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Article: A Phase I Trial of the IGF‐1R Antibody Ganitumab (AMG 479) in Combination with Everolimus (RAD001) and Panitumumab in Patients with Advanced Cancer

TitleA Phase I Trial of the IGF‐1R Antibody Ganitumab (AMG 479) in Combination with Everolimus (RAD001) and Panitumumab in Patients with Advanced Cancer
Authors
KeywordsGanitumab
Everolimus
Panitumumab
Phase I
Advanced cancer
Issue Date2018
PublisherAlphaMed Press, Inc. The Journal's web site is located at http://www.theoncologist.org/
Citation
The Oncologist, 2018, v. 23 n. 7, p. 782-790 How to Cite?
AbstractPurpose. This study evaluated the maximum tolerated dose or recommended phase II dose (RPTD) and safety and tolerability of the ganitumab and everolimus doublet regimen followed by the ganitumab, everolimus, and panitumumab triplet regimen. Materials and Methods. This was a standard 3 + 3 dose escalation trial. Doublet therapy consisted of ganitumab at 12 mg/kg every 2 weeks; doses of everolimus were adjusted according to dose‐limiting toxicities (DLTs). Panitumumab at 4.8 mg/kg every 2 weeks was added to the RPTD of ganitumab and everolimus. DLTs were assessed in cycle 1; toxicity evaluation was closely monitored throughout treatment. Treatment continued until disease progression or undesirable toxicity. Pretreatment and on‐treatment skin biopsies were collected to assess insulin‐like growth factor 1 receptor and mammalian target of rapamycin (mTOR) target modulation. Results. Forty‐three subjects were enrolled. In the doublet regimen, two DLTs were observed in cohort 1, no DLTs in cohort −1, and one in cohort −1B. The triplet combination was discontinued because of unacceptable toxicity. Common adverse events were thrombocytopenia/neutropenia, skin rash, mucositis, fatigue, and hyperglycemia. In the doublet regimen, two patients with refractory non‐small cell lung cancer (NSCLC) achieved prolonged complete responses ranging from 18 to >60 months; one treatment‐naïve patient with chondrosarcoma achieved prolonged stable disease >24 months. In dermal granulation tissue, the insulin‐like growth factor receptor and mTOR pathways were potently and specifically inhibited by ganitumab and everolimus, respectively. Conclusion. The triplet regimen of ganitumab, everolimus, and panitumumab was associated with unacceptable toxicity. However, the doublet of ganitumab at 12 mg/kg every 2 weeks and everolimus five times weekly had an acceptable safety profile and demonstrated notable clinical activity in patients with refractory NSCLC and sarcoma. Implications for Practice. This trial evaluated the maximum tolerated dose or recommended phase II dose and safety and tolerability of the ganitumab and everolimus doublet regimen followed by the ganitumab, everolimus, and panitumumab triplet regimen. Although the triplet regimen of ganitumab, everolimus, and panitumumab was associated with unacceptable toxicity, the doublet of ganitumab at 12 mg/kg every 2 weeks and everolimus at five times weekly had an acceptable safety profile and demonstrated notable clinical activity in patients with refractory non‐small cell lung cancer and sarcoma.
Persistent Identifierhttp://hdl.handle.net/10722/274531
ISSN
2017 Impact Factor: 5.306
2015 SCImago Journal Rankings: 2.391
PubMed Central ID

 

DC FieldValueLanguage
dc.contributor.authorVlahovic, G-
dc.contributor.authorMeadows, KL-
dc.contributor.authorHatch, AJ-
dc.contributor.authorJia, J-
dc.contributor.authorNixon, A-
dc.contributor.authorUronis, HE-
dc.contributor.authorMorse, MA-
dc.contributor.authorSelim, MA-
dc.contributor.authorCrawford, J-
dc.contributor.authorRiedel, R-
dc.contributor.authorZafar, SY-
dc.contributor.authorHoward, LA-
dc.contributor.authorO'Neill, M-
dc.contributor.authorMeadows, JJ-
dc.contributor.authorHaley, ST-
dc.contributor.authorArrowood, CC-
dc.contributor.authorRushing, C-
dc.contributor.authorPang, H-
dc.contributor.authorHurwitz, HI-
dc.date.accessioned2019-08-18T15:03:33Z-
dc.date.available2019-08-18T15:03:33Z-
dc.date.issued2018-
dc.identifier.citationThe Oncologist, 2018, v. 23 n. 7, p. 782-790-
dc.identifier.issn1083-7159-
dc.identifier.urihttp://hdl.handle.net/10722/274531-
dc.description.abstractPurpose. This study evaluated the maximum tolerated dose or recommended phase II dose (RPTD) and safety and tolerability of the ganitumab and everolimus doublet regimen followed by the ganitumab, everolimus, and panitumumab triplet regimen. Materials and Methods. This was a standard 3 + 3 dose escalation trial. Doublet therapy consisted of ganitumab at 12 mg/kg every 2 weeks; doses of everolimus were adjusted according to dose‐limiting toxicities (DLTs). Panitumumab at 4.8 mg/kg every 2 weeks was added to the RPTD of ganitumab and everolimus. DLTs were assessed in cycle 1; toxicity evaluation was closely monitored throughout treatment. Treatment continued until disease progression or undesirable toxicity. Pretreatment and on‐treatment skin biopsies were collected to assess insulin‐like growth factor 1 receptor and mammalian target of rapamycin (mTOR) target modulation. Results. Forty‐three subjects were enrolled. In the doublet regimen, two DLTs were observed in cohort 1, no DLTs in cohort −1, and one in cohort −1B. The triplet combination was discontinued because of unacceptable toxicity. Common adverse events were thrombocytopenia/neutropenia, skin rash, mucositis, fatigue, and hyperglycemia. In the doublet regimen, two patients with refractory non‐small cell lung cancer (NSCLC) achieved prolonged complete responses ranging from 18 to >60 months; one treatment‐naïve patient with chondrosarcoma achieved prolonged stable disease >24 months. In dermal granulation tissue, the insulin‐like growth factor receptor and mTOR pathways were potently and specifically inhibited by ganitumab and everolimus, respectively. Conclusion. The triplet regimen of ganitumab, everolimus, and panitumumab was associated with unacceptable toxicity. However, the doublet of ganitumab at 12 mg/kg every 2 weeks and everolimus five times weekly had an acceptable safety profile and demonstrated notable clinical activity in patients with refractory NSCLC and sarcoma. Implications for Practice. This trial evaluated the maximum tolerated dose or recommended phase II dose and safety and tolerability of the ganitumab and everolimus doublet regimen followed by the ganitumab, everolimus, and panitumumab triplet regimen. Although the triplet regimen of ganitumab, everolimus, and panitumumab was associated with unacceptable toxicity, the doublet of ganitumab at 12 mg/kg every 2 weeks and everolimus at five times weekly had an acceptable safety profile and demonstrated notable clinical activity in patients with refractory non‐small cell lung cancer and sarcoma.-
dc.languageeng-
dc.publisherAlphaMed Press, Inc. The Journal's web site is located at http://www.theoncologist.org/-
dc.relation.ispartofThe Oncologist-
dc.subjectGanitumab-
dc.subjectEverolimus-
dc.subjectPanitumumab-
dc.subjectPhase I-
dc.subjectAdvanced cancer-
dc.titleA Phase I Trial of the IGF‐1R Antibody Ganitumab (AMG 479) in Combination with Everolimus (RAD001) and Panitumumab in Patients with Advanced Cancer-
dc.typeArticle-
dc.identifier.emailPang, H: herbpang@hku.hk-
dc.identifier.authorityPang, H=rp01857-
dc.description.naturelink_to_OA_fulltext-
dc.identifier.doi10.1634/theoncologist.2016-0377-
dc.identifier.pmid29572245-
dc.identifier.pmcidPMC6058343-
dc.identifier.scopuseid_2-s2.0-85044271437-
dc.identifier.hkuros301763-
dc.identifier.volume23-
dc.identifier.issue7-
dc.identifier.spage782-
dc.identifier.epage790-
dc.publisher.placeUnited States-

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