Palbociclib and cetuximab in platinum-resistant and in cetuximab-resistant human papillomavirus-unrelated head and neck cancer: a multicentre, multigroup, phase 2 trial.


Journal

The Lancet. Oncology
ISSN: 1474-5488
Titre abrégé: Lancet Oncol
Pays: England
ID NLM: 100957246

Informations de publication

Date de publication:
09 2019
Historique:
received: 05 03 2019
revised: 14 05 2019
accepted: 28 05 2019
pubmed: 29 7 2019
medline: 1 7 2020
entrez: 29 7 2019
Statut: ppublish

Résumé

Most head and neck squamous-cell carcinomas (HNSCCs) are driven by p16 We did a multicentre, multigroup, phase 2 trial to evaluate the activity of palbociclib and cetuximab in platinum-resistant (group 1) and cetuximab-resistant (group 2) HPV-unrelated HNSCC. The study was done across eight university sites in the USA. Eligibility required measurable disease (according to Response Evaluation Criteria in Solid Tumors, version 1·1 [RECIST 1·1]), Eastern Cooperative Oncology Group (ECOG) performance status of 0-2, age of 18 years or older, and disease progression on platinum but cetuximab-naive (group 1) or disease progression on cetuximab (group 2). All patients received palbociclib orally (125 mg/day, on days 1-21) and intravenous cetuximab (400 mg/m Between Oct 19, 2015, and Nov 7, 2018, 62 patients were enrolled onto the trial: 30 patients were enrolled in group 1 and 32 in group 2. Median follow-up was 5·4 months (IQR 4·4-12·1) for group 1 and 5·5 months (4·3-8·3) for group 2. In group 1, of 28 evaluable patients, an objective response was achieved by 11 (39%; 95% CI 22-59). In group 2, of 27 evaluable patients, an objective response was achieved by five (19%; 6-38) in group 2. The most common grade 3-4 palbociclib-related adverse event was neutropenia (in 21 [34%] of 62 patients). No treatment-related deaths occurred. In patients with platinum-resistant or cetuximab-resistant HPV-unrelated HNSCC, palbociclib and cetuximab results in promising activity outcomes. Further studies of CDK4/6 inhibitors are warranted in HPV-unrelated HNSCC. Pfizer.

Sections du résumé

BACKGROUND
Most head and neck squamous-cell carcinomas (HNSCCs) are driven by p16
METHODS
We did a multicentre, multigroup, phase 2 trial to evaluate the activity of palbociclib and cetuximab in platinum-resistant (group 1) and cetuximab-resistant (group 2) HPV-unrelated HNSCC. The study was done across eight university sites in the USA. Eligibility required measurable disease (according to Response Evaluation Criteria in Solid Tumors, version 1·1 [RECIST 1·1]), Eastern Cooperative Oncology Group (ECOG) performance status of 0-2, age of 18 years or older, and disease progression on platinum but cetuximab-naive (group 1) or disease progression on cetuximab (group 2). All patients received palbociclib orally (125 mg/day, on days 1-21) and intravenous cetuximab (400 mg/m
FINDINGS
Between Oct 19, 2015, and Nov 7, 2018, 62 patients were enrolled onto the trial: 30 patients were enrolled in group 1 and 32 in group 2. Median follow-up was 5·4 months (IQR 4·4-12·1) for group 1 and 5·5 months (4·3-8·3) for group 2. In group 1, of 28 evaluable patients, an objective response was achieved by 11 (39%; 95% CI 22-59). In group 2, of 27 evaluable patients, an objective response was achieved by five (19%; 6-38) in group 2. The most common grade 3-4 palbociclib-related adverse event was neutropenia (in 21 [34%] of 62 patients). No treatment-related deaths occurred.
INTERPRETATION
In patients with platinum-resistant or cetuximab-resistant HPV-unrelated HNSCC, palbociclib and cetuximab results in promising activity outcomes. Further studies of CDK4/6 inhibitors are warranted in HPV-unrelated HNSCC.
FUNDING
Pfizer.

Identifiants

pubmed: 31351869
pii: S1470-2045(19)30405-X
doi: 10.1016/S1470-2045(19)30405-X
pii:
doi:

Substances chimiques

CCND1 protein, human 0
Cyclin-Dependent Kinase Inhibitor p16 0
Piperazines 0
Pyridines 0
Cyclin D1 136601-57-5
Platinum 49DFR088MY
CDK4 protein, human EC 2.7.11.22
CDK6 protein, human EC 2.7.11.22
Cyclin-Dependent Kinase 4 EC 2.7.11.22
Cyclin-Dependent Kinase 6 EC 2.7.11.22
palbociclib G9ZF61LE7G
Cetuximab PQX0D8J21J

Banques de données

ClinicalTrials.gov
['NCT02101034']

Types de publication

Clinical Trial, Phase II Journal Article Multicenter Study Randomized Controlled Trial Research Support, N.I.H., Extramural Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

1295-1305

Commentaires et corrections

Type : CommentIn

Informations de copyright

Copyright © 2019 Elsevier Ltd. All rights reserved.

Auteurs

Douglas Adkins (D)

Division of Medical Oncology, Washington University School of Medicine, St Louis, MO, USA; Alvin J Siteman Cancer Center, Washington University School of Medicine, St Louis, MO, USA. Electronic address: dadkins@wustl.edu.

Jessica Ley (J)

Division of Medical Oncology, Washington University School of Medicine, St Louis, MO, USA.

Prakash Neupane (P)

Division of Oncology, University of Kansas School of Medicine, Kansas City, KS, USA.

Francis Worden (F)

Department of Medicine, University of Michigan, Ann Arbor, MI, USA.

Assuntina G Sacco (AG)

University of California San Diego Moores Cancer Center, La Jolla, CA, USA.

Kevin Palka (K)

Division of Medical Oncology, Washington University School of Medicine, St Louis, MO, USA; Department of Medicine, St Louis University, St Louis, MO, USA.

Juneko E Grilley-Olson (JE)

Department of Medicine, Division of Hematology-Oncology, and Lineberger Comprehensive Cancer Center, University of North Carolina School of Medicine, Chapel Hill, NC, USA.

Ronald Maggiore (R)

Department of Medicine, Wilmont Cancer Institute at the University of Rochester, Rochester, NY, USA.

Noha N Salama (NN)

Department of Pharmaceutics and Industrial Pharmacy, Faculty of Pharmacy, Cairo University, Cairo, Egypt; Department of Pharmaceutical and Administrative Sciences, St Louis College of Pharmacy, St Louis, MO, USA.

Kathryn Trinkaus (K)

Biostatistics Shared Resource, Washington University School of Medicine, St Louis, MO, USA.

Brian A Van Tine (BA)

Division of Medical Oncology, Washington University School of Medicine, St Louis, MO, USA; Alvin J Siteman Cancer Center, Washington University School of Medicine, St Louis, MO, USA.

Conor E Steuer (CE)

Winship Cancer Institute of Emory University, Atlanta, GA, USA.

Nabil F Saba (NF)

Winship Cancer Institute of Emory University, Atlanta, GA, USA.

Peter Oppelt (P)

Division of Medical Oncology, Washington University School of Medicine, St Louis, MO, USA; Alvin J Siteman Cancer Center, Washington University School of Medicine, St Louis, MO, USA.

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Classifications MeSH