Department of Digestive Oncology, University Hospitals Gasthuisberg, Leuven, and KU Leuven, Leuven, Belgium.
Department of Oncology, Przychodnia Lekarska NZOZ KOMED, Konin, Poland.
Clin Cancer Res. 2019 Apr 15;25(8):2414-2423. doi: 10.1158/1078-0432.CCR-18-1337. Epub 2018 Oct 26.
gene amplification is associated with poor prognosis in gastric/gastroesophageal junction/esophageal (G/GEJ/E) cancers. We determined antitumor activity, safety, and pharmacokinetics of the small-molecule MET inhibitor AMG 337 in -amplified G/GEJ/E adenocarcinoma or other solid tumors. In this phase II, single-arm study, adults with -amplified G/GEJ/E adenocarcinoma (cohort 1) or other -amplified solid tumors (cohort 2) received AMG 337 300 mg/day orally in 28-day cycles. The primary endpoint was objective response rate (ORR; cohort 1). Secondary endpoints included ORR (cohort 2), progression-free survival (PFS), overall survival (OS), and safety.
Of 2101 patients screened for amplification, 132 were -amplified and 60 were enrolled: 45 in cohort 1, and 15 in cohort 2. Fifty-six patients (97%) had metastatic disease; 57 had prior lines of therapy (1 prior line, 29%; ≥2 prior lines, 69%). A protocol-permitted review showed efficacy that was lower-than-expected based on preliminary data from a first-in-human study, and enrollment was stopped. Fifty-eight patients received ≥1 AMG 337 dose. ORR in cohort 1 was 18% (8 partial responses). No responses were observed in cohort 2. Of 54 evaluable patients, median (95% CI) PFS and OS were 3.4 (2.2-5.0) and 7.9 (4.8-10.9) months, respectively. The most frequent adverse events (AEs) were headache (60%), nausea (38%), vomiting (38%), and abdominal pain, decreased appetite, and peripheral edema (33% each); 71% had grade ≥3 AEs and 59% had serious AEs.
AMG 337 showed antitumor activity in -amplified G/GEJ/E adenocarcinoma but not in -amplified non-small-cell lung cancer..
基因扩增与胃/胃食管交界处/食管(G/GEJ/E)癌症的预后不良相关。我们确定了小分子 MET 抑制剂 AMG 337 在 -扩增 G/GEJ/E 腺癌或其他实体瘤中的抗肿瘤活性、安全性和药代动力学。在这项 II 期、单臂研究中,-扩增 G/GEJ/E 腺癌(队列 1)或其他 -扩增实体瘤(队列 2)的成年患者每日口服 AMG 337 300mg,每 28 天为一个周期。主要终点是客观缓解率(ORR;队列 1)。次要终点包括 ORR(队列 2)、无进展生存期(PFS)、总生存期(OS)和安全性。
在筛选的 132 例患者中,有 132 例患者存在扩增,其中 60 例患者入组:队列 1 45 例,队列 2 15 例。56 例患者(97%)患有转移性疾病;57 例患者有既往治疗线数(1 线治疗,29%;≥2 线治疗,69%)。一项协议允许的审查显示,疗效低于首次人体研究初步数据所预期的疗效,因此停止了入组。58 例患者接受了≥1 剂 AMG 337。队列 1 的 ORR 为 18%(8 例部分缓解)。队列 2 未观察到缓解。54 例可评估患者的中位(95%CI)PFS 和 OS 分别为 3.4(2.2-5.0)和 7.9(4.8-10.9)个月。最常见的不良事件(AE)为头痛(60%)、恶心(38%)、呕吐(38%)和腹痛、食欲下降和外周水肿(各 33%);71%的患者发生≥3 级 AE,59%的患者发生严重 AE。
AMG 337 在 -扩增 G/GEJ/E 腺癌中显示出抗肿瘤活性,但在 -扩增非小细胞肺癌中没有。