A phase II evaluation of motesanib (AMG 706) in the treatment of persistent or recurrent ovarian, fallopian tube and primary peritoneal carcinomas: a Gynecologic Oncology Group study.

Abstract

OBJECTIVES:

Vascular endothelial growth factors (VEGF) and their receptors have a critical role in stimulating the growth of ovarian cancer cells. Motesanib is a small molecule inhibitor of multiple receptor tyrosine kinases including VEGF receptors 1-3, as well as c-KIT and platelet-derived growth factor which are related to the VEGF family.

PATIENTS AND METHODS:

Twenty-two eligible patients with recurrent ovarian, fallopian tube or primary peritoneal carcinoma were treated with an oral daily dose of 125 mg of motesanib. Peripheral blood was analyzed for circulating tumor cells (CTC) and circulating endothelial cells/circulating endothelial progenitors (CEC/CEP), VEGF levels and cell-free circulating DNA (cfDNA).

RESULTS:

The study was abruptly halted after four patients developed posterior reversible encephalopathy syndrome. One patient had a partial response and seven patients had stable disease at the time they were removed from study treatment. Twelve of the 22 patients (50%) had indeterminate responses at trial closure. Early closure without clinical efficacy data precludes meaningful correlative studies.

CONCLUSIONS:

The serious central nervous system toxicity observed in patients with recurrent ovarian cancer precluded full examination of this agent in this population. There were no clear cut explanations for the high incidence of this known class effect in the study population compared with patients with other cancers.

• Authors: R J Schilder, M W Sill, H A Lankes, M A Gold, R S Mannel, S C Modesitt, P Hanjani, A J Bonebrake, A K Sood, A K Godwin, W Hu, R K Alpaugh
• Journal: Gynecologic oncology (Gynecol Oncol) Vol. 129 Issue 1 Pg. 86-91 (Apr 2013) ISSN: 1095-6859 [Electronic] United States
• PMID: 23321064 (Publication Type: Clinical Trial, Phase II, Journal Article, Research Support, N.I.H., Extramural)
• Copyright: Copyright © 2013 Elsevier Inc. All rights reserved.

Chemical References

• Angiogenesis Inhibitors
• DNA, Neoplasm
• Glial Cell Line-Derived Neurotrophic Factor
• Indoles
• Oligonucleotides
• Protein Kinase Inhibitors
• Vascular Endothelial Growth Factor A
• Niacinamide
• Protein-Tyrosine Kinases
• imetelstat

Topics

• Aged
• Aged, 80 and over
• Angiogenesis Inhibitors (therapeutic use)
• DNA, Neoplasm (analysis)
• Fallopian Tube Neoplasms (drug therapy)
• Female
• Glial Cell Line-Derived Neurotrophic Factor (physiology)
• Humans
• Indoles (adverse effects, therapeutic use)
• Middle Aged
• Neoplasm Recurrence, Local (drug therapy)
• Niacinamide (adverse effects, analogs & derivatives, therapeutic use)
• Oligonucleotides
• Ovarian Neoplasms (drug therapy)
• Peritoneal Neoplasms (drug therapy)
• Protein Kinase Inhibitors (therapeutic use)
• Protein-Tyrosine Kinases (antagonists & inhibitors)
• Vascular Endothelial Growth Factor A (blood)