A mixed-methods feasibility trial of protein kinase C iota inhibition with auranofin in asymptomatic ovarian cancer patients.

Abstract

PURPOSE:

This trial was undertaken (1) to determine the feasibility of enrolling asymptomatic ovarian cancer patients with CA-125 elevation in a trial with the protein kinase C iota (PKCι) inhibitor auranofin and (2) to understand patients' perceptions of CA-125 monitoring.

METHODS:

Asymptomatic ovarian cancer patients with CA-125 elevation received 3 mg auranofin orally twice per day and were evaluated. The patients participated in interviews about CA-125 monitoring.

RESULTS:

Ten patients were enrolled in slightly over 6 months, exceeding our anticipated accrual rate. Four manifested stable CA-125 levels for 1 month or longer. The median progression-free survival was 2.8 months (95% CI: 1.3-3.8); auranofin was well tolerated. One patient had baseline and monthly CA-125 levels of 5,570, 6,085, 3,511, and 2,230 U/ml, respectively, stopped auranofin because of radiographic progression at 3 months, and manifested an increase in CA-125 to 7,168 U/ml approximately 3 months later. Patient interviews revealed (1) the important role of CA-125 in cancer monitoring, (2) ardent advocacy of CA-125 testing, and (3) an evolution toward CA-125 assuming a life of its own.

CONCLUSIONS:

This study showed the feasibility of enrolling asymptomatic ovarian cancer patients with CA-125 elevation in a trial with auranofin. One patient had a decline in CA-125, suggesting that PKCι inhibition merits further study in ovarian cancer.

• Authors: Aminah Jatoi, Carmen Radecki Breitkopf, Nathan R Foster, Matthew S Block, Megan Grudem, Andrea Wahner Hendrickson, Rachel E Carlson, Brigitte Barrette, Nina Karlin, Alan P Fields
• Journal: Oncology (Oncology) Vol. 88 Issue 4 Pg. 208-13 ( 2015) ISSN: 1423-0232 [Electronic] Switzerland
• PMID: 25502607 (Publication Type: Journal Article, Research Support, N.I.H., Extramural)
• Copyright: © 2014 S. Karger AG, Basel.

Chemical References

• Antirheumatic Agents
• Biomarkers, Tumor
• CA-125 Antigen
• Isoenzymes
• Auranofin
• Protein Kinase C
• protein kinase C lambda

Topics

• Administration, Oral
• Aged
• Aged, 80 and over
• Antirheumatic Agents (therapeutic use)
• Auranofin (therapeutic use)
• Biomarkers, Tumor (metabolism)
• CA-125 Antigen (metabolism)
• Drug Administration Schedule
• Feasibility Studies
• Female
• Follow-Up Studies
• Humans
• Isoenzymes (antagonists & inhibitors)
• Middle Aged
• Neoplasm Staging
• Ovarian Neoplasms (drug therapy, enzymology, pathology)
• Pilot Projects
• Prognosis
• Protein Kinase C (antagonists & inhibitors)
• Survival Rate