Abstract | PURPOSE: EXPERIMENTAL DESIGN: A phase I clinical study of escalating doses of the HER TKI lapatinib given as a 2-day pulse before a weekly infusion of nab-paclitaxel (100 mg/m(2)) was conducted in patients with advanced solid tumors. RESULTS: Twenty-five patients were treated. Treatment was associated with grade 1 to 2 toxicities including diarrhea, nausea, rash, neutropenia, neuropathy, fatigue, alopecia, and anemia. The two dose-limiting toxicities were grade 3 vomiting and grade 4 neutropenia, and the maximum tolerated dose of lapatinib was defined as 5250 mg/day in divided doses. Lapatinib concentrations increased with increasing dose. Dynamic Contrast Enhanced Magnetic Resonance Imaging studies in a subset of patients confirmed a decrease in tumor vascular permeability immediately following a lapatinib pulse. Sixty-five percent of evaluable patients experienced a partial or stable response on this therapy, 72% of whom were previously taxane-refractory. CONCLUSION: A 2-day pulse of high-dose lapatinib given before weekly nab-paclitaxel is a feasible and tolerable clinical regimen, suitable for testing this novel vascular-priming chemosensitization hypothesis developed in preclinical models.
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Authors | Amy J Chien, Julie A Illi, Andrew H Ko, Wolfgang M Korn, Lawrence Fong, Lee-may Chen, Mohammed Kashani-Sabet, Charles J Ryan, Jonathan E Rosenberg, Sarita Dubey, Eric J Small, Thierry M Jahan, Nola M Hylton, Benjamin M Yeh, Yong Huang, Kevin M Koch, Mark M Moasser |
Journal | Clinical cancer research : an official journal of the American Association for Cancer Research
(Clin Cancer Res)
Vol. 15
Issue 17
Pg. 5569-75
(Sep 01 2009)
ISSN: 1557-3265 [Electronic] United States |
PMID | 19706807
(Publication Type: Clinical Trial, Phase I, Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't)
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Chemical References |
- Albumin-Bound Paclitaxel
- Albumins
- Protein Kinase Inhibitors
- Quinazolines
- Lapatinib
- ErbB Receptors
- Paclitaxel
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Topics |
- Administration, Oral
- Albumin-Bound Paclitaxel
- Albumins
(administration & dosage, adverse effects)
- Antineoplastic Combined Chemotherapy Protocols
- Dose-Response Relationship, Drug
- ErbB Receptors
(metabolism)
- Female
- Humans
- Injections, Intravenous
- Lapatinib
- Male
- Middle Aged
- Nanoparticles
(administration & dosage)
- Neoplasms
(drug therapy, pathology)
- Paclitaxel
(administration & dosage, adverse effects)
- Protein Kinase Inhibitors
(administration & dosage, therapeutic use, toxicity)
- Quinazolines
(administration & dosage, adverse effects)
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