Abstract | BACKGROUND: MATERIALS AND METHODS: A 3 + 3 dose-escalation study was carried out at a starting daily dose of 60 mg pictilisib on days 1-21 of a 28-day cycle and 150 mg erlotinib from day 2 of cycle 1. The primary objectives of the study were to assess safety and tolerability, identify dose-limiting toxicities (DLTs), estimate the maximum tolerated dose, and identify the recommended phase II dose (RP2D). Evaluation of a dose-expansion cohort at the RP2D was performed. RESULTS: Fifty-seven patients were treated in the study. All patients experienced at least one adverse event (AE). Grade ≥3 AEs, serious AEs, and deaths were reported in 38 (66.7%), 19 (33.3%), and 4 (7.0%) patients, respectively. DLTs occurred in nine patients across eight cohorts and the RP2D was determined to be 340 mg pictilisib on a "5 days on, 2 days off" schedule plus 100 mg erlotinib. Two patients (3.5%) experienced partial response and 19 (33.3%) had stable disease. CONCLUSION: Combining pictilisib with erlotinib in patients with advanced solid tumors is feasible; however, antitumor activity is limited. Additional studies may identify patients likely to benefit from combined inhibition of EGFR and PI3K pathways. IMPLICATIONS FOR PRACTICE: Combining drugs targeting different signaling pathways in cancer growth and survival could overcome drug resistance and improve antitumor activity. In this first-in-human study for the combination, addition of the PI3K inhibitor pictilisib to the EGFR tyrosine kinase inhibitor erlotinib resulted in toxicity that led to dose and schedule modifications to identify a tolerable recommended phase II dose of 340 mg pictilisib on a "5 days on, 2 days off" schedule plus 100 mg erlotinib daily. The limited antitumor activity observed, however, suggests that additional studies are needed to identify patients most likely to benefit from combined EGFR and PI3K inhibition.
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Authors | Stephen Leong, Rebecca A Moss, Daniel W Bowles, Joseph A Ware, Jing Zhou, Jill M Spoerke, Mark R Lackner, Geetha Shankar, Jennifer L Schutzman, Ruud van der Noll, Emile E Voest, Jan H M Schellens |
Journal | The oncologist
(Oncologist)
Vol. 22
Issue 12
Pg. 1491-1499
(12 2017)
ISSN: 1549-490X [Electronic] England |
PMID | 28798270
(Publication Type: Clinical Trial, Phase I, Journal Article)
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Copyright | © AlphaMed Press 2017. |
Chemical References |
- 2-(1H-indazol-4-yl)-6-(4-methanesulfonylpiperazin-1-ylmethyl)-4-morpholin-4-ylthieno(3,2-d)pyrimidine
- Indazoles
- Phosphoinositide-3 Kinase Inhibitors
- Protein Kinase Inhibitors
- Sulfonamides
- Erlotinib Hydrochloride
- EGFR protein, human
- ErbB Receptors
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Topics |
- Adult
- Aged
- Antineoplastic Combined Chemotherapy Protocols
(administration & dosage)
- Cell Proliferation
(genetics)
- Dose-Response Relationship, Drug
- ErbB Receptors
(antagonists & inhibitors, genetics)
- Erlotinib Hydrochloride
(administration & dosage, adverse effects, pharmacokinetics)
- Female
- Humans
- Indazoles
(administration & dosage, adverse effects, pharmacokinetics)
- Male
- Maximum Tolerated Dose
- Middle Aged
- Neoplasm Staging
- Neoplasms
(drug therapy, genetics, pathology)
- Phosphatidylinositol 3-Kinases
(genetics)
- Phosphoinositide-3 Kinase Inhibitors
- Protein Kinase Inhibitors
(administration & dosage, adverse effects, pharmacokinetics)
- Sulfonamides
(administration & dosage, adverse effects, pharmacokinetics)
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