Section of Hematology/Oncology, University of Chicago, 5841 S. Maryland Avenue, MC 2115, Chicago, IL 60637-1470, USA.
Invest New Drugs. 2012 Jun;30(3):1211-5. doi: 10.1007/s10637-011-9681-x. Epub 2011 May 7.
Treatment options for metastatic colorectal cancer (CRC) are limited after a fluoropyrimidine, oxaliplatin and irinotecan; novel agents need to be explored in this setting. Dasatinib, an oral inhibitor of Src family kinases, inhibits proliferation in CRC cell lines and has antitumor activity in CRC xenograft models.
We conducted a multi-center phase II trial of dasatinib in unresectable, previously-treated metastatic CRC patients. No more than 2 prior chemotherapy regimens were permitted, which must have contained a fluoropyrimidine, oxaliplatin and irinotecan. The primary endpoint was progression-free survival (PFS) at 4 months. The Simon two-stage design required that at least 5 of the first 19 patients be progression-free at 4 months to expand to a second stage.
Nineteen patients enrolled at 9 centers. The study was terminated after the first stage due to lack of efficacy. There were no objective responses; 1 patient (5%) had stable disease for 7.3 months. The PFS rate at 4 months was 5.3% (90% CI: 0.3, 22.6). Median PFS was 1.6 months (90% CI: 1.4, 1.8). Median overall survival was 5.1 months (90% CI: 2.4, 6.3). Grade 3/4 toxicities included fatigue in 16% of patients, and anemia, anorexia, nausea/vomiting and dyspnea in 11%.
Dasatinib is inactive as a single agent in previously treated metastatic CRC patients.
氟尿嘧啶、奥沙利铂和伊立替康治疗转移性结直肠癌(CRC)后,治疗选择有限;需要在这种情况下探索新的药物。达沙替尼是一种 SRC 家族激酶的口服抑制剂,抑制 CRC 细胞系的增殖,并在 CRC 异种移植模型中具有抗肿瘤活性。
我们对不可切除的、既往治疗过的转移性 CRC 患者进行了达沙替尼的多中心 II 期试验。允许使用不超过 2 种既往化疗方案,这些方案必须包含氟尿嘧啶、奥沙利铂和伊立替康。主要终点是 4 个月时的无进展生存期(PFS)。Simon 两阶段设计要求前 19 名患者中至少有 5 名在 4 个月时无进展,才能扩展到第二阶段。
9 个中心共招募了 19 名患者。由于疗效不佳,该研究在第一阶段后终止。没有客观反应;1 名患者(5%)疾病稳定 7.3 个月。4 个月时的 PFS 率为 5.3%(90%CI:0.3,22.6)。中位 PFS 为 1.6 个月(90%CI:1.4,1.8)。中位总生存期为 5.1 个月(90%CI:2.4,6.3)。3/4 级毒性包括 16%的患者出现疲劳,11%的患者出现贫血、厌食、恶心/呕吐和呼吸困难。
达沙替尼作为单一药物在既往治疗的转移性 CRC 患者中无效。