HealthCare Pharmaceuticals, Montville, NJ
| | | | - Dirk Laurent
- Bayer HealthCare Pharmaceuticals, Berlin, Germany
| | - Lisa Cupit
- Bayer HealthCare Pharmaceuticals, Montville, NJ
| |
Collapse
|
13
|
Grothey A, Van Cutsem E, Sobrero A, Siena S, Falcone A, Ychou M, Humblet Y, Bouché O, Mineur L, Barone C, Adenis A, Tabernero J, Yoshino T, Lenz HJ, Goldberg RM, Sargent DJ, Cihon F, Cupit L, Wagner A, Laurent D. Regorafenib monotherapy for previously treated metastatic colorectal cancer (CORRECT): an international, multicentre, randomised, placebo-controlled, phase 3 trial. Lancet 2013. [PMID: 23177514 DOI: 10.1016/s0140-6736(12)61900-x] [Citation(s) in RCA: 1899] [Impact Index Per Article: 172.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND No treatment options are available for patients with metastatic colorectal cancer that progresses after all approved standard therapies, but many patients maintain a good performance status and could be candidates for further therapy. An international phase 3 trial was done to assess the multikinase inhibitor regorafenib in these patients. METHODS We did this trial at 114 centres in 16 countries. Patients with documented metastatic colorectal cancer and progression during or within 3 months after the last standard therapy were randomised (in a 2:1 ratio; by computer-generated randomisation list and interactive voice response system; preallocated block design (block size six); stratified by previous treatment with VEGF-targeting drugs, time from diagnosis of metastatic disease, and geographical region) to receive best supportive care plus oral regorafenib 160 mg or placebo once daily, for the first 3 weeks of each 4 week cycle. The primary endpoint was overall survival. The study sponsor, participants, and investigators were masked to treatment assignment. Efficacy analyses were by intention to treat. This trial is registered at ClinicalTrials.gov, number NCT01103323. FINDINGS Between April 30, 2010, and March 22, 2011, 1052 patients were screened, 760 patients were randomised to receive regorafenib (n=505) or placebo (n=255), and 753 patients initiated treatment (regorafenib n=500; placebo n=253; population for safety analyses). The primary endpoint of overall survival was met at a preplanned interim analysis; data cutoff was on July 21, 2011. Median overall survival was 6·4 months in the regorafenib group versus 5·0 months in the placebo group (hazard ratio 0·77; 95% CI 0·64-0·94; one-sided p=0·0052). Treatment-related adverse events occurred in 465 (93%) patients assigned regorafenib and in 154 (61%) of those assigned placebo. The most common adverse events of grade three or higher related to regorafenib were hand-foot skin reaction (83 patients, 17%), fatigue (48, 10%), diarrhoea (36, 7%), hypertension (36, 7%), and rash or desquamation (29, 6%). INTERPRETATION Regorafenib is the first small-molecule multikinase inhibitor with survival benefits in metastatic colorectal cancer which has progressed after all standard therapies. The present study provides evidence for a continuing role of targeted treatment after disease progression, with regorafenib offering a potential new line of therapy in this treatment-refractory population. FUNDING Bayer HealthCare Pharmaceuticals.
Collapse
Affiliation(s)
- Axel Grothey
- Division of Medical Oncology, Mayo Clinic, Rochester, MN, USA
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
14
|
Grothey A, Van Cutsem E, Sobrero A, Siena S, Falcone A, Ychou M, Humblet Y, Bouché O, Mineur L, Barone C, Adenis A, Tabernero J, Yoshino T, Lenz HJ, Goldberg RM, Sargent DJ, Cihon F, Cupit L, Wagner A, Laurent D. Regorafenib monotherapy for previously treated metastatic colorectal cancer (CORRECT): an international, multicentre, randomised, placebo-controlled, phase 3 trial. Lancet 2012. [PMID: 23177514 DOI: 10.1016/s0140-6736(12)] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 09/30/2022]
Abstract
BACKGROUND No treatment options are available for patients with metastatic colorectal cancer that progresses after all approved standard therapies, but many patients maintain a good performance status and could be candidates for further therapy. An international phase 3 trial was done to assess the multikinase inhibitor regorafenib in these patients. METHODS We did this trial at 114 centres in 16 countries. Patients with documented metastatic colorectal cancer and progression during or within 3 months after the last standard therapy were randomised (in a 2:1 ratio; by computer-generated randomisation list and interactive voice response system; preallocated block design (block size six); stratified by previous treatment with VEGF-targeting drugs, time from diagnosis of metastatic disease, and geographical region) to receive best supportive care plus oral regorafenib 160 mg or placebo once daily, for the first 3 weeks of each 4 week cycle. The primary endpoint was overall survival. The study sponsor, participants, and investigators were masked to treatment assignment. Efficacy analyses were by intention to treat. This trial is registered at ClinicalTrials.gov, number NCT01103323. FINDINGS Between April 30, 2010, and March 22, 2011, 1052 patients were screened, 760 patients were randomised to receive regorafenib (n=505) or placebo (n=255), and 753 patients initiated treatment (regorafenib n=500; placebo n=253; population for safety analyses). The primary endpoint of overall survival was met at a preplanned interim analysis; data cutoff was on July 21, 2011. Median overall survival was 6·4 months in the regorafenib group versus 5·0 months in the placebo group (hazard ratio 0·77; 95% CI 0·64-0·94; one-sided p=0·0052). Treatment-related adverse events occurred in 465 (93%) patients assigned regorafenib and in 154 (61%) of those assigned placebo. The most common adverse events of grade three or higher related to regorafenib were hand-foot skin reaction (83 patients, 17%), fatigue (48, 10%), diarrhoea (36, 7%), hypertension (36, 7%), and rash or desquamation (29, 6%). INTERPRETATION Regorafenib is the first small-molecule multikinase inhibitor with survival benefits in metastatic colorectal cancer which has progressed after all standard therapies. The present study provides evidence for a continuing role of targeted treatment after disease progression, with regorafenib offering a potential new line of therapy in this treatment-refractory population. FUNDING Bayer HealthCare Pharmaceuticals.
Collapse
Affiliation(s)
- Axel Grothey
- Division of Medical Oncology, Mayo Clinic, Rochester, MN, USA
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
15
|
Grothey A, Van Cutsem E, Sobrero A, Siena S, Falcone A, Ychou M, Humblet Y, Bouché O, Mineur L, Barone C, Adenis A, Tabernero J, Yoshino T, Lenz HJ, Goldberg RM, Sargent DJ, Cihon F, Cupit L, Wagner A, Laurent D. Regorafenib monotherapy for previously treated metastatic colorectal cancer (CORRECT): an international, multicentre, randomised, placebo-controlled, phase 3 trial. Lancet 2012. [PMID: 23177514 DOI: 10.1016/s0140-6736(12)61900] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
BACKGROUND No treatment options are available for patients with metastatic colorectal cancer that progresses after all approved standard therapies, but many patients maintain a good performance status and could be candidates for further therapy. An international phase 3 trial was done to assess the multikinase inhibitor regorafenib in these patients. METHODS We did this trial at 114 centres in 16 countries. Patients with documented metastatic colorectal cancer and progression during or within 3 months after the last standard therapy were randomised (in a 2:1 ratio; by computer-generated randomisation list and interactive voice response system; preallocated block design (block size six); stratified by previous treatment with VEGF-targeting drugs, time from diagnosis of metastatic disease, and geographical region) to receive best supportive care plus oral regorafenib 160 mg or placebo once daily, for the first 3 weeks of each 4 week cycle. The primary endpoint was overall survival. The study sponsor, participants, and investigators were masked to treatment assignment. Efficacy analyses were by intention to treat. This trial is registered at ClinicalTrials.gov, number NCT01103323. FINDINGS Between April 30, 2010, and March 22, 2011, 1052 patients were screened, 760 patients were randomised to receive regorafenib (n=505) or placebo (n=255), and 753 patients initiated treatment (regorafenib n=500; placebo n=253; population for safety analyses). The primary endpoint of overall survival was met at a preplanned interim analysis; data cutoff was on July 21, 2011. Median overall survival was 6·4 months in the regorafenib group versus 5·0 months in the placebo group (hazard ratio 0·77; 95% CI 0·64-0·94; one-sided p=0·0052). Treatment-related adverse events occurred in 465 (93%) patients assigned regorafenib and in 154 (61%) of those assigned placebo. The most common adverse events of grade three or higher related to regorafenib were hand-foot skin reaction (83 patients, 17%), fatigue (48, 10%), diarrhoea (36, 7%), hypertension (36, 7%), and rash or desquamation (29, 6%). INTERPRETATION Regorafenib is the first small-molecule multikinase inhibitor with survival benefits in metastatic colorectal cancer which has progressed after all standard therapies. The present study provides evidence for a continuing role of targeted treatment after disease progression, with regorafenib offering a potential new line of therapy in this treatment-refractory population. FUNDING Bayer HealthCare Pharmaceuticals.
Collapse
Affiliation(s)
- Axel Grothey
- Division of Medical Oncology, Mayo Clinic, Rochester, MN, USA
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
16
|
Van Cutsem E, Grothey A, Sobrero A, Siena S, Falcone A, Ychou M, Humblet Y, Bouche O, Mineur L, Barone C, Adenis A, Tabernero J, Yoshino T, Lenz HJ, Goldberg R, Sargent D, Cihon F, Cupit L, Wagner A, Laurent D. Phase 3 Correct Trial of Regorafenib in Metastatic Colorectal Cancer (MCRC): Overall Survival Update. Ann Oncol 2012. [DOI: 10.1016/s0923-7534(20)34319-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
|
17
|
Bukowski RM, Stadler WM, McDermott DF, Dutcher JP, Knox JJ, Miller WH, Hainsworth JD, Henderson CA, Hajdenberg J, Kindwall-Keller TL, Ernstoff MS, Drabkin HA, Curti BD, Chu L, Ryan CW, Hotte SJ, Xia C, Cupit L, Figlin RA. Safety and efficacy of sorafenib in elderly patients treated in the North American advanced renal cell carcinoma sorafenib expanded access program. Oncology 2010; 78:340-7. [PMID: 20733337 DOI: 10.1159/000320223] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2010] [Accepted: 04/02/2010] [Indexed: 11/19/2022]
Abstract
OBJECTIVE In this retrospective analysis of the Advanced Renal Cell Carcinoma Sorafenib (ARCCS) program in North America, we compared the safety and efficacy of sorafenib in patients aged ≥70 with those aged <70 years. METHODS Patients were treated with oral sorafenib twice daily until the occurrence of disease progression or treatment intolerance. The primary objective of the ARCCS program was making sorafenib available to patients with advanced renal cell carcinoma (RCC) in the USA and Canada before marketing approval was obtained; the secondary objective was the evaluation of its safety and efficacy. RESULTS Of the 2,504 patients enrolled in the ARCCS program who received at least 1 dose of sorafenib, 736 (29%) were aged ≥70 years. The most common grade ≥3 adverse events included rash/desquamation (5% in both groups), hand-foot skin reaction (8% in those aged ≥70 years vs. 10% in those <70 years of age), hypertension (5 vs. 4%) and fatigue (7 vs. 4%). Partial response was seen in 4% of the patients in both age groups. The median overall survival for the ≥70-year versus <70-year groups was also similar (46 vs. 50 weeks). CONCLUSIONS There were no substantial differences in safety and efficacy between patients aged ≥70 and <70 years with advanced RCC treated with sorafenib.
Collapse
Affiliation(s)
- Ronald M Bukowski
- Department of Solid Tumor Oncology, Cleveland Clinic Taussig Cancer Center, Cleveland Clinic Foundation, Cleveland, OH 441214, USA.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
18
|
Stadler WM, Figlin RA, McDermott DF, Dutcher JP, Knox JJ, Miller WH, Hainsworth JD, Henderson CA, George JR, Hajdenberg J, Kindwall-Keller TL, Ernstoff MS, Drabkin HA, Curti BD, Chu L, Ryan CW, Hotte SJ, Xia C, Cupit L, Bukowski RM. Safety and efficacy results of the advanced renal cell carcinoma sorafenib expanded access program in North America. Cancer 2010; 116:1272-80. [PMID: 20082451 DOI: 10.1002/cncr.24864] [Citation(s) in RCA: 217] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND The Advanced Renal Cell Carcinoma Sorafenib (ARCCS) program made sorafenib available to patients with advanced renal cell carcinoma (RCC) before regulatory approval. METHODS In this nonrandomized, open-label expanded access program, 2504 patients from the United States and Canada were treated with oral sorafenib 400 mg twice daily. Safety and efficacy were explored overall and in subgroups of patients including those with no prior therapy, nonclear cell (nonclear cell) RCC, brain metastases, prior bevacizumab treatment, and elderly patients. Sorafenib was approved for RCC 6 months after study initiation, at which time patients with no prior therapy or with nonclear cell RCC could enroll in an extension protocol for continued assessment for a period of 6 months. RESULTS The most common grade > or =2 drug-related adverse events were hand-foot skin reaction (18%), rash (14%), hypertension (12%), and fatigue (11%). In the 1891 patients evaluable for response, complete response was observed in 1 patient, partial response in 67 patients (4%), and stable disease for at least 8 weeks in 1511 patients (80%). Median progression-free survival in the extension population was 36 weeks (95% confidence interval [CI], 33-45 weeks; censorship rate, 56%); median overall survival in the entire population was 50 weeks (95% CI, 46-52 weeks; censorship rate, 63%). The efficacy and safety results were similar across the subgroups. CONCLUSIONS Sorafenib 400 mg twice daily demonstrated activity and a clinically acceptable toxicity profile in all patient subsets enrolled in the ARCCS expanded access program (clinicaltrials.gov identifier: NCT00111020).
Collapse
Affiliation(s)
- Walter M Stadler
- Department of Medicine, University of Chicago Medical Center, Chicago, Illinois
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
19
|
Scagliotti G, Novello S, von Pawel J, Reck M, Pereira JR, Thomas M, Abrão Miziara JE, Balint B, De Marinis F, Keller A, Arén O, Csollak M, Albert I, Barrios CH, Grossi F, Krzakowski M, Cupit L, Cihon F, Dimatteo S, Hanna N. Phase III study of carboplatin and paclitaxel alone or with sorafenib in advanced non-small-cell lung cancer. J Clin Oncol 2010; 28:1835-42. [PMID: 20212250 DOI: 10.1200/jco.2009.26.1321] [Citation(s) in RCA: 376] [Impact Index Per Article: 26.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
PURPOSE This phase III, multicenter, randomized, placebo-controlled trial assessed the efficacy and safety of sorafenib, an oral multikinase inhibitor, in combination with carboplatin and paclitaxel in chemotherapy-naïve patients with unresectable stage IIIB or IV non-small-cell lung cancer (NSCLC). PATIENTS AND METHODS Nine hundred twenty-six patients were randomly assigned to receive up to six 21-day cycles of carboplatin area under the curve 6 and paclitaxel 200 mg/m(2) (CP) on day 1, followed by either sorafenib 400 mg twice a day (n = 464, arm A) or placebo (n = 462, arm B) on days 2 to 19. The maintenance phase after CP consisted of sorafenib 400 mg or placebo twice a day. The primary end point was overall survival (OS); secondary end points included progression-free survival and tumor response. RESULTS Overall demographics were balanced between arms; 223 patients (24%) had squamous cell histology. On the basis of a planned interim analysis, median OS was 10.7 months in arm A and 10.6 months in arm B (hazard ratio [HR] = 1.15; 95% CI, 0.94 to 1.41; P = .915). The study was terminated after the interim analysis concluded that the study was highly unlikely to meet its primary end point. A prespecified exploratory analysis revealed that patients with squamous cell histology had greater mortality in arm A than in arm B (HR = 1.85; 95% CI, 1.22 to 2.81). Main grade 3 or 4 sorafenib-related toxicities included rash (8.4%), hand-foot skin reaction (7.8%), and diarrhea (3.5%). CONCLUSION No clinical benefit was observed from adding sorafenib to CP chemotherapy as first-line treatment for NSCLC.
Collapse
Affiliation(s)
- Giorgio Scagliotti
- Department of Clinical and Biological Sciences, University of Turin, San Luigi Hospital, Regione Gonzole 10, Orbassano, Torino, Italy 10043.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
20
|
Pacey S, Ratain MJ, Flaherty KT, Kaye SB, Cupit L, Rowinsky EK, Xia C, O'Dwyer PJ, Judson IR. Efficacy and safety of sorafenib in a subset of patients with advanced soft tissue sarcoma from a Phase II randomized discontinuation trial. Invest New Drugs 2009; 29:481-8. [PMID: 20016927 DOI: 10.1007/s10637-009-9367-9] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2009] [Accepted: 11/26/2009] [Indexed: 01/19/2023]
Abstract
AIM Phase II multi-disease randomized discontinuation trial to assess the safety and efficacy of sorafenib including patients with advanced soft tissue sarcoma (STS). METHODS Sorafenib (400 mg twice daily) was initially administered for 12 weeks. Patients with: ≥25% tumour shrinkage continued sorafenib; ≥25% tumour growth discontinued; other patients were randomized and received sorafenib or placebo. RESULTS Twenty-six patients (median age 55 years) were enrolled. Common drug-related adverse events, including fatigue, hand-foot skin reaction, rash or gastrointestinal disturbances, were manageable, reversible and generally low grade. Fatigue, skin toxicity, nausea, diarrhoea and hypertension occurred at grade ≥3 in 19% of patients. After 12 weeks eight (31%) patients had not progressed. Three patients who experienced tumour shrinkage and continued on sorafenib, and five (19%) were randomized either to continue sorafenib or to receive placebo. Of the three patients randomized to sorafenib, one achieved a partial response and two had SD. Overall one patient achieved a partial response and three further patients achieved minor responses. CONCLUSIONS There was evidence of disease activity in STS as defined by tumor regressions including one objective partial response. Further investigation in STS is warranted.
Collapse
Affiliation(s)
- Simon Pacey
- The Royal Marsden Hospital, Downs Rd, Sutton, Surrey, SM2 5PT, UK
| | | | | | | | | | | | | | | | | |
Collapse
|
21
|
Blumenschein GR, Gatzemeier U, Fossella F, Stewart DJ, Cupit L, Cihon F, O'Leary J, Reck M. Phase II, multicenter, uncontrolled trial of single-agent sorafenib in patients with relapsed or refractory, advanced non-small-cell lung cancer. J Clin Oncol 2009; 27:4274-80. [PMID: 19652055 DOI: 10.1200/jco.2009.22.0541] [Citation(s) in RCA: 167] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
PURPOSE Sorafenib is an oral multikinase inhibitor that targets the Ras/Raf/MEK/ERK mitogenic signaling pathway and the angiogenic receptor tyrosine kinases, vascular endothelial growth factor receptor 2 and platelet-derived growth factor receptor beta. We evaluated the antitumor response and tolerability of sorafenib in patients with relapsed or refractory, advanced non-small-cell lung cancer (NSCLC), most of whom had received prior platinum-based chemotherapy. PATIENTS AND METHODS This was a phase II, single-arm, multicenter study. Patients with relapsed or refractory advanced NSCLC received sorafenib 400 mg orally twice daily until tumor progression or an unacceptable drug-related toxicity occurred. The primary objective was to measure response rate. RESULTS Of 54 patients enrolled, 52 received sorafenib. The predominant histologies were adenocarcinoma (54%) and squamous cell carcinoma (31%). No complete or partial responses were observed. Stable disease (SD) was achieved in 30 (59%) of the 51 patients who were evaluable for efficacy. Four patients with SD developed tumor cavitation. Median progression-free survival (PFS) was 2.7 months, and median overall survival was 6.7 months. Patients with SD had a median PFS of 5.5 months. Major grades 3 to 4, treatment-related toxicities included hand-foot skin reaction (10%), hypertension (4%), fatigue (2%), and diarrhea (2%). Nine patients died within a 30-day period after discontinuing sorafenib, and one patient experienced pulmonary hemorrhage that was considered drug related. CONCLUSION Continuous treatment with sorafenib 400 mg twice daily was associated with disease stabilization in patients with advanced NSCLC. The broad activity of sorafenib and its acceptable toxicity profile suggest that additional investigation of sorafenib as therapy for patients with NSCLC is warranted.
Collapse
Affiliation(s)
- George R Blumenschein
- The M. D. Anderson Cancer Center, 1515 Holcombe Blvd, Box 432, Houston, TX 77030-4009, USA.
| | | | | | | | | | | | | | | |
Collapse
|
22
|
Bukowski RM, Stadler WM, Figlin RA, Knox JJ, Gabrail N, McDermott DF, Cupit L, Miller WH, Hainsworth JD, Ryan CW. Safety and efficacy of sorafenib in elderly patients (pts) ≥65 years: A subset analysis from the Advanced Renal Cell Carcinoma Sorafenib (ARCCS) Expanded Access Program in North America. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.5045] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
|
23
|
Knox JJ, Figlin RA, Stadler WM, McDermott DF, Gabrail N, Miller WH, Hainsworth J, Ryan CW, Cupit L, Bukowski RM. The Advanced Renal Cell Carcinoma Sorafenib (ARCCS) expanded access trial in North America: Safety and efficacy. J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.5011] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
5011 Background: A prior phase III trial (TARGETs) demonstrated that sorafenib (SOR) doubled median progression-free survival versus placebo in previously treated clear cell renal cell cancer (RCC) patients (pts). The ARCCS trial made SOR available to a broader range of RCC pts through an expanded access program. Methods: This open-label, nonrandomized trial enrolled pts with advanced RCC not eligible for, or without access to, other SOR clinical trials; ECOG PS 0–2 with waivers granted for pts with ECOG PS 3–4; age =15 yrs; and adequate prior treatment of brain metastases. Major exclusion criteria included treatment <4 wks prior, life expectancy <2 mos, uncontrolled hypertension, and severe renal impairment requiring dialysis. Objectives were to analyze the safety and efficacy (response by RECIST) of 400 mg bid SOR in a community-based setting. Enrollment ceased on 12/20/05 when SOR became commercially available in the US, and those with no prior therapy or non-clear cell RCC continued in an extension protocol. Enrollment completed in Canada in 8/06. Results: A total of 2488 pts were valid for safety: 69% male with median age 63 yrs and most (83%) had prior nephrectomy; histologies included 78% clear-cell, 7% papillary, 1% chromophobe, and <1% collecting duct and oncocytoma. Median time from diagnosis for all pts was 1.4 yrs (range <1–34). Of those pts receiving prior therapy (n=1249), treatments included interferon alfa (54%), interleukin 2 (43%), bevacizumab (23%), thalidomide (12%), and sunitinib (2%). Grade 3 and 4 adverse events occurring in > 2% pts were hand- foot skin reaction 7.2%, fatigue 5.3%, hypertension 4.4%, rash/desquamation 4%, dehydration and dyspnea 2.7%, and diarrhea 2.5%. Efficacy assessment, mainly PFS, was limited by the short median time (14 wks) on study due to many pts enrolling during the last 2 months of the study. Of 1,850 pts evaluable for response, 17.5% had unconfirmed PR. One (0.1%), 67 (3.6%), 1479 (79.9%) and 303 (16.4%) had CR, PR, SD, and PD, respectively. Conclusions: ARCCS pts were representative of the broader range of RCC pts in the community including those excluded from previous SOR trials. Toxicity and response rates were similar to those reported previously, supporting the generalizability of the phase III trial data. [Table: see text]
Collapse
Affiliation(s)
- J. J. Knox
- Princess Margaret Hospital, Toronto, ON, Canada; City of Hope Comprehensive Cancer Center, Los Angeles, CA; University of Chicago Medical Center, Chicago, IL; Beth Israel Deaconess Medical Center, Boston, MA; Gabrail Cancer Center, Canton, OH; Jewish General Hospital, McGill University, Montreal, PQ, Canada; Sarah Cannon Research Institute, Nashville, TN; Oregon Health and Science University, Portland, OR; Bayer HealthCare, West Haven, CT; Cleveland Clinic Foundation, Cleveland, OH
| | - R. A. Figlin
- Princess Margaret Hospital, Toronto, ON, Canada; City of Hope Comprehensive Cancer Center, Los Angeles, CA; University of Chicago Medical Center, Chicago, IL; Beth Israel Deaconess Medical Center, Boston, MA; Gabrail Cancer Center, Canton, OH; Jewish General Hospital, McGill University, Montreal, PQ, Canada; Sarah Cannon Research Institute, Nashville, TN; Oregon Health and Science University, Portland, OR; Bayer HealthCare, West Haven, CT; Cleveland Clinic Foundation, Cleveland, OH
| | - W. M. Stadler
- Princess Margaret Hospital, Toronto, ON, Canada; City of Hope Comprehensive Cancer Center, Los Angeles, CA; University of Chicago Medical Center, Chicago, IL; Beth Israel Deaconess Medical Center, Boston, MA; Gabrail Cancer Center, Canton, OH; Jewish General Hospital, McGill University, Montreal, PQ, Canada; Sarah Cannon Research Institute, Nashville, TN; Oregon Health and Science University, Portland, OR; Bayer HealthCare, West Haven, CT; Cleveland Clinic Foundation, Cleveland, OH
| | - D. F. McDermott
- Princess Margaret Hospital, Toronto, ON, Canada; City of Hope Comprehensive Cancer Center, Los Angeles, CA; University of Chicago Medical Center, Chicago, IL; Beth Israel Deaconess Medical Center, Boston, MA; Gabrail Cancer Center, Canton, OH; Jewish General Hospital, McGill University, Montreal, PQ, Canada; Sarah Cannon Research Institute, Nashville, TN; Oregon Health and Science University, Portland, OR; Bayer HealthCare, West Haven, CT; Cleveland Clinic Foundation, Cleveland, OH
| | - N. Gabrail
- Princess Margaret Hospital, Toronto, ON, Canada; City of Hope Comprehensive Cancer Center, Los Angeles, CA; University of Chicago Medical Center, Chicago, IL; Beth Israel Deaconess Medical Center, Boston, MA; Gabrail Cancer Center, Canton, OH; Jewish General Hospital, McGill University, Montreal, PQ, Canada; Sarah Cannon Research Institute, Nashville, TN; Oregon Health and Science University, Portland, OR; Bayer HealthCare, West Haven, CT; Cleveland Clinic Foundation, Cleveland, OH
| | - W. H. Miller
- Princess Margaret Hospital, Toronto, ON, Canada; City of Hope Comprehensive Cancer Center, Los Angeles, CA; University of Chicago Medical Center, Chicago, IL; Beth Israel Deaconess Medical Center, Boston, MA; Gabrail Cancer Center, Canton, OH; Jewish General Hospital, McGill University, Montreal, PQ, Canada; Sarah Cannon Research Institute, Nashville, TN; Oregon Health and Science University, Portland, OR; Bayer HealthCare, West Haven, CT; Cleveland Clinic Foundation, Cleveland, OH
| | - J. Hainsworth
- Princess Margaret Hospital, Toronto, ON, Canada; City of Hope Comprehensive Cancer Center, Los Angeles, CA; University of Chicago Medical Center, Chicago, IL; Beth Israel Deaconess Medical Center, Boston, MA; Gabrail Cancer Center, Canton, OH; Jewish General Hospital, McGill University, Montreal, PQ, Canada; Sarah Cannon Research Institute, Nashville, TN; Oregon Health and Science University, Portland, OR; Bayer HealthCare, West Haven, CT; Cleveland Clinic Foundation, Cleveland, OH
| | - C. W. Ryan
- Princess Margaret Hospital, Toronto, ON, Canada; City of Hope Comprehensive Cancer Center, Los Angeles, CA; University of Chicago Medical Center, Chicago, IL; Beth Israel Deaconess Medical Center, Boston, MA; Gabrail Cancer Center, Canton, OH; Jewish General Hospital, McGill University, Montreal, PQ, Canada; Sarah Cannon Research Institute, Nashville, TN; Oregon Health and Science University, Portland, OR; Bayer HealthCare, West Haven, CT; Cleveland Clinic Foundation, Cleveland, OH
| | - L. Cupit
- Princess Margaret Hospital, Toronto, ON, Canada; City of Hope Comprehensive Cancer Center, Los Angeles, CA; University of Chicago Medical Center, Chicago, IL; Beth Israel Deaconess Medical Center, Boston, MA; Gabrail Cancer Center, Canton, OH; Jewish General Hospital, McGill University, Montreal, PQ, Canada; Sarah Cannon Research Institute, Nashville, TN; Oregon Health and Science University, Portland, OR; Bayer HealthCare, West Haven, CT; Cleveland Clinic Foundation, Cleveland, OH
| | - R. M. Bukowski
- Princess Margaret Hospital, Toronto, ON, Canada; City of Hope Comprehensive Cancer Center, Los Angeles, CA; University of Chicago Medical Center, Chicago, IL; Beth Israel Deaconess Medical Center, Boston, MA; Gabrail Cancer Center, Canton, OH; Jewish General Hospital, McGill University, Montreal, PQ, Canada; Sarah Cannon Research Institute, Nashville, TN; Oregon Health and Science University, Portland, OR; Bayer HealthCare, West Haven, CT; Cleveland Clinic Foundation, Cleveland, OH
| |
Collapse
|
24
|
Bohn MC, Marciano F, Cupit L, Gash DM. Recovery of dopaminergic fibers in striatum of the 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine-treated mouse is enhanced by grafts of adrenal medulla. Prog Brain Res 1988; 78:535-42. [PMID: 3266803 DOI: 10.1016/s0079-6123(08)60328-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
|
25
|
Abstract
The drug, 1-methyl-4-phenyl-1,2,5,6-tetrahydropyridine (MPTP), depletes striatal dopamine levels in primates and certain rodents, including mice, and produces parkinsonian-like symptoms in humans and nonhuman primates. To investigate the consequences of grafting adrenal medullary tissue into the brain of a rodent model of Parkinson's disease, a piece of adult mouse adrenal medulla was grafted unilaterally into mouse striatum 1 week after MPTP treatment. This MPTP treatment resulted in the virtual disappearance of tyrosine hydroxylase-immunoreactive fibers and severely depleted striatal dopamine levels. At 2, 4, and 6 weeks after grafting, dense tyrosine hydroxylase-immunoreactive fibers were observed in the grafted striatum, while only sparse fibers were seen in the contralateral striatum. In all cases, tyrosine hydroxylase-immunoreactive fibers appeared to be from the host rather than from the grafts, which survived poorly. These observations suggest that, in mice, adrenal medullary grafts exert a neurotrophic action in the host brain to enhance recovery of dopaminergic neurons. This effect may be relevant to the symptomatic recovery in Parkinson's disease patients who have received adrenal medullary grafts.
Collapse
|
26
|
Cupit L. Helping expectant parents understand the fetal monitor. Pediatr Nurs 1980; 6:21-3. [PMID: 6900248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
|