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A phase 2 and biomarker study of cabozantinib in patients with advanced cholangiocarcinoma
Cancer, 2017-06, Vol.123 (11), p.1979-1988
Goyal, Lipika
Zheng, Hui
Yurgelun, Matthew B.
Abrams, Thomas A.
Allen, Jill N.
Cleary, James M.
Knowles, Michelle
Regan, Eileen
Reardon, Amanda
Khachatryan, Anna
Jain, Rakesh K.
Nardi, Valentina
Borger, Darrell R.
Duda, Dan G.
Zhu, Andrew X.
2017
Volltextzugriff (PDF)
Details
Autor(en) / Beteiligte
Goyal, Lipika
Zheng, Hui
Yurgelun, Matthew B.
Abrams, Thomas A.
Allen, Jill N.
Cleary, James M.
Knowles, Michelle
Regan, Eileen
Reardon, Amanda
Khachatryan, Anna
Jain, Rakesh K.
Nardi, Valentina
Borger, Darrell R.
Duda, Dan G.
Zhu, Andrew X.
Titel
A phase 2 and biomarker study of cabozantinib in patients with advanced cholangiocarcinoma
Ist Teil von
Cancer, 2017-06, Vol.123 (11), p.1979-1988
Ort / Verlag
United States: Wiley Subscription Services, Inc
Erscheinungsjahr
2017
Quelle
MEDLINE
Beschreibungen/Notizen
BACKGROUND Advanced cholangiocarcinoma carries a poor prognosis, and no standard treatment exists beyond first‐line gemcitabine/platinum‐based chemotherapy. A single‐arm, phase 2 and biomarker study of cabozantinib, a multikinase inhibitor with potent activity against vascular endothelial growth factor receptor 2 (VEGFR2) and MET, was performed for patients with advanced refractory cholangiocarcinoma. METHODS Previously treated patients with unresectable or metastatic cholangiocarcinoma received cabozantinib (60 mg orally and daily on a continuous schedule). The primary endpoint was progression‐free survival (PFS). Tumor MET expression and plasma biomarkers were evaluated. RESULTS The study enrolled 19 patients with cholangiocarcinoma (female, 68%; median age, 67 years; intrahepatic vs extrahepatic, 84% vs 16%). The median PFS was 1.8 months (95% confidence interval, 1.6‐5.4 months), and the median overall survival (OS) was 5.2 months (95% confidence interval, 2.7‐10.5 months). Grade 3/4 adverse events occurred in 89% of the patients and included neutropenia (5%), hyperbilirubinemia (5%), epistaxis (5%), bowel perforation (5%), enterocutaneous fistulas (5%), and hypertension (11%). One patient with 3 + MET expression in the tumor stayed on treatment for 278 days, but the MET expression did not correlate with the outcomes in the overall study population. Plasma vascular endothelial growth factor, placental growth factor, and stromal cell–derived factor 1α increased and soluble VEGFR2 and angiopoietin 2 decreased after treatment (all P values < .01). Plasma tissue inhibitor of matrix metalloproteinase 1 was inversely correlated with PFS, and soluble MET (sMET) and interleukin 6 were inversely correlated with OS. CONCLUSIONS In unselected patients with cholangiocarcinoma, cabozantinib demonstrated limited activity and significant toxicity. In the first clinical trial to assess the role of MET inhibition in cholangiocarcinoma, 1 patient with a MET‐high tumor had a prolonged benefit from treatment. Baseline plasma soluble MET was associated with OS. Any further development of this drug in cholangiocarcinoma should include a dose reduction and a biomarker‐driven approach. Cancer 2017;123:1979–1988. © 2017 American Cancer Society. In a phase 2 trial in patients with advanced refractory cholangiocarcinoma, cabozantinib has demonstrated limited efficacy and significant toxicity. A biomarker analysis shows on‐target antiangiogenic activity of cabozantinib, and baseline plasma‐soluble MET correlates with overall survival. Any further development of this drug in cholangiocarcinoma should include dose reduction, a biomarker‐driven approach, and the consideration of its combination with other drugs.
Sprache
Englisch
Identifikatoren
ISSN: 0008-543X
eISSN: 1097-0142
DOI: 10.1002/cncr.30571
Titel-ID: cdi_proquest_journals_1920463317
Format
–
Schlagworte
Age
,
Aged
,
Angiopoietin
,
Angiopoietin-2 - metabolism
,
Anilides - therapeutic use
,
Antiangiogenics
,
Bile Duct Neoplasms - drug therapy
,
Bile Duct Neoplasms - metabolism
,
Bile Duct Neoplasms - pathology
,
Biomarkers
,
Biomarkers, Tumor - metabolism
,
cabozantinib
,
Cancer
,
Chemokine CXCL12 - metabolism
,
Chemotherapy
,
Cholangiocarcinoma
,
Cholangiocarcinoma - drug therapy
,
Cholangiocarcinoma - metabolism
,
Cholangiocarcinoma - pathology
,
Confidence intervals
,
Disease-Free Survival
,
Drug dosages
,
Drugs
,
Epistaxis - chemically induced
,
Female
,
Gemcitabine
,
Humans
,
Hyperbilirubinemia
,
Hyperbilirubinemia - chemically induced
,
Hypertension
,
Hypertension - chemically induced
,
Inhibition
,
Inhibitor drugs
,
Inhibitors
,
Interleukin 6
,
Interleukin-6 - metabolism
,
Intestinal Fistula - chemically induced
,
Intestinal Perforation - chemically induced
,
Intestine
,
Male
,
Matrix metalloproteinase
,
Matrix Metalloproteinase 1 - metabolism
,
Medical prognosis
,
Metalloproteinase
,
Metastases
,
Middle Aged
,
Neoplasm Metastasis
,
Neutropenia
,
Neutropenia - chemically induced
,
Oncology
,
Patients
,
Perforation
,
phase 2
,
Placenta
,
Placenta Growth Factor - metabolism
,
Plasma
,
Platinum
,
Population studies
,
Protein Kinase Inhibitors - therapeutic use
,
Proto-Oncogene Proteins c-met - antagonists & inhibitors
,
Proto-Oncogene Proteins c-met - metabolism
,
Pyridines - therapeutic use
,
Quality
,
Reduction (metal working)
,
SDF-1 protein
,
soluble MET
,
Survival
,
Survival Rate
,
Toxicity
,
Vascular endothelial growth factor
,
Vascular Endothelial Growth Factor A - metabolism
,
Vascular endothelial growth factor receptor 2
,
vascular endothelial growth factor receptor 2 (VEGFR2)
,
Vascular Endothelial Growth Factor Receptor-2 - antagonists & inhibitors
,
Vascular Endothelial Growth Factor Receptor-2 - metabolism
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