Phase 2 trial of the farnesyltransferase inhibitor tipifarnib for relapsed/refractory peripheral T-cell lymphoma.

ABSTRACT: A phase 2, international, open-label, nonrandomized, single-arm trial was conducted to evaluate the efficacy and safety of tipifarnib, a farnesyltransferase inhibitor, as monotherapy for relapsed/refractory peripheral T-cell lymphoma (PTCL) and to evaluate tumor mutation profile as a biomarker of response. Adults with relapsed/refractory PTCL received tipifarnib 300 mg orally twice daily for 21 days in a 28-day cycle. The primary end point was objective response rate (ORR); secondary end points included ORR, progression-free survival (PFS), duration of response (DOR), and adverse events (AEs) in specific subtypes. Sixty-five patients with PTCL were enrolled: n = 38 angioimmunoblastic T-cell lymphoma (AITL), n = 25 PTCL not otherwise specified, and n = 2 other T-cell lymphomas. The ORR was 39.7% (95% confidence interval [CI], 28.1-52.5) in all patients and 56.3% (95% CI, 39.3-71.8) for AITL. Median PFS was 3.5 months overall (954% CI, 2.1-4.4), and 3.6 months (95% CI, 1.9-8.3) for AITL. Median DOR was 3.7 months (95% CI, 2.0-15.3), and greatest in patients with AITL (7.8 months; 95% CI, 2.0-16.3). The median overall survival was 32.8 months (95% CI, 14.4 to not applicable). Tipifarnib-related hematologic AEs were manageable and included neutropenia (43.1%), thrombocytopenia (36.9%), and anemia (30.8%); other tipifarnib-related AEs included nausea (29.2%) and diarrhea (27.7%). One treatment-related death occurred. Mutations in RhoA, DNMT3A, and IDH2 were seen in 60%, 33%, and 27%, respectively, in the AITL tipifarnib responder group vs 36%, 9%, and 9% in the nonresponder group. Tipifarnib monotherapy demonstrated encouraging clinical activity in heavily pretreated relapsed/refractory PTCL, especially in AITL, with a manageable safety profile. This trial was registered at www.ClinicalTrials.gov as #NCT02464228.

A New Microarray, Enriched in Pancreas and Pancreatic Cancer cDNAs to Identify Genes Relevant to Pancreatic Cancer.

BACKGROUND: Identification and characterization of genes that are relevant to pancreatic cancer remains a priority for developing detection and diagnostic tests and identifying targets for treatment. MATERIALS AND METHODS: In order to discover relevant genes, we developed a microarray composed of 5763 pancreas and pancreatic cancer cDNA clones, representing genes of known and unknown function. The Pittsburgh Pancreas Enriched ARray (PittPEAR) was used to compare the gene expression differences between pancreatic cancer and normal pancreas. RESULTS: Two hundred and sixty-four genes were identified: 85 were overexpressed and 176 were underexpressed in cancer compared to normal tissue. Two of the top five genes included the cell cycle division 37 (CDC37) and period Drosophila homolog protein 1 (PER1), which play critical roles in cell division and transcriptional regulation, respectively. Underexpression of many genes probably reflected the loss of acinar and islet cells from the tumors. The biological functions of overexpressed genes include immune response genes, cytoskeletal and genes related to the extracellular matrix, cell invasion, migration, adhesion and motility. Apoptosis and transcription factor genes were also identified. CONCLUSION: We conclude that the PittPEAR microarray provides a useful tool for identifying genes that are relevant to the development and maintenance of pancreatic cancer.