Phase I study investigating the safety and feasibility of combining imatinib mesylate (Gleevec) with sorafenib in patients with refractory castration-resistant prostate cancer

Background: Determining the maximum tolerated dose (MTD) and the dose-limiting toxicity (DLT) of sorafenib (S) plus imatinib (IM) in castration-resistant prostate cancer (CRPC) patients. Methods: Refractory CRPC patients were enrolled onto this 3+3 dose escalation designed study. Imatinib pharmacoki...

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Veröffentlicht in:British journal of cancer 2012-08, Vol.107 (4), p.592-597
Hauptverfasser: Nabhan, C, Villines, D, Valdez, T V, Tolzien, K, Lestingi, T M, Bitran, J D, Christner, S M, Egorin, M J, Beumer, J H
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container_end_page 597
container_issue 4
container_start_page 592
container_title British journal of cancer
container_volume 107
creator Nabhan, C
Villines, D
Valdez, T V
Tolzien, K
Lestingi, T M
Bitran, J D
Christner, S M
Egorin, M J
Beumer, J H
description Background: Determining the maximum tolerated dose (MTD) and the dose-limiting toxicity (DLT) of sorafenib (S) plus imatinib (IM) in castration-resistant prostate cancer (CRPC) patients. Methods: Refractory CRPC patients were enrolled onto this 3+3 dose escalation designed study. Imatinib pharmacokinetics (PK) were determined on day 15, 4 h post dose with a validated LC–MS assay. Results: Seventeen patients were enrolled; 10 evaluable (6 at 400 mg S qd with 300 mg IM qd (DL0) and 4 at 400 mg S bid with 300 mg IM qd (DL1)); inevaluable patients received
doi_str_mv 10.1038/bjc.2012.312
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Methods: Refractory CRPC patients were enrolled onto this 3+3 dose escalation designed study. Imatinib pharmacokinetics (PK) were determined on day 15, 4 h post dose with a validated LC–MS assay. Results: Seventeen patients were enrolled; 10 evaluable (6 at 400 mg S qd with 300 mg IM qd (DL0) and 4 at 400 mg S bid with 300 mg IM qd (DL1)); inevaluable patients received &lt;1 cycle. The median age was 73 (57–89); median prostatic serum antigen was 284 ng ml −1 (11.7–9027). Median number of prior non-hormonal therapies was 3 (1–12). Dose-limiting toxicities were diarrhoea and hand-foot syndrome. Maximum tolerated dose was 400 mg S and 300 mg IM both daily. No biochemical responses were observed. Two patients had stable disease by RECIST. Median time to progression was 2 months (1–5). Median OS was 6 months (1–30+) with 3/17 patients (17%) alive at 21 months median follow-up. Ten patients had PK data suggesting that S reduced IM clearance by 55%, resulting in 77% increased exposure ( P =0.005; compared with historical data). Conclusion: This is the first report showing that S+IM can be administered in CRPC at a dose of 400 mg S and 300 mg IM, daily.</description><identifier>ISSN: 0007-0920</identifier><identifier>EISSN: 1532-1827</identifier><identifier>DOI: 10.1038/bjc.2012.312</identifier><identifier>PMID: 22805325</identifier><identifier>CODEN: BJCAAI</identifier><language>eng</language><publisher>London: Nature Publishing Group UK</publisher><subject>631/92/436/108 ; 692/699/67/589/466 ; 692/700/565/1436/1437 ; Adult ; Aged ; Aged, 80 and over ; Antineoplastic Combined Chemotherapy Protocols - adverse effects ; Antineoplastic Combined Chemotherapy Protocols - therapeutic use ; Benzamides ; Benzenesulfonates - administration &amp; dosage ; Biological and medical sciences ; Biomedical and Life Sciences ; Biomedicine ; Bisphosphonates ; Cancer Research ; Cancer therapies ; Castration ; Chemotherapy ; Clinical Study ; Cytotoxicity ; Drug Administration Schedule ; Drug dosages ; Drug Resistance ; Epidemiology ; Hematology ; Humans ; Imatinib Mesylate ; Male ; Maximum Tolerated Dose ; Medical research ; Medical sciences ; Medicine ; Metastasis ; Middle Aged ; Molecular Medicine ; Nephrology. Urinary tract diseases ; Niacinamide - analogs &amp; derivatives ; Oncology ; Phenylurea Compounds ; Piperazines - administration &amp; dosage ; Piperazines - pharmacokinetics ; Prostate cancer ; Prostatic Neoplasms - drug therapy ; Pyridines - administration &amp; dosage ; Pyrimidines - administration &amp; dosage ; Pyrimidines - pharmacokinetics ; Retreatment ; Treatment Failure ; Tumors ; Tumors of the urinary system ; Urinary tract. 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Methods: Refractory CRPC patients were enrolled onto this 3+3 dose escalation designed study. Imatinib pharmacokinetics (PK) were determined on day 15, 4 h post dose with a validated LC–MS assay. Results: Seventeen patients were enrolled; 10 evaluable (6 at 400 mg S qd with 300 mg IM qd (DL0) and 4 at 400 mg S bid with 300 mg IM qd (DL1)); inevaluable patients received &lt;1 cycle. The median age was 73 (57–89); median prostatic serum antigen was 284 ng ml −1 (11.7–9027). Median number of prior non-hormonal therapies was 3 (1–12). Dose-limiting toxicities were diarrhoea and hand-foot syndrome. Maximum tolerated dose was 400 mg S and 300 mg IM both daily. No biochemical responses were observed. Two patients had stable disease by RECIST. Median time to progression was 2 months (1–5). Median OS was 6 months (1–30+) with 3/17 patients (17%) alive at 21 months median follow-up. Ten patients had PK data suggesting that S reduced IM clearance by 55%, resulting in 77% increased exposure ( P =0.005; compared with historical data). Conclusion: This is the first report showing that S+IM can be administered in CRPC at a dose of 400 mg S and 300 mg IM, daily.</description><subject>631/92/436/108</subject><subject>692/699/67/589/466</subject><subject>692/700/565/1436/1437</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Antineoplastic Combined Chemotherapy Protocols - adverse effects</subject><subject>Antineoplastic Combined Chemotherapy Protocols - therapeutic use</subject><subject>Benzamides</subject><subject>Benzenesulfonates - administration &amp; dosage</subject><subject>Biological and medical sciences</subject><subject>Biomedical and Life Sciences</subject><subject>Biomedicine</subject><subject>Bisphosphonates</subject><subject>Cancer Research</subject><subject>Cancer therapies</subject><subject>Castration</subject><subject>Chemotherapy</subject><subject>Clinical Study</subject><subject>Cytotoxicity</subject><subject>Drug Administration Schedule</subject><subject>Drug dosages</subject><subject>Drug Resistance</subject><subject>Epidemiology</subject><subject>Hematology</subject><subject>Humans</subject><subject>Imatinib Mesylate</subject><subject>Male</subject><subject>Maximum Tolerated Dose</subject><subject>Medical research</subject><subject>Medical sciences</subject><subject>Medicine</subject><subject>Metastasis</subject><subject>Middle Aged</subject><subject>Molecular Medicine</subject><subject>Nephrology. Urinary tract diseases</subject><subject>Niacinamide - analogs &amp; derivatives</subject><subject>Oncology</subject><subject>Phenylurea Compounds</subject><subject>Piperazines - administration &amp; dosage</subject><subject>Piperazines - pharmacokinetics</subject><subject>Prostate cancer</subject><subject>Prostatic Neoplasms - drug therapy</subject><subject>Pyridines - administration &amp; dosage</subject><subject>Pyrimidines - administration &amp; dosage</subject><subject>Pyrimidines - pharmacokinetics</subject><subject>Retreatment</subject><subject>Treatment Failure</subject><subject>Tumors</subject><subject>Tumors of the urinary system</subject><subject>Urinary tract. 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Methods: Refractory CRPC patients were enrolled onto this 3+3 dose escalation designed study. Imatinib pharmacokinetics (PK) were determined on day 15, 4 h post dose with a validated LC–MS assay. Results: Seventeen patients were enrolled; 10 evaluable (6 at 400 mg S qd with 300 mg IM qd (DL0) and 4 at 400 mg S bid with 300 mg IM qd (DL1)); inevaluable patients received &lt;1 cycle. The median age was 73 (57–89); median prostatic serum antigen was 284 ng ml −1 (11.7–9027). Median number of prior non-hormonal therapies was 3 (1–12). Dose-limiting toxicities were diarrhoea and hand-foot syndrome. Maximum tolerated dose was 400 mg S and 300 mg IM both daily. No biochemical responses were observed. Two patients had stable disease by RECIST. Median time to progression was 2 months (1–5). Median OS was 6 months (1–30+) with 3/17 patients (17%) alive at 21 months median follow-up. 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subjects 631/92/436/108
692/699/67/589/466
692/700/565/1436/1437
Adult
Aged
Aged, 80 and over
Antineoplastic Combined Chemotherapy Protocols - adverse effects
Antineoplastic Combined Chemotherapy Protocols - therapeutic use
Benzamides
Benzenesulfonates - administration & dosage
Biological and medical sciences
Biomedical and Life Sciences
Biomedicine
Bisphosphonates
Cancer Research
Cancer therapies
Castration
Chemotherapy
Clinical Study
Cytotoxicity
Drug Administration Schedule
Drug dosages
Drug Resistance
Epidemiology
Hematology
Humans
Imatinib Mesylate
Male
Maximum Tolerated Dose
Medical research
Medical sciences
Medicine
Metastasis
Middle Aged
Molecular Medicine
Nephrology. Urinary tract diseases
Niacinamide - analogs & derivatives
Oncology
Phenylurea Compounds
Piperazines - administration & dosage
Piperazines - pharmacokinetics
Prostate cancer
Prostatic Neoplasms - drug therapy
Pyridines - administration & dosage
Pyrimidines - administration & dosage
Pyrimidines - pharmacokinetics
Retreatment
Treatment Failure
Tumors
Tumors of the urinary system
Urinary tract. Prostate gland
title Phase I study investigating the safety and feasibility of combining imatinib mesylate (Gleevec) with sorafenib in patients with refractory castration-resistant prostate cancer
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