A phase I/II study of pemetrexed with sirolimus in advanced, previously treated non-small cell lung cancer.

Lung cancer pemetrexed phase I/II, sirolimus thymidylate synthase (TS)

Journal

Translational lung cancer research
ISSN: 2218-6751
Titre abrégé: Transl Lung Cancer Res
Pays: China
ID NLM: 101646875

Informations de publication

Date de publication:
Jun 2019
Historique:
entrez: 2 8 2019
pubmed: 2 8 2019
medline: 2 8 2019
Statut: ppublish

Résumé

Single-agent pemetrexed is a treatment for recurrent non-squamous non-small cell lung cancer (NSCLC) that provides limited benefit. Preclinical studies showed promising synergistic effects when the mammalian target of rapamycin (mTOR) inhibitor sirolimus was added to pemetrexed. This was a single-institution phase I/II study of pemetrexed in combination with sirolimus. The primary endpoint for the phase I was to determine the maximum tolerated dose (MTD) and safety of the combination. The primary endpoint for the phase II portion was to determine the overall response rate at the MTD. Key eligibility criteria included recurrent, metastatic NSCLC, ECOG performance status of 0-2, and adequate organ function. Sirolimus was administered orally daily after an initial loading dose, and pemetrexed was given intravenously on day 1 of every 21-day cycle. Forty-two patients with recurrent, metastatic NSCLC were enrolled, 22 in phase I and 20 in phase II. The MTD was pemetrexed 500 mg/m The combination of pemetrexed and sirolimus is active in heavily-pretreated NSCLC (ClinicalTrials.gov Identifier: NCT00923273).

Sections du résumé

BACKGROUND BACKGROUND
Single-agent pemetrexed is a treatment for recurrent non-squamous non-small cell lung cancer (NSCLC) that provides limited benefit. Preclinical studies showed promising synergistic effects when the mammalian target of rapamycin (mTOR) inhibitor sirolimus was added to pemetrexed.
METHODS METHODS
This was a single-institution phase I/II study of pemetrexed in combination with sirolimus. The primary endpoint for the phase I was to determine the maximum tolerated dose (MTD) and safety of the combination. The primary endpoint for the phase II portion was to determine the overall response rate at the MTD. Key eligibility criteria included recurrent, metastatic NSCLC, ECOG performance status of 0-2, and adequate organ function. Sirolimus was administered orally daily after an initial loading dose, and pemetrexed was given intravenously on day 1 of every 21-day cycle.
RESULTS RESULTS
Forty-two patients with recurrent, metastatic NSCLC were enrolled, 22 in phase I and 20 in phase II. The MTD was pemetrexed 500 mg/m
CONCLUSIONS CONCLUSIONS
The combination of pemetrexed and sirolimus is active in heavily-pretreated NSCLC (ClinicalTrials.gov Identifier: NCT00923273).

Identifiants

pubmed: 31367538
doi: 10.21037/tlcr.2019.04.19
pii: tlcr-08-03-247
pmc: PMC6626857
doi:

Banques de données

ClinicalTrials.gov
['NCT00923273']

Types de publication

Journal Article

Langues

eng

Pagination

247-257

Déclaration de conflit d'intérêts

Conflicts of Interest: Phillip A. Dennis is employed by Astrazeneca and owns its stocks. Marc S. Ballas is employed by GlaxoSmithKline and receives personal fees from Astrazeneca and Bristol Myers Squibb. The other authors have no conflicts of interest to declare.

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Auteurs

Takefumi Komiya (T)

Medical Oncology Service, Center for Cancer Research, National Cancer Institute, Bethesda, MD, USA.

Regan M Memmott (RM)

Medical Oncology Service, Center for Cancer Research, National Cancer Institute, Bethesda, MD, USA.

Gideon M Blumenthal (GM)

Medical Oncology Service, Center for Cancer Research, National Cancer Institute, Bethesda, MD, USA.

Wendy Bernstein (W)

Medical Oncology Service, Center for Cancer Research, National Cancer Institute, Bethesda, MD, USA.

Marc S Ballas (MS)

Medical Oncology Service, Center for Cancer Research, National Cancer Institute, Bethesda, MD, USA.

Roopa De Chowdhury (R)

Medical Oncology Service, Center for Cancer Research, National Cancer Institute, Bethesda, MD, USA.

Guinevere Chun (G)

Medical Oncology Service, Center for Cancer Research, National Cancer Institute, Bethesda, MD, USA.

Cody J Peer (CJ)

Medical Oncology Service, Center for Cancer Research, National Cancer Institute, Bethesda, MD, USA.

William D Figg (WD)

Medical Oncology Service, Center for Cancer Research, National Cancer Institute, Bethesda, MD, USA.

David J Liewehr (DJ)

Biostatistics and Data Management Section, National Cancer Institute, Rockville, MD, USA.

Seth M Steinberg (SM)

Biostatistics and Data Management Section, National Cancer Institute, Rockville, MD, USA.

Giuseppe Giaccone (G)

Medical Oncology Service, Center for Cancer Research, National Cancer Institute, Bethesda, MD, USA.

Eva Szabo (E)

Medical Oncology Service, Center for Cancer Research, National Cancer Institute, Bethesda, MD, USA.
Lung and Upper Aerodigestive Cancer Research Group, Division of Cancer Prevention, National Cancer Institute, Bethesda, MD, USA.

Shigeru Kawabata (S)

Medical Oncology Service, Center for Cancer Research, National Cancer Institute, Bethesda, MD, USA.

Junji Tsurutani (J)

Medical Oncology Service, Center for Cancer Research, National Cancer Institute, Bethesda, MD, USA.

Arun Rajan (A)

Medical Oncology Service, Center for Cancer Research, National Cancer Institute, Bethesda, MD, USA.

Phillip A Dennis (PA)

Medical Oncology Service, Center for Cancer Research, National Cancer Institute, Bethesda, MD, USA.

Classifications MeSH