Binimetinib plus Gemcitabine and Cisplatin Phase I/II Trial in Patients with Advanced Biliary Cancers
| Autor: | Andrea Cercek, James J. Harding, Ahmet Zehir, Emily Valentino, Maeve A. Lowery, Imane El Dika, Joanne F. Chou, Teresa Rasalan-Ho, Mikaela Bradley, Kenneth H. Yu, Ezra Morgono, Ellen Hollywood, Michael F. Berger, Marinela Capanu, Ghassan K. Abou-Alfa, Philip C. Wong, Ryan Ptashkin, Scott R. Gerst, Erica Salehi, Eileen M. O'Reilly |
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| Rok vydání: | 2019 |
| Předmět: |
Male
Proto-Oncogene Proteins B-raf 0301 basic medicine Oncology Cancer Research medicine.medical_specialty MAP Kinase Signaling System medicine.medical_treatment Kaplan-Meier Estimate MAP3K1 Deoxycytidine Drug Administration Schedule Article 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Internal medicine Antineoplastic Combined Chemotherapy Protocols Humans Medicine In patient Dosing Aged Aged 80 and over Cisplatin Chemotherapy business.industry Binimetinib Middle Aged Gemcitabine Clinical trial Biliary Tract Neoplasms 030104 developmental biology chemistry 030220 oncology & carcinogenesis Mutation Benzimidazoles Female business medicine.drug |
| Zdroj: | Clinical Cancer Research. 25:937-945 |
| ISSN: | 1557-3265 1078-0432 |
| DOI: | 10.1158/1078-0432.ccr-18-1927 |
| Popis: | Purpose: Mutations in the RAS/RAF/MEK/ERK signaling pathway are commonly found in biliary tract cancer (BTC). Binimetinib, a selective inhibitor of MEK1/2, has single-agent activity. Preclinical data support binimetinib combination with chemotherapy, when given in an interrupted dosing schedule. Patients and Methods: A phase I/II trial evaluated binimetinib in combination with gemcitabine and cisplatin in patients with untreated advanced BTC. The primary endpoints were to determine the MTD (phase I), and PFS 6 and RR (phase II). Tumor tissue for targeted gene sequencing and blood samples for peripheral blood pERK expression were evaluated. Patients received oral binimetinib twice daily with gemcitabine and cisplatin on day 8 and 15 of a 21-day cycle. Binimetinib was held for 2 days prior to and on day of each chemotherapy treatment. Results: Twelve patients enrolled in the phase I showed the MTD of binimetinib at 45 mg orally twice daily with gemcitabine 800 and cisplatin 20 mg/m2. Twenty-nine patients were treated in the phase II. Six patients treated at MTD in phase I were evaluable as part of phase II. PFS 6 months was 54% and RR was 36%. Median overall survival was 13.3 months (95% CI, 9.8–16.5). MSK-IMPACT 410-gene panel showed aberrations in the RAS–RAF–MEK–ERK pathway and mutations in PIK3CA, AKT2, PIK3CG, BRAF, and MAP3K1 in responding patients. Conclusions: Binimetinib with gemcitabine and cisplatin did not show an improvement in PFS 6 and RR. Molecular profiling may help select patients who may benefit from this triplet therapy, which is not planned at this time. |
| Databáze: | OpenAIRE |
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