Abstract | PURPOSE: PATIENTS AND METHODS: This study enrolled patients to dosing combinations of neratinib and temsirolimus. The primary objective was to estimate the toxicity contour of the combination and establish recommended phase II doses. RESULTS: Sixty patients were treated on 12 of 16 possible dosing combinations. Diarrhea was the most common drug-related (93%) and dose-limiting toxicity (DLT), constituting four of 10 DLTs. Dose-limiting grade 3 metabolic abnormalities were also observed. Other frequent drug-related toxicities included nausea, stomatitis (both 53%), and anemia (48%). Two maximum-tolerated dose combinations were identified: 200 mg of neratinib/25 mg of temsirolimus and 160 mg of neratinib/50 mg of temsirolimus. Responses were noted in patients with HER2-amplified breast cancer resistant to trastuzumab, HER2-mutant non-small-cell lung cancer, and tumor types without identified mutations in the HER-PI3K-mTOR pathway. CONCLUSION: The combination of neratinib and temsirolimus was tolerable and demonstrated antitumor activity in multiple tumor types, warranting further evaluation.
|
Authors | Leena Gandhi, Rastislav Bahleda, Sara M Tolaney, Eunice L Kwak, James M Cleary, Shuchi S Pandya, Antoine Hollebecque, Richat Abbas, Revathi Ananthakrishnan, Anna Berkenblit, Mizue Krygowski, Yali Liang, Kathleen W Turnbull, Geoffrey I Shapiro, Jean-Charles Soria |
Journal | Journal of clinical oncology : official journal of the American Society of Clinical Oncology
(J Clin Oncol)
Vol. 32
Issue 2
Pg. 68-75
(Jan 10 2014)
ISSN: 1527-7755 [Electronic] United States |
PMID | 24323026
(Publication Type: Clinical Trial, Phase I, Journal Article, Research Support, Non-U.S. Gov't)
|
Chemical References |
- Quinolines
- temsirolimus
- ERBB2 protein, human
- Receptor, ErbB-2
- TOR Serine-Threonine Kinases
- neratinib
- Sirolimus
|
Topics |
- Aged
- Anemia
(chemically induced)
- Antineoplastic Combined Chemotherapy Protocols
(adverse effects, pharmacokinetics, therapeutic use)
- Area Under Curve
- Breast Neoplasms
(drug therapy, genetics, metabolism)
- Diarrhea
(chemically induced)
- Dose-Response Relationship, Drug
- Female
- Gene Amplification
- Humans
- Lung Neoplasms
(drug therapy, genetics, metabolism)
- Male
- Middle Aged
- Mutation
- Nausea
(chemically induced)
- Neoplasms
(drug therapy, genetics, metabolism)
- Phosphatidylinositol 3-Kinases
(metabolism)
- Quinolines
(administration & dosage, adverse effects, pharmacokinetics)
- Receptor, ErbB-2
(genetics, metabolism)
- Signal Transduction
(drug effects)
- Sirolimus
(administration & dosage, adverse effects, analogs & derivatives, pharmacokinetics)
- Stomatitis
(chemically induced)
- TOR Serine-Threonine Kinases
(metabolism)
- Treatment Outcome
|