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一项关于PX-866与西妥昔单抗用于转移性结直肠癌或头颈部复发/转移性鳞状细胞癌患者的多中心1期研究。

A multicenter phase 1 study of PX-866 and cetuximab in patients with metastatic colorectal carcinoma or recurrent/metastatic squamous cell carcinoma of the head and neck.

作者信息

Bowles Daniel W, Senzer Neil, Hausman Diana, Peterson Scott, Vo Alex, Walker Luke, Cohen Roger B, Jimeno Antonio

机构信息

Division of Medical Oncology, University of Colorado School of Medicine, 12801 East 17th Avenue MS 8117 Aurora, Denver, CO, 80045, USA,

出版信息

Invest New Drugs. 2014 Dec;32(6):1197-203. doi: 10.1007/s10637-014-0124-3. Epub 2014 Jun 12.

Abstract

BACKGROUND

This phase I, dose-finding study determined the safety, maximum tolerated dose (MTD)/recommended phase 2 dose (RP2D), and antitumor activity of PX-866, a phosphatidylinositol 3-kinase inhibitor, combined with cetuximab in patients with incurable colorectal cancer or squamous cell carcinoma of the head and neck.

METHODS

PX-866 was administered at escalating doses (6-8 mg daily) combined with cetuximab given at a 400 mg/m(2) loading dose followed by 250 mg/m(2) weekly. A "3 + 3" study design was used. Prior therapy with anti-EGFR therapies, including cetuximab, was allowed.

RESULTS

Eleven patients were enrolled. The most frequent treatment-emergent adverse event was diarrhea (90.1%), followed by hypomagnesemia (72.2%), vomiting (72.2%), fatigue (54.5%), nausea (54.5%), rash (45.5%) and peripheral edema (40%). No dose limiting toxicities were observed. The RP2D was 8 mg, the same as the single-agent PX-866 MTD. Best responses in 9 evaluable patients were: 4 partial responses (44.4%), 4 stable disease (44.4%), and 1 disease progression (11.1%). The median progression free survival was 106 days (range: 1-271).

CONCLUSION

Treatment with PX-866 and cetuximab was tolerated with signs of anti-tumor activity. Further development of this combination is warranted.

摘要

背景

本I期剂量探索性研究确定了磷脂酰肌醇3激酶抑制剂PX - 866与西妥昔单抗联合用于不可治愈的结直肠癌或头颈部鳞状细胞癌患者时的安全性、最大耐受剂量(MTD)/推荐的2期剂量(RP2D)以及抗肿瘤活性。

方法

PX - 866以递增剂量(每日6 - 8毫克)给药,联合西妥昔单抗,西妥昔单抗的给药方案为初始剂量400毫克/平方米,随后每周250毫克/平方米。采用“3 + 3”研究设计。允许患者先前接受包括西妥昔单抗在内的抗表皮生长因子受体(EGFR)治疗。

结果

共入组11例患者。最常见的治疗中出现的不良事件为腹泻(90.1%),其次为低镁血症(72.2%)、呕吐(72.2%)、疲劳(54.5%)、恶心(54.5%)、皮疹(45.5%)和外周水肿(40%)。未观察到剂量限制性毒性。RP2D为8毫克,与PX - 866单药的MTD相同。9例可评估患者的最佳反应为:4例部分缓解(44.4%)、4例疾病稳定(44.4%)和1例疾病进展(11.1%)。无进展生存期的中位数为106天(范围:1 - 271天)。

结论

PX - 866与西妥昔单抗联合治疗耐受性良好且有抗肿瘤活性迹象。该联合方案值得进一步研发。

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