Replacement of ixazomib for relapsed/refractory multiple myeloma patients refractory to a bortezomib or carfilzomib-containing combination therapy
| Autor: | Tanya M. Spektor, Steven Jeffrey Hager, Mehdi M. Moezi, Robert A. Moss, Stephen Lim, Shahrooz Eshaghian, Alan Cartmell, Joseph Z. Ye, Tina Maluso, Alberto Bessudo, Regina A. Swift, G. Q. Chen, James R. Berenson, Jacob D. Bitran, Alexa Cohen, Teresa A. Coleman, John Stewart Hrom |
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| Rok vydání: | 2017 |
| Předmět: |
Oncology
Cancer Research medicine.medical_specialty Combination therapy business.industry Bortezomib medicine.disease Carfilzomib Ixazomib 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine chemistry Refractory 030220 oncology & carcinogenesis Internal medicine Relapsed refractory medicine Proteasome inhibitor business Multiple myeloma 030215 immunology medicine.drug |
| Zdroj: | Journal of Clinical Oncology. 35:8013-8013 |
| ISSN: | 1527-7755 0732-183X |
| DOI: | 10.1200/jco.2017.35.15_suppl.8013 |
| Popis: | 8013 Background: The proteasome inhibitor (PI) ixazomib (Ixz) is the first orally administered PI approved for treating multiple myeloma (MM). It has shown clinical activity as a single agent and when used in other combinations. In this phase 1/2 trial, we evaluated Ixz as a replacement therapy for bortezomib or carfilzomib for MM patients who were refractory to a bortezomib- or carfilzomib-containing combination regimen. Methods: This was a phase 1/2, intra-patient, multicenter, open-label trial evaluating the replacement of ixazomib for bortezomib or carfilzomib for MM patients who were refractory in combination with the other agents that the patients had received and failed. Patients received Ixz on days 1, 8 and 15 on a 28-day schedule and the other drugs were administered using the same doses and schedules as they were receiving during their prior regimen. If the Ixz maximum tolerated dose (MTD) for a particular combination regimen was previously determined, then patients were enrolled directly into Phase 2 (PhII). If not, MTD was determined during the Phase 1 (PhI) portion of the trial. Results: To date, a total of 40 patients have been enrolled; 37 patients (21 were enrolled in PhI and 16 in PhII) had completed at least one cycle of this treatment. Patients received a median of 5 prior treatments (range, 1-22). The median follow-up time for all patients was 1.6 months (range, 0.1-10.7 months), whereas that of PhII was 2.2 months (range, 0.2-10.7 months). There was no clinical benefit (CBR; 0%) nor any overall response rate (ORR; 0%) for patients receiving Ixz 3 mg (PhI). Nine patients (43%) showed stable disease (SD) while 12 (57%) exhibited disease progression (PD). In PhII (4mg Ixz) portion of the trial, ORR and CBR were both 18.7% with 16 (43.2%) patients showing SD, and 18 (48.6%) patients displaying PD. Common ≥ Gr3 adverse events were anemia (11%), thrombocytopenia (5.4%), hyponatremia (5.4%), dehydration (5.4%) and neutropenia (2.7%). Conclusions: Replacement of bortezomib or carfilzomib with Ixz infrequently leads to responses among RRMM patient who have progressed while on proteasome inhibitor -containing combination regimens. Clinical trial information: NCT02206425. |
| Databáze: | OpenAIRE |
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