Abstract | PURPOSE: EXPERIMENTAL DESIGN: Eligible men had castration-resistant prostate cancer treated with one prior chemotherapy. Subjects were treated with 6 mg/kg CNTO328 i.v. every 2 weeks for 12 cycles. Response was assessed after every three cycles. Primary end point was prostate-specific antigen (PSA) response rate defined as a 50% reduction. Accrual was planned in two stages, with 20 eligible patients in the first stage and 40 overall. Plasma cytokines and growth factors were measured by Luminex. RESULTS: Fifty-three eligible subjects had all received prior taxane therapy. Two (3.8%; 95% CI, 0.5-13.0%) had PSA response. None of the 31 patients with measurable disease had a RECIST (Response Evaluation Criteria in Solid Tumors) response but 7 (23%) had stable disease. With median follow-up of 14.8 months, median progression-free survival was 1.6 months (95% CI, 1.6-1.7) and median overall survival was 11.6 months (95% CI, 7.5-19.0). Grade 3/4 toxicities included disseminated intravascular coagulation (1), central nervous system ischemia (1), elevated aspartate aminotransferase (1), gastritis/ esophagitis (2), thrombocytopenia (2), pain (2), leukopenia (1), and neuropathy (2). Median baseline IL-6 levels were 12.5 pg/mL (interquartile range, 2.5-41.5). Patients with IL-6 >12.5 pg/mL had worse survival than those with levels <12.5 pg/mL (53% versus 94%; P = 0.02). After treatment, IL-6 levels were >250-fold higher. Thirty-two of 38 patients had a decline in C-reactive protein plasma levels at 6 weeks. CONCLUSIONS: CNTO328 resulted in a PSA response rate of 3.8% and a RECIST stable disease rate of 23%. Declining C-reactive protein levels during treatment may reflect biological activity. Despite evidence of CNTO-mediated IL-6 inhibition, elevated baseline IL-6 levels portended a poor prognosis.
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Authors | Tanya B Dorff, Bryan Goldman, Jacek K Pinski, Philip C Mack, Primo N Lara Jr, Peter J Van Veldhuizen Jr, David I Quinn, Nicholas J Vogelzang, Ian M Thompson Jr, Maha H A Hussain |
Journal | Clinical cancer research : an official journal of the American Association for Cancer Research
(Clin Cancer Res)
Vol. 16
Issue 11
Pg. 3028-34
(Jun 01 2010)
ISSN: 1557-3265 [Electronic] United States |
PMID | 20484019
(Publication Type: Clinical Trial, Phase II, Journal Article, Multicenter Study, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't)
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Copyright | Copyright 2010 AACR. |
Chemical References |
- Antibodies, Monoclonal
- Interleukin-6
- siltuximab
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Topics |
- Aged
- Aged, 80 and over
- Antibodies, Monoclonal
(adverse effects, therapeutic use)
- Antineoplastic Combined Chemotherapy Protocols
(therapeutic use)
- Castration
- Drug Resistance, Neoplasm
- Humans
- Interleukin-6
(antagonists & inhibitors)
- Male
- Middle Aged
- Prostatic Neoplasms
(drug therapy, mortality)
- Retreatment
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