NUK - logo
E-viri
Celotno besedilo
Recenzirano
  • Phase I study of the MEK in...
    Tolcher, Anthony W.; Patnaik, Amita; Papadopoulos, Kyriakos P.; Rasco, Drew W.; Becerra, Carlos R.; Allred, Alicia J.; Orford, Keith; Aktan, Gursel; Ferron-Brady, Geraldine; Ibrahim, Nageatte; Gauvin, Jennifer; Motwani, Monica; Cornfeld, Mark

    Cancer chemotherapy and pharmacology, 01/2015, Letnik: 75, Številka: 1
    Journal Article

    Purpose To identify the maximum tolerated dose (MTD) and recommended Phase II dose of MEK/AKT inhibitor combination of trametinib and afuresertib. Patients and methods Eligibility criteria were advanced solid tumors, 18 years or older, Eastern Cooperative Oncology Group performance status 0 or 1, and adequate organ function. Exclusion criteria included Type 1 diabetes, active GI disease, leptomeningeal disease, or current evidence/risk of retinal venous occlusion/central serous retinopathy. Clinical safety parameters and response were evaluated and analyzed. Results Twenty patients were enrolled. Dose-limiting toxicities (Grade 2 esophagitis; Grade 3 aspartate aminotransferase increased, mucosal inflammation and hypokalemia) were reported at starting dose (1.5 mg trametinib/50 mg afuresertib once daily continuously), exceeding the MTD. Subsequent de-escalation cohorts (1.5 mg/25 mg or 1.0 mg/50 mg trametinib/afuresertib) were defined as MTDs for continuous dosing. Intermittent dosing schedule 1.5 mg trametinib (continuous)/50 mg afuresertib (Days 1–10 every 28 days) was evaluated and considered tolerable. No patients were enrolled in Phase II. The most common adverse events reported (≥10 % of all patients) included: diarrhea (60 %), dermatitis acneiform (55 %), maculo-papular rash (45 %), fatigue (30 %), dry skin (25 %), nausea (25 %), dyspnea (20 %), and vomiting (20 %). One partial response (BRAF wild-type melanoma) was reported; four patients had stable disease as best response. Conclusion Continuous daily dosing of trametinib/afuresertib combination was poorly tolerated. Evaluation of intermittent dose schedule showed greater tolerability. Given the interest in combination treatment regimens of MAPK and PI3K/AKT pathway inhibitors, further study of intermittent dose schedule or combination of trametinib with more selective inhibitors may be warranted.