1. A phase Ib dose allocation study of oral administration of lucitanib given in combination with fulvestrant in patients with estrogen receptor-positive and FGFR1-amplified or non-amplified metastatic breast cancer
- Author
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Campone, F, Bachelot, F, Penault-Llorca, F., Pallis, F, Agrapart, F, Pierrat, F, Poirot, F., Dubois, F., Xuereb, F, Bossard, F., Guigal-Stephan, F, Lockhart, F, Andre, F., Campone, M., Bachelot, Thomas, Pallis, A., Agrapart, Vincent, Pierrat, M., Poirot, C., Xuereb, L., Bossard, C., Guigal-Stephan, N., Lockhart, B., Centre Jean Perrin [Clermont-Ferrand] (UNICANCER/CJP), UNICANCER, Imagerie Moléculaire et Stratégies Théranostiques (IMoST), Université Clermont Auvergne [2017-2020] (UCA [2017-2020])-Institut National de la Santé et de la Recherche Médicale (INSERM), CSI, INPG, Grenoble (CSI), Institut National Polytechnique de Grenoble (INPG), Institut de Recherches Internationales Servier [Suresnes] (IRIS), Laboratoire de rhéologie (LR), Centre National de la Recherche Scientifique (CNRS)-Institut National Polytechnique de Grenoble (INPG)-Université Joseph Fourier - Grenoble 1 (UJF), Institut de Cancérologie de l'Ouest [Angers/Nantes] (UNICANCER/ICO), Centre Léon Bérard [Lyon], CHU Tenon [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020]), Université Joseph Fourier - Grenoble 1 (UJF)-Institut National Polytechnique de Grenoble (INPG)-Centre National de la Recherche Scientifique (CNRS), and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)
- Subjects
0301 basic medicine ,Oncology ,Cancer Research ,Administration, Oral ,Estrogen receptor ,Toxicology ,Tyrosine-kinase inhibitor ,0302 clinical medicine ,Antineoplastic Combined Chemotherapy Protocols ,Medicine ,Pharmacology (medical) ,Neoplasm Metastasis ,Fulvestrant ,Hormone receptor positive ,Middle Aged ,Metastatic breast cancer ,3. Good health ,Postmenopause ,Receptors, Estrogen ,Tolerability ,030220 oncology & carcinogenesis ,embryonic structures ,VEGF pathway lucitanib ,Quinolines ,Female ,medicine.drug ,medicine.medical_specialty ,Maximum Tolerated Dose ,medicine.drug_class ,FGFR Inhibition ,[SDV.CAN]Life Sciences [q-bio]/Cancer ,Breast Neoplasms ,FGF pathway ,Naphthalenes ,03 medical and health sciences ,Internal medicine ,Humans ,Endocrine system ,Receptor, Fibroblast Growth Factor, Type 1 ,Adverse effect ,Aged ,Pharmacology ,Dose-Response Relationship, Drug ,business.industry ,medicine.disease ,030104 developmental biology ,business - Abstract
The primary objective of this multicentric dose allocation and dose expansion study was to determine the MTD and the DLTs of the lucitanib (a tyrosine kinase inhibitor of the FGFR/VEGFR/PDFGR pathways)/fulvestrant combination. Postmenopausal women with ER+/HER2− mBC, who have relapsed during or after treatment with fulvestrant, were eligible. The study had a dose allocation part to assess the tolerability of the combination followed by a dose expansion part. Eighteen patients with ER+, mBC were enrolled; median age was 66 years, 50% had a PS: 0 and all had received previous endocrine treatment. The study was prematurely terminated after 18 patients (15 in part 1 and 3 in part 2) based on preclinical experiments that failed to confirm the hypothesis that addition of lucitanib would reverse sensitivity to endocrine treatments. Based on data of global lucitanib development, it was decided to stop the dose allocation at 12.5 mg and to start the dose expansion part at 10 mg/day. The most common grade ≥ 3 toxicities (> 10% of patients) were hypertension (78%) and asthenia (22%). All patients required at ≥ 1 interruption, 13 patients (72%) required ≥ 1 dose reduction. Three patients (72%) withdrew from the study for AEs (at 10 mg). Three patients achieved a confirmed PR (10 mg n = 1; 12.5 mg n = 2). Although the combination is feasible it requires close monitoring of the patients for the management of adverse events. Further investigation is required to better understand the potential role of FGFR inhibition in reversing resistance to endocrine treatment.
- Published
- 2019
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