The Activity of Crizotinib in Chemo-Refractory MET-Amplified Esophageal and Gastric Adenocarcinomas: Results from the AcSé-Crizotinib Program.


Journal

Targeted oncology
ISSN: 1776-260X
Titre abrégé: Target Oncol
Pays: France
ID NLM: 101270595

Informations de publication

Date de publication:
05 2021
Historique:
accepted: 20 03 2021
pubmed: 14 4 2021
medline: 1 12 2021
entrez: 13 4 2021
Statut: ppublish

Résumé

The AcSé-crizotinib program provides extensive screening of crizotinib-targeted genomic alteration in several malignancies. We here report the results in patients with esogastric MET-amplified adenocarcinomas. The objective of the study was to evaluate the efficacy and tolerability of crizotinib in patients with pretreated esogastric MET-amplified adenocarcinoma who have no alternative treatment options. MET expression was evaluated by fluorescence in situ hybridization in tumor samples with immunohistochemistry scores ≥ 2+. Patients with chemo-refractory tumors showing ≥ 6 MET copies were eligible for crizotinib 250 mg twice daily. The primary efficacy outcome was the objective response rate after two cycles of crizotinib. MET was prospectively analyzed in 570 esogastric adenocarcinomas. Amplifications were found in 35/570 adenocarcinomas (29/523 gastric and 6/47 esophageal). Nine patients were treated with crizotinib. The objective response rate after two cycles was 33.3% (95% CI 7.5-70), the best overall response rate was 55.6% (95% CI 21.2-86.3), with median progression-free survival of 3.2 months (95% CI 1.0-5.4), and overall survival of 8.1 months (95% CI 1.7-24.6). Safety was consistent with that previously reported for crizotinib. Large-scale screening for MET-amplified esogastric adenocarcinomas is feasible. MET amplification was observed in 5.5% of gastric and 12.8% of esophageal adenocarcinomas. Crizotinib shows encouraging results in selected patients. Thus, c-MET inhibition for MET-amplified tumors deserves further evaluation. NCT02034981. 14 January 2014.

Sections du résumé

BACKGROUND
The AcSé-crizotinib program provides extensive screening of crizotinib-targeted genomic alteration in several malignancies. We here report the results in patients with esogastric MET-amplified adenocarcinomas.
OBJECTIVE
The objective of the study was to evaluate the efficacy and tolerability of crizotinib in patients with pretreated esogastric MET-amplified adenocarcinoma who have no alternative treatment options.
PATIENTS AND METHODS
MET expression was evaluated by fluorescence in situ hybridization in tumor samples with immunohistochemistry scores ≥ 2+. Patients with chemo-refractory tumors showing ≥ 6 MET copies were eligible for crizotinib 250 mg twice daily. The primary efficacy outcome was the objective response rate after two cycles of crizotinib.
RESULTS
MET was prospectively analyzed in 570 esogastric adenocarcinomas. Amplifications were found in 35/570 adenocarcinomas (29/523 gastric and 6/47 esophageal). Nine patients were treated with crizotinib. The objective response rate after two cycles was 33.3% (95% CI 7.5-70), the best overall response rate was 55.6% (95% CI 21.2-86.3), with median progression-free survival of 3.2 months (95% CI 1.0-5.4), and overall survival of 8.1 months (95% CI 1.7-24.6). Safety was consistent with that previously reported for crizotinib.
CONCLUSIONS
Large-scale screening for MET-amplified esogastric adenocarcinomas is feasible. MET amplification was observed in 5.5% of gastric and 12.8% of esophageal adenocarcinomas. Crizotinib shows encouraging results in selected patients. Thus, c-MET inhibition for MET-amplified tumors deserves further evaluation.
TRIAL REGISTRATION NUMBER
NCT02034981.
DATE OF REGISTRATION
14 January 2014.

Identifiants

pubmed: 33847874
doi: 10.1007/s11523-021-00811-8
pii: 10.1007/s11523-021-00811-8
pmc: PMC8105218
doi:

Substances chimiques

Protein Kinase Inhibitors 0
Crizotinib 53AH36668S

Banques de données

ClinicalTrials.gov
['NCT02034981']

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

381-388

Références

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Auteurs

Thomas Aparicio (T)

Gastroenterology and Digestive Oncology Department, Hôpital Saint Louis, APHP, Université de Paris, 1 Avenue Claude Vellefaux, 75010, Paris, France. thomas.aparicio@aphp.fr.

Nathalie Cozic (N)

Department of Biostatistics and Epidemiology, Gustave Roussy, University Paris-Saclay, Villejuif, France.
Oncostat U1018, Inserm, University Paris-Saclay, Labeled Ligue Contre le Cancer, Villejuif, France.

Christelle de la Fouchardière (C)

Medical Oncology Department, Centre Léon Bérard, Lyon, France.
Cancer Research Center of Lyon, UMR INSERM 1052, CNRS 5286, 69373, Lyon, France.

Emeline Meriaux (E)

Institut du Cancer de l'Ouest-Centre René Gauducheau, Saint Herblain, France.

Jérome Plaza (J)

Hopitaux Privés de Metz-Hôpital Belle Isle, Metz, France.

Laurent Mineur (L)

Institut du cancer Sainte-Catherine Avignon Provence, Avignon, France.

Rosine Guimbaud (R)

Universitary Hospital of Toulouse, Toulouse, France.

Emmanuelle Samalin (E)

Medical Oncology Department, Institut du Cancer de Montpellier, Université de Montpellier, Montpellier, France.

Florence Mary (F)

Gastroenterology and Digestive Oncology, Hôpital Avicenne, AP-HP, Bobigny, France.

Thierry Lecomte (T)

Gastroenterology and Digestive Oncology, Tours University Hospital, UMR INSERM 1069, Université de Tours, Tours, France.

Carlos Gomez-Roca (C)

Institut Claudius Regaud, Toulouse, France.
IUCT-Oncopole, Toulouse, France.

Paul-Arthur Haineaux (PA)

Department of Medical Oncology, Poitiers University Hospital, Poitiers, France.

Alain Gratet (A)

Clinique Pasteur, Toulouse, France.

Jannick Selves (J)

IUCT-Oncopole, Toulouse, France.

Yves Menu (Y)

Hôpital Saint Antoine, APHP, Paris, France.

Nikias Colignon (N)

Hôpital Saint Antoine, APHP, Paris, France.

Laetitia Johnson (L)

Unicancer, Paris, France.

Frédéric Legrand (F)

Department of Clinical Research, Institut National du Cancer, Boulogne Billancourt, France.

Gilles Vassal (G)

Gustave Roussy, Villejuif, France.

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