1
|
Assouline S, Amrein L, Aloyz R, Banerji V, Caplan S, Owen C, Hasegawa W, Robinson S, Shivakumar S, Prica A, Peters A, Hagerman L, Rodriguez L, Skamene T, Panasci L, Chen BE, Hay AE. IND.216: a phase II study of buparlisib and associated biomarkers, raptor and p70S6K, in patients with relapsed and refractory chronic lymphocytic leukemia. Leuk Lymphoma 2020; 61:1653-1659. [PMID: 32154751 DOI: 10.1080/10428194.2020.1734594] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Buparlisib is an orally available pan-Class I PI3K inhibitor, that is more potent than idelalisib in vitro. Its distinct toxicities include hyperglycemia, hypertension, and mood disturbance. IND216 is a single arm phase II trial of buparlisib in Relapsed/refractory (R/R) chronic lymphocytic leukemia (CLL). Fourteen patients were enrolled, 13 were evaluable for response and toxicity. Six of 13 patients had a partial response (46%) with a median duration of response of 15.5 months, all 11 patients with tumor assessment experienced tumor shrinkage. The most common adverse events (≥15%) were hyperglycemia, fatigue, anxiety, and gastrointestinal toxicities; all were < grade 3 except for fatigue. Three patients stopped therapy for alterations in mood. Lower levels of raptor were significantly associated with greater tumor shrinkage, suggesting that raptor could be a biomarker for response. This requires further validation in a larger CLL patient cohort. The clinical activity of buparlisib is comparable to other phosphatidylinositol-3-kinase inhibitors, with a different toxicity profile.Novelty and impactBuparlisib, an oral, pan PI3 kinase inhibitor, is associated with a 46% partial response rate among patients with relapse chronic lymphocytic leukemia (CLL). This is a similar clinical activity to other phosphatidylinositol-3-kinase inhibitors tested. However, buparlisib has a distinct toxicity profile, characterized by hyperglycemia, hypertension, and mood alteration. In agreement with our previous preclinical study, our results suggest that basal raptor expression in CLL correlates with clinical response to buparlisib.
Collapse
Affiliation(s)
- Sarit Assouline
- Segal Cancer Centre, Jewish General Hospital, McGill University, Montreal, Canada
| | - Lilian Amrein
- Segal Cancer Centre, Jewish General Hospital, McGill University, Montreal, Canada.,Unicancer, Paris, France
| | - Raquel Aloyz
- Segal Cancer Centre, Jewish General Hospital, McGill University, Montreal, Canada
| | | | - Stephen Caplan
- Segal Cancer Centre, Jewish General Hospital, McGill University, Montreal, Canada
| | | | | | | | | | - Anca Prica
- University Health Network, Princess Margaret Cancer Centre, Toronto, Canada
| | - Anthea Peters
- Department of Medicine, Cross Cancer Institute, University of Alberta, Edmonton, Canada
| | - Linda Hagerman
- Canadian Cancer Trials Group, Queen's University, Kingston, Canada
| | - Laura Rodriguez
- Canadian Cancer Trials Group, Queen's University, Kingston, Canada
| | - Tanya Skamene
- Segal Cancer Centre, Jewish General Hospital, McGill University, Montreal, Canada
| | - Lawrence Panasci
- Segal Cancer Centre, Jewish General Hospital, McGill University, Montreal, Canada
| | - Bingshu E Chen
- Canadian Cancer Trials Group, Queen's University, Kingston, Canada
| | - Annette E Hay
- Canadian Cancer Trials Group, Queen's University, Kingston, Canada
| |
Collapse
|
2
|
Reiman T, Savage KJ, Crump M, Cheung MC, MacDonald D, Buckstein R, Couban S, Piliotis E, Imrie K, Spaner D, Shivakumar S, Kuruvilla J, Villa D, Shepherd LE, Skamene T, Winch C, Chen BE, Hay AE. A phase I study of romidepsin, gemcitabine, dexamethasone and cisplatin combination therapy in the treatment of peripheral T-cell and diffuse large B-cell lymphoma; the Canadian cancer trials group LY.15 study†. Leuk Lymphoma 2018; 60:912-919. [PMID: 30301414 DOI: 10.1080/10428194.2018.1515937] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
We investigated GDP (gemcitabine, 1000 mg/m2 IV d1, d8; dexamethasone, 40 mg po d1-4; cisplatin, 75 mg/m2 IV d1) combined with romidepsin on days 1 and 8 every 21 days to a maximum of six cycles in a standard 3 + 3, phase I dose escalation trial for patients with relapsed/refractory peripheral T-cell (PTCL) or diffuse large B-cell (DLBCL) lymphoma (NCT01846390). After treating four patients, gemcitabine and romidepsin were given on days 1 and 15 every 28 days. On the 21-day schedule at 6 mg/m2 romidepsin, there were three dose-limiting toxicities (DLTs) among four patients. On the 28-day schedule, there were no DLTs at the 6, 8, or 10 mg/m2 dose. At 12 mg/m2, there were four observed grade 3 DLTs among six evaluable patients. Full doses of GDP can be combined with a recommended phase II romidepsin dose of 10 mg/m2 if given on a day 1, 15 every 28 days schedule.
Collapse
Affiliation(s)
- Tony Reiman
- a Department of oncology, Saint John Regional Hospital , Dalhousie University, and University of New Brunswick , Saint John , Canada
| | | | - Michael Crump
- c Department of Medical Oncology and Hematology, Princess Margaret Cancer Centre , Toronto , Canada
| | - Matthew C Cheung
- d Division of Hematology, Sunnybrook Health Services Centre , Toronto , Canada
| | - David MacDonald
- e Department of Hematology, QEII Health Sciences Centre , Halifax , Canada
| | - Rena Buckstein
- d Division of Hematology, Sunnybrook Health Services Centre , Toronto , Canada
| | - Stephen Couban
- e Department of Hematology, QEII Health Sciences Centre , Halifax , Canada
| | - Eugenia Piliotis
- d Division of Hematology, Sunnybrook Health Services Centre , Toronto , Canada
| | - Kevin Imrie
- f Department of Hematology, Sunnybrook Health Services Centre , Toronto , Canada
| | - David Spaner
- d Division of Hematology, Sunnybrook Health Services Centre , Toronto , Canada
| | - Sudeep Shivakumar
- e Department of Hematology, QEII Health Sciences Centre , Halifax , Canada
| | - John Kuruvilla
- c Department of Medical Oncology and Hematology, Princess Margaret Cancer Centre , Toronto , Canada
| | - Diego Villa
- g Canadian Cancer Trials Group, Cancer Research Institute , Queen's University , Kingston , Canada
| | - Lois E Shepherd
- g Canadian Cancer Trials Group, Cancer Research Institute , Queen's University , Kingston , Canada
| | - Tanya Skamene
- g Canadian Cancer Trials Group, Cancer Research Institute , Queen's University , Kingston , Canada
| | - Chad Winch
- g Canadian Cancer Trials Group, Cancer Research Institute , Queen's University , Kingston , Canada
| | - Bingshu E Chen
- g Canadian Cancer Trials Group, Cancer Research Institute , Queen's University , Kingston , Canada
| | - Annette E Hay
- g Canadian Cancer Trials Group, Cancer Research Institute , Queen's University , Kingston , Canada
| |
Collapse
|
3
|
Skamene T, Siu LL, Renouf DJ, Laskin JJ, Bedard PL, Jones SJM, Ferrario C, Whitlock J, Petrie J, Sullivan P, Malone ER, Nomikos D, Chen BE, Dancey J. Canadian profiling and targeted agent utilization trial (CAPTUR/PM.1): A phase II basket precision medicine trial. J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.15_suppl.tps12127] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [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)
| | | | | | - Janessa J. Laskin
- Department of Medical Oncology, British Columbia Cancer Agency, Vancouver, BC, Canada
| | | | - Steven J. M. Jones
- Canada's Michael Smith Genome Sciences Centre, British Columbia Cancer Agency, Vancouver, BC, Canada
| | - Cristiano Ferrario
- Segal Cancer Centre, Jewish General Hospital, McGill University, Montreal, QC, Canada
| | | | - Joan Petrie
- Canadian Cancer Trials Group, Kingston, ON, Canada
| | | | | | - Dora Nomikos
- NCIC Clinical Trials Group, Kingston, ON, Canada
| | | | | |
Collapse
|
4
|
Kuruvilla J, Crump M, Villa D, Aslam M, Prica A, Scott D, Abdel-Samad N, Couban S, Doucet S, Dudebout J, Fleury I, Fraser G, Larouche J, Shafey M, Skrabek P, Skamene T, Winch C, Shepherd L, Chen B, Hay A. CANADIAN CANCER TRIALS GROUP (CCTG) LY.17: A RANDOMIZED PHASE II STUDY EVALUATING NOVEL SALVAGE THERAPY PRE-AUTOLOGOUS STEM CELL TRANSPLANT (ASCT) IN RELAPSED/REFRACTORY DIFFUSE LARGE B CELL LYMPHOMA (RR-DLBCL) - OUTCOME OF IBRUTINIB + R-GDP. Hematol Oncol 2017. [DOI: 10.1002/hon.2437_76] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- J. Kuruvilla
- Canadian Cancer Trials Group; CCTG; Kingston Canada
| | - M. Crump
- Canadian Cancer Trials Group; CCTG; Kingston Canada
| | - D. Villa
- Canadian Cancer Trials Group; CCTG; Kingston Canada
| | - M. Aslam
- Canadian Cancer Trials Group; CCTG; Kingston Canada
| | - A. Prica
- Canadian Cancer Trials Group; CCTG; Kingston Canada
| | - D.W. Scott
- Canadian Cancer Trials Group; CCTG; Kingston Canada
| | | | - S. Couban
- Canadian Cancer Trials Group; CCTG; Kingston Canada
| | - S. Doucet
- Canadian Cancer Trials Group; CCTG; Kingston Canada
| | - J. Dudebout
- Canadian Cancer Trials Group; CCTG; Kingston Canada
| | - I. Fleury
- Canadian Cancer Trials Group; CCTG; Kingston Canada
| | - G. Fraser
- Canadian Cancer Trials Group; CCTG; Kingston Canada
| | - J. Larouche
- Canadian Cancer Trials Group; CCTG; Kingston Canada
| | - M. Shafey
- Canadian Cancer Trials Group; CCTG; Kingston Canada
| | - P. Skrabek
- Canadian Cancer Trials Group; CCTG; Kingston Canada
| | - T. Skamene
- Canadian Cancer Trials Group; CCTG; Kingston Canada
| | - C. Winch
- Canadian Cancer Trials Group; CCTG; Kingston Canada
| | - L. Shepherd
- Canadian Cancer Trials Group; CCTG; Kingston Canada
| | - B.E. Chen
- Canadian Cancer Trials Group; CCTG; Kingston Canada
| | - A.E. Hay
- Canadian Cancer Trials Group; CCTG; Kingston Canada
| |
Collapse
|
5
|
Skamene T, Crump M, Savage KJ, Reiman T, Kuruvilla J, Good D, LeBrun D, Meyer RM, Sehn LH, Soulières D, Stakiw J, Laferriere N, Luminari S, Shepherd LE, Djurfeldt M, Zhu L, Chen BE, Hay AE. Salvage chemotherapy and autologous stem cell transplantation for peripheral T-cell lymphoma: a subset analysis of the Canadian Cancer Trials Group LY.12 randomized phase 3 study . Leuk Lymphoma 2017; 58:2319-2327. [PMID: 28504033 DOI: 10.1080/10428194.2017.1312379] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Peripheral T-cell lymphoma (PTCL) is a rare, heterogeneous malignancy. Of the 619 patients with relapsed and refractory (R/R) aggressive lymphoma enrolled in the Canadian Cancer Trials Group LY.12 phase 3 trial, 59 (9.5%) had PTCL. Among these, 81% had advanced stage disease, 41% had an International Prognostic Score ≥3, and 41% were refractory to primary therapy. Within the PTCL cohort, the overall response rate after two cycles of salvage chemotherapy was 36%; no difference was observed between dexamethasone, cytarabine, cisplatin (10/30, 33%), and gemcitabine, cisplatin, dexamethasone (11/29, 38%) therapy. At one year, event-free survival (EFS) was 16% and overall survival (OS) was 28%. For PTCL patients, who received autologous stem cell transplant, two-year EFS and OS were 21% and 42%, respectively. Patients with PTCL had inferior OS (HR 0.49, p < .0001) and EFS (HR 0.53, p < .0001) compared to B-cell lymphoma. Outcomes for patients with R/R PTCL are poor with currently available therapies.
Collapse
Affiliation(s)
- Tanya Skamene
- a Canadian Cancer Trials Group, Queen's University , Kingston , Canada
| | - Michael Crump
- b Princess Margaret Cancer Centre , Toronto , Canada
| | - Kerry J Savage
- c Centre for Lymphoid Cancer, BC Cancer Agency , Vancouver , Canada
| | - Tony Reiman
- d Department of Medicine , Dalhousie University , Halifax , Canada.,e Department of Biology , University of New Brunswick , Saint John , Canada.,f Saint John Regional Hospital , Saint John , Canada
| | | | - David Good
- g Department of Pathology & Molecular Medicine , Queen's University , Kingston , Canada
| | - David LeBrun
- g Department of Pathology & Molecular Medicine , Queen's University , Kingston , Canada
| | - Ralph M Meyer
- h Department of Oncology , Juravinski Hospital and Cancer Centre, McMaster University , Hamilton , Canada
| | - Laurie H Sehn
- c Centre for Lymphoid Cancer, BC Cancer Agency , Vancouver , Canada
| | - Denis Soulières
- i Centre Hospitalier de l'Université de Montréal , Montréal , Canada
| | | | - Nicole Laferriere
- k Department of Oncology , Thunder Bay Regional Health Sciences, Lakehead University , Thunder Bay , Canada
| | - Stefano Luminari
- l Hematology , Arcispedale Santa Maria Nuova IRCCS, University of Modena and Reggio Emilia , Reggio Emilia , Italy
| | - Lois E Shepherd
- a Canadian Cancer Trials Group, Queen's University , Kingston , Canada.,g Department of Pathology & Molecular Medicine , Queen's University , Kingston , Canada
| | - Marina Djurfeldt
- a Canadian Cancer Trials Group, Queen's University , Kingston , Canada
| | - Liting Zhu
- a Canadian Cancer Trials Group, Queen's University , Kingston , Canada
| | - Bingshu E Chen
- a Canadian Cancer Trials Group, Queen's University , Kingston , Canada
| | - Annette E Hay
- a Canadian Cancer Trials Group, Queen's University , Kingston , Canada.,m Department of Medicine , Queen's University , Kingston , Canada
| |
Collapse
|
6
|
Roberge D, Skamene T, Turcotte R, Powell T, Saran N, Freeman C. Inter- and intra-observer variation in soft-tissue sarcoma target definition. Cancer Radiother 2011; 15:421-5. [DOI: 10.1016/j.canrad.2011.03.006] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2010] [Revised: 03/12/2011] [Accepted: 03/18/2011] [Indexed: 11/26/2022]
|