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Phase I/Ib study of crenolanib with ramucirumab and paclitaxel as second-line therapy for advanced esophagogastric adenocarcinoma.
- Source :
-
Cancer chemotherapy and pharmacology [Cancer Chemother Pharmacol] 2022 Feb; Vol. 89 (2), pp. 255-265. Date of Electronic Publication: 2022 Jan 23. - Publication Year :
- 2022
-
Abstract
- Purpose: Paclitaxel plus ramucirumab is a standard second-line regimen for patients with advanced gastric adenocarcinoma, but clinical benefit remains modest. One potential resistance mechanism to VEGFR2 inhibition is activation of the PDGF/PDGFR pathway, which can be blocked by the selective inhibitor crenolanib. Therefore, we performed a phase I/Ib study of crenolanib in combination with paclitaxel/ramucirumab.<br />Methods: Patients with metastatic esophagogastric adenocarcinoma refractory to first-line therapy received escalating doses of crenolanib [60 mg twice daily (BID) to 100 mg three times daily (TID)] in combination with paclitaxel 80 mg/m <superscript>2</superscript> intravenously on days 1, 8 and 15 and ramucirumab 8 mg/kg intravenously on days 1 and 15 of a 28-day cycle. The primary objective was to determine the maximally tolerated dose (MTD) of crenolanib. Additional patients were enrolled in the dose expansion cohort to assess 6-month progression-free survival (PFS) at the MTD.<br />Results: We enrolled 19 patients in the dose escalation phase and 8 patients in the dose expansion phase at the MTD of crenolanib 100 mg BID. Common grade 3/4 treatment-emergent adverse events included leukopenia (19%), anemia (11%) and neutropenia (11%). In the 14 patients treated at the MTD, 6-month PFS was 43% [95% confidence interval (CI) 23-78%] and the objective response rate (ORR) was 42% (95% CI 15-72%). The trial was terminated early due to withdrawal of crenolanib by the sponsor.<br />Conclusions: The addition of crenolanib to paclitaxel/ramucirumab is safe and well-tolerated at a dose level up to 100 mg BID.<br />Clinical Trial Registration: NCT03193918. June 19, 2017.<br /> (© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)
- Subjects :
- Adenocarcinoma pathology
Adult
Aged
Antibodies, Monoclonal, Humanized administration & dosage
Antineoplastic Combined Chemotherapy Protocols adverse effects
Antineoplastic Combined Chemotherapy Protocols pharmacology
Benzimidazoles administration & dosage
Dose-Response Relationship, Drug
Esophageal Neoplasms pathology
Female
Humans
Male
Maximum Tolerated Dose
Middle Aged
Paclitaxel administration & dosage
Piperidines administration & dosage
Progression-Free Survival
Stomach Neoplasms pathology
Ramucirumab
Adenocarcinoma drug therapy
Antineoplastic Combined Chemotherapy Protocols administration & dosage
Esophageal Neoplasms drug therapy
Stomach Neoplasms drug therapy
Subjects
Details
- Language :
- English
- ISSN :
- 1432-0843
- Volume :
- 89
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- Cancer chemotherapy and pharmacology
- Publication Type :
- Academic Journal
- Accession number :
- 35066693
- Full Text :
- https://doi.org/10.1007/s00280-021-04384-1