Phase II Study of Arginine Deprivation Therapy With Pegargiminase in Patients With Relapsed Sensitive or Refractory Small-cell Lung Cancer.

Autor: Hall PE; Department of Medical Oncology, Barts Health NHS Trust, London, United Kingdom., Ready N; Department of Medicine, Duke University Medical Center, Durham, NC., Johnston A; Medical Affairs, Polaris Pharmaceuticals Inc., San Diego, CA., Bomalaski JS; Medical Affairs, Polaris Pharmaceuticals Inc., San Diego, CA., Venhaus RR; Cancer Trials Management, Ludwig Institute for Cancer Research, New York, NY., Sheaff M; Department of Pathology, Barts Health NHS Trust, London, United Kingdom., Krug L; Department of Medicine, Thoracic Oncology Service, Division of Solid Tumor Oncology, Memorial Sloan-Kettering Cancer Center, New York, NY; Department of Medicine, Weill Cornell Medical College, New York, NY., Szlosarek PW; Department of Medical Oncology, Barts Health NHS Trust, London, United Kingdom; Centre for Molecular Oncology, Queen Mary University of London, London, United Kingdom. Electronic address: p.w.szlosarek@qmul.ac.uk.
Jazyk: angličtina
Zdroj: Clinical lung cancer [Clin Lung Cancer] 2020 Nov; Vol. 21 (6), pp. 527-533. Date of Electronic Publication: 2020 Jul 30.
DOI: 10.1016/j.cllc.2020.07.012
Abstrakt: Background: Pre-clinical studies indicated that arginine-deprivation therapy using pegylated arginine deiminase (pegargiminase, ADI-PEG 20) may be effective in patients with argininosuccinate synthetase 1 (ASS1)-deficient small-cell lung cancer (SCLC).
Patients and Methods: Patients were enrolled into either a 'sensitive' disease cohort (≥ 90 days response to first-line chemotherapy) or a 'refractory' disease cohort (progression while on chemotherapy or < 90 days afterwards or ≥ third-line treatment). Patients received weekly intramuscular pegargiminase, 320 IU/m 2 (36.8 mg/m 2 ), until unacceptable toxicity or disease progression. The primary endpoint was tumor response assessed by Response Evaluation Criteria in Solid Tumors (RECIST) 1.1 with secondary endpoints including tolerability, pharmacodynamics, and immunogenicity.
Results: Between January 2011 and January 2014, 22 patients were enrolled: 9 in the sensitive disease cohort and 13 in the refractory disease cohort. At a pre-planned interim analysis, the best overall response observed was stable disease in 2 patients in each cohort (18.2%). Owing to the lack of response and slow accrual in the sensitive disease cohort, the study was terminated early. Pegargiminase treatment was well-tolerated with no unexpected adverse events or discontinuations.
Conclusion: Although pegargiminase monotherapy in SCLC failed to meet its primary endpoint of RECIST-confirmed responses, more recent molecular stratification, including MYC status, may provide new opportunities moving forward.
(Copyright © 2020 The Authors. Published by Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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