Clinical Activity of the γ-Secretase Inhibitor PF-03084014 in Adults With Desmoid Tumors (Aggressive Fibromatosis).

Abstract

Purpose Desmoid tumors (aggressive fibromatosis) arise from connective tissue cells or fibroblasts. In general, they are slow growing and do not metastasize; however, locally aggressive desmoid tumors can cause severe morbidity and loss of function. Disease recurrence after surgery and/or radiation and diagnosis of multifocal desmoid tumors highlight the need to develop effective systemic treatments for this disease. In this study, we evaluate objective response rate after therapy with the γ-secretase inhibitor PF-03084014 in patients with recurrent, refractory, progressive desmoid tumors. Patients and Methods Seventeen patients with desmoid tumors received PF-03084014 150 mg orally twice a day in 3-week cycles. Response to treatment was evaluated at cycle 1 and every six cycles, that is, 18 weeks, by RECIST (Response Evaluation Criteria in Solid Tumors) version 1.1. Patient-reported outcomes were measured at baseline and at every restaging visit by using the MD Anderson Symptoms Inventory. Archival tumor and blood samples were genotyped for somatic and germline mutations in APC and CTNNB1. Results Of 17 patients accrued to the study, 15 had mutations in APC or CTNNB1 genes. Sixteen patients (94%) were evaluable for response; five (29%) experienced a confirmed partial response and have been on study for more than 2 years. Another five patients with prolonged stable disease as their best response remain on study. Patient-reported outcomes confirmed clinician reporting that the investigational agent was well tolerated and, in subgroup analyses, participants who demonstrated partial response also experienced clinically meaningful and statistically significant improvements in symptom burden. Conclusion PF-03084014 was well tolerated and demonstrated promising clinical benefit in patients with refractory, progressive desmoid tumors who receive long-term treatment.

• Authors: Shivaani Kummar, Geraldine O'Sullivan Coyne, Khanh T Do, Baris Turkbey, Paul S Meltzer, Eric Polley, Peter L Choyke, Robert Meehan, Rasa Vilimas, Yvonne Horneffer, Lamin Juwara, Ann Lih, Amul Choudhary, Sandra A Mitchell, Lee J Helman, James H Doroshow, Alice P Chen
• Journal: Journal of clinical oncology : official journal of the American Society of Clinical Oncology (J Clin Oncol) Vol. 35 Issue 14 Pg. 1561-1569 (May 10 2017) ISSN: 1527-7755 [Electronic] United States
• PMID: 28350521 (Publication Type: Clinical Trial, Phase II, Journal Article)

Chemical References

• APC protein, human
• Adenomatous Polyposis Coli Protein
• Antineoplastic Agents
• CTNNB1 protein, human
• Tetrahydronaphthalenes
• beta Catenin
• Amyloid Precursor Protein Secretases
• Valine
• nirogacestat

Topics

• Adenomatous Polyposis Coli Protein (genetics)
• Adult
• Aged
• Amyloid Precursor Protein Secretases (antagonists & inhibitors)
• Antineoplastic Agents (adverse effects, therapeutic use)
• Female
• Fibromatosis, Aggressive (diagnostic imaging, drug therapy, genetics)
• Genotype
• Humans
• Magnetic Resonance Imaging
• Male
• Middle Aged
• Mutation
• Patient Reported Outcome Measures
• Response Evaluation Criteria in Solid Tumors
• Retreatment
• Symptom Assessment
• Tetrahydronaphthalenes (adverse effects, therapeutic use)
• Tomography, X-Ray Computed
• Valine (adverse effects, analogs & derivatives, therapeutic use)
• Young Adult
• beta Catenin (genetics)