دورية أكاديمية

A phase I trial of the pan-ERBB inhibitor neratinib combined with the MEK inhibitor trametinib in patients with advanced cancer with EGFR mutation/amplification, HER2 mutation/amplification, HER3/4 mutation or KRAS mutation

التفاصيل البيبلوغرافية
العنوان: A phase I trial of the pan-ERBB inhibitor neratinib combined with the MEK inhibitor trametinib in patients with advanced cancer with EGFR mutation/amplification, HER2 mutation/amplification, HER3/4 mutation or KRAS mutation
المؤلفون: Piha-Paul, Sarina A., Tseng, Chieh, Tran, Hai T., Gao, Meng, Karp, Daniel D., Subbiah, Vivek, Tsimberidou, Apostolia Maria, Kawedia, Jitesh D., Fu, Siqing, Pant, Shubham, Yap, Timothy A., Morris, Van K., Kee, Bryan K., Blum Murphy, Mariela, Lim, JoAnn, Meric-Bernstam, Funda
المساهمون: Puma Biotechnology
المصدر: Cancer Chemotherapy and Pharmacology ; volume 92, issue 2, page 107-118 ; ISSN 0344-5704 1432-0843
بيانات النشر: Springer Science and Business Media LLC
سنة النشر: 2023
مصطلحات موضوعية: Pharmacology (medical), Cancer Research, Pharmacology, Toxicology, Oncology
الوصف: Purpose Aberrant alterations of ERBB receptor tyrosine kinases lead to tumorigenesis. Single agent therapy targeting EGFR or HER2 has shown clinical successes, but drug resistance often develops due to aberrant or compensatory mechanisms. Herein, we sought to determine the feasibility and safety of neratinib and trametinib in patients with EGFR mutation/amplification, HER2 mutation/amplification, HER3/4 mutation and KRAS mutation. Methods Patients with actionable somatic mutations or amplifications in ERBB genes or actionable KRAS mutations were enrolled to receive neratinib and trametinib in this phase I dose escalation trial. The primary endpoint was determination of the maximum tolerated dose (MTD) and dose-limiting toxicity (DLT). Secondary endpoints included pharmacokinetic analysis and preliminary anti-tumor efficacy. Results Twenty patients were enrolled with a median age of 50.5 years and a median of 3 lines of prior therapy. Grade 3 treatment-related toxicities included: diarrhea (25%), vomiting (10%), nausea (5%), fatigue (5%) and malaise (5%). The MTD was dose level (DL) minus 1 (neratinib 160 mg daily with trametinib 1 mg, 5 days on and 2 days off) given 2 DLTs of grade 3 diarrhea in DL1 (neratinib 160 mg daily with trametinib 1 mg daily). The treatment-related toxicities of DL1 included: diarrhea (100%), nausea (55.6%) and rash (55.6%). Pharmacokinetic data showed trametinib clearance was significantly reduced leading to high drug exposures of trametinib. Two patients achieved stable disease (SD) ≥ 4 months. Conclusion Neratinib and trametinib combination was toxic and had limited clinical efficacy. This may be due to suboptimal drug dosing given drug–drug interactions. Trial registration ID: NCT03065387.
نوع الوثيقة: article in journal/newspaper
اللغة: English
DOI: 10.1007/s00280-023-04545-4
DOI: 10.1007/s00280-023-04545-4.pdf
DOI: 10.1007/s00280-023-04545-4/fulltext.html
الإتاحة: https://doi.org/10.1007/s00280-023-04545-4Test
حقوق: https://creativecommons.org/licenses/by/4.0Test ; https://creativecommons.org/licenses/by/4.0Test
رقم الانضمام: edsbas.1DCAFDA4
قاعدة البيانات: BASE