Vistusertib (dual m-TORC1/2 inhibitor) in combination with paclitaxel in patients with high-grade serous ovarian and squamous non-small-cell lung cancer.
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Authors
Basu, B
Krebs, MG
Sundar, R
Wilson, RH
Spicer, J
Jones, R
Brada, M
Talbot, DC
Steele, N
Ingles Garces, AH
Brugger, W
Harrington, EA
Evans, J
Hall, E
Tovey, H
de Oliveira, FM
Carreira, S
Swales, K
Ruddle, R
Raynaud, FI
Purchase, B
Dawes, JC
Parmar, M
Turner, AJ
Tunariu, N
Banerjee, S
de Bono, JS
Banerji, U
Krebs, MG
Sundar, R
Wilson, RH
Spicer, J
Jones, R
Brada, M
Talbot, DC
Steele, N
Ingles Garces, AH
Brugger, W
Harrington, EA
Evans, J
Hall, E
Tovey, H
de Oliveira, FM
Carreira, S
Swales, K
Ruddle, R
Raynaud, FI
Purchase, B
Dawes, JC
Parmar, M
Turner, AJ
Tunariu, N
Banerjee, S
de Bono, JS
Banerji, U
Document Type
Journal Article
Date
2018-07-17
Date Accepted
2018-06-29
Date Available
Abstract
BACKGROUND: We have previously shown that raised p-S6K levels correlate with resistance to chemotherapy in ovarian cancer. We hypothesised that inhibiting p-S6K signalling with the dual m-TORC1/2 inhibitor in patients receiving weekly paclitaxel could improve outcomes in such patients. PATIENTS AND METHODS: In dose escalation, weekly paclitaxel (80 mg/m2) was given 6/7 weeks in combination with two intermittent schedules of vistusertib (dosing starting on the day of paclitaxel): schedule A, vistusertib dosed bd for 3 consecutive days per week (3/7 days) and schedule B, vistusertib dosed bd for 2 consecutive days per week (2/7 days). After establishing a recommended phase II dose (RP2D), expansion cohorts in high-grade serous ovarian cancer (HGSOC) and squamous non-small-cell lung cancer (sqNSCLC) were explored in 25 and 40 patients, respectively. RESULTS: The dose-escalation arms comprised 22 patients with advanced solid tumours. The dose-limiting toxicities were fatigue and mucositis in schedule A and rash in schedule B. On the basis of toxicity and pharmacokinetic (PK) and pharmacodynamic (PD) evaluations, the RP2D was established as 80 mg/m2 paclitaxel with 50 mg vistusertib bd 3/7 days for 6/7 weeks. In the HGSOC expansion, RECIST and GCIG CA125 response rates were 13/25 (52%) and 16/25 (64%), respectively, with median progression-free survival (mPFS) of 5.8 months (95% CI: 3.28-18.54). The RP2D was not well tolerated in the SqNSCLC expansion, but toxicities were manageable after the daily vistusertib dose was reduced to 25 mg bd for the following 23 patients. The RECIST response rate in this group was 8/23 (35%), and the mPFS was 5.8 months (95% CI: 2.76-21.25). DISCUSSION: In this phase I trial, we report a highly active and well-tolerated combination of vistusertib, administered as an intermittent schedule with weekly paclitaxel, in patients with HGSOC and SqNSCLC. CLINICAL TRIAL REGISTRATION: ClinicialTrials.gov identifier: CNCT02193633.
Citation
Annals of oncology : official journal of the European Society for Medical Oncology, 2018, 29 (9), pp. 1918 - 1925
Source Title
Publisher
OXFORD UNIV PRESS
ISSN
0923-7534
eISSN
1569-8041
Collections
Research Team
Clinical Pharmacology & Trials (including Drug Metabolism & Pharmacokinetics Group)
Cancer Biomarkers
Clinical PD Biomarker Group
Clinical Pharmacology – Adaptive Therapy
Clinical Trials & Statistics Unit
ICR-CTSU Urology and Head and Neck Trials Team
Medicine Drug Development Unit (de Bono)
Prostate Cancer Targeted Therapy Group
Cancer Biomarkers
Clinical PD Biomarker Group
Clinical Pharmacology – Adaptive Therapy
Clinical Trials & Statistics Unit
ICR-CTSU Urology and Head and Neck Trials Team
Medicine Drug Development Unit (de Bono)
Prostate Cancer Targeted Therapy Group