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Gumbleton M, Allan S, Conway H, Boucher K, Marvin J, Hawks J, Burnett W, Van Brocklin M, Whisenant J, Gilcrease G, Gupta S. A phase I open-label study of the safety and efficacy of apatinib (rivoceranib) administered to patients with advanced malignancies to improve sensitivity to pembrolizumab in the second- or later-line setting ( APPEASE). BMC Res Notes 2023; 16:16. [PMID: 36797744 PMCID: PMC9936706 DOI: 10.1186/s13104-023-06283-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 01/30/2023] [Indexed: 02/18/2023] Open
Abstract
OBJECTIVE APPEASE is a phase I study to assess the safety, dosing, and efficacy of rivoceranib (a selective, small-molecule inhibitor of VEGFR2) in combination with pembrolizumab. We aimed to treat patients with metastatic malignancies who have progressed through at least first-line therapy, with pembrolizumab 200 mg every 3 weeks, as well as escalating doses of rivoceranib until disease progression or unacceptable toxicity. RESULTS Five patients were enrolled on the starting dose of rivoceranib 300 mg once daily. There were no dose-limiting toxicities observed in combination with pembrolizumab. The dose of rivoceranib was not escalated due to study closure. We note a treatment related grade 3 adverse event (AE) rate of 40%, predominantly in urothelial cancer patients, with no deaths related to treatment related AEs. The disease control rate was 75% (3 of 4) and the median progression free survival (PFS) was 3.6 months. Tumor shrinkage was noted in patients who were previously progressing on pembrolizumab alone. Apatinib 300 mg is safe and demonstrates anti-tumor activity in advanced solid tumors in combination with pembrolizumab. Further dose escalation and efficacy need to be investigated in larger disease-specific patient populations. TRIAL REGISTRATION NUMBER Clinical trial registration number: NCT03407976. Date of registration: January 17, 2018.
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Affiliation(s)
- Matthew Gumbleton
- Huntsman Cancer Institute, University of Utah, 2000 Circle of Hope Drive, Salt Lake City, UT USA
- Division of Oncology, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, UT USA
| | - Stephanie Allan
- Huntsman Cancer Institute, University of Utah, 2000 Circle of Hope Drive, Salt Lake City, UT USA
| | - Hannah Conway
- Huntsman Cancer Institute, University of Utah, 2000 Circle of Hope Drive, Salt Lake City, UT USA
| | - Kenneth Boucher
- Division of Epidemiology and Huntsman Cancer Institute, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, UT USA
| | - James Marvin
- Flow Cytometry Core Facility, Health Science Center, University of Utah, Salt Lake City, UT USA
| | - Josiah Hawks
- Division of Oncology, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, UT USA
| | - William Burnett
- Department of Oncological Sciences, University of Utah School of Medicine, Salt Lake City, UT USA
| | - Matthew Van Brocklin
- Division of Oncology, Department of Surgery, University of Utah School of Medicine, Salt Lake City, UT USA
| | - Jonathan Whisenant
- Huntsman Cancer Institute, University of Utah, 2000 Circle of Hope Drive, Salt Lake City, UT USA
- Division of Oncology, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, UT USA
| | - Glynn Gilcrease
- Huntsman Cancer Institute, University of Utah, 2000 Circle of Hope Drive, Salt Lake City, UT USA
- Division of Oncology, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, UT USA
| | - Sumati Gupta
- Huntsman Cancer Institute, University of Utah, 2000 Circle of Hope Drive, Salt Lake City, UT USA
- Division of Oncology, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, UT USA
- Department of Veterans Affairs Medical Center, Salt Lake City, UT USA
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