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A Phase I Trial of the PI3K Inhibitor Buparlisib Combined With Capecitabine in Patients With Metastatic Breast Cancer.
McRee, Autumn J; Marcom, Paul K; Moore, Dominic T; Zamboni, William C; Kornblum, Zachary A; Hu, Zhiyuan; Phipps, Rachel; Anders, Carey K; Reeder-Hayes, Katherine; Carey, Lisa A; Weck, Karen E; Perou, Charles M; Dees, E Claire.
Afiliação
  • McRee AJ; Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC. Electronic address: autumn_mcree@med.unc.edu.
  • Marcom PK; Duke Cancer Institute, Duke University Medical Center, Durham, NC.
  • Moore DT; Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC.
  • Zamboni WC; Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC.
  • Kornblum ZA; Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC.
  • Hu Z; Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC.
  • Phipps R; Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC.
  • Anders CK; Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC.
  • Reeder-Hayes K; Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC.
  • Carey LA; Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC.
  • Weck KE; Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC.
  • Perou CM; Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC.
  • Dees EC; Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC.
Clin Breast Cancer ; 18(4): 289-297, 2018 08.
Article em En | MEDLINE | ID: mdl-29153866
BACKGROUND: Buparlisib is an oral pan-class I phosphotidyinositol-3-kinase (PI3K) inhibitor. The present phase I study evaluated the safety, pharmacokinetics, and efficacy of buparlisib with capecitabine in patients with metastatic breast cancer. PATIENTS AND METHODS: Patients received buparlisib once daily (range, 50 to 100 mg) for 3 weeks with capecitabine twice daily (range, 1000 to 1250 mg/m2) for 2 weeks with a 1-week break. Dose escalation used a traditional "3 + 3" design with standard definitions of dose-limiting toxicity (DLT) and maximum tolerated dose. RESULTS: Of the 25 patients enrolled, 23 were evaluable for DLT and 17 were evaluable for response. The maximum tolerated dose of the combination was buparlisib 100 mg daily and capecitabine 1000 mg/m2 twice daily. DLTs included grade 3 hyperglycemia and grade 3 confusion. The most common grade 3 toxicities were diarrhea and elevation of aspartate aminotransferase and alanine transaminase. One patient exhibited a complete response to treatment and four had a confirmed partial response. In cohorts 3 and 4, in which the buparlisib dose remained constant but the capecitabine dose was increased, significant increases in the buparlisib plasma concentration were noted. CONCLUSION: The combination of buparlisib with capecitabine in patients with metastatic breast cancer was generally well-tolerated, with several patients demonstrating prolonged responses. Unexpectedly low rates of PIK3CA mutations (3 of 17) were seen, and only 2 of 7 tumors with subtyping were luminal, making exploration of these putative predictive markers impossible. Further study of the combination is not unreasonable, with expanded pharmacokinetics and sequencing analysis to better elucidate potential drug-drug interactions and more accurate predictive biomarkers of response.
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Neoplasias da Mama / Protocolos de Quimioterapia Combinada Antineoplásica / Morfolinas / Inibidores de Proteínas Quinases / Capecitabina / Aminopiridinas / Antimetabólitos Antineoplásicos Tipo de estudo: Clinical_trials / Prognostic_studies Limite: Adult / Female / Humans / Middle aged Idioma: En Ano de publicação: 2018 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Neoplasias da Mama / Protocolos de Quimioterapia Combinada Antineoplásica / Morfolinas / Inibidores de Proteínas Quinases / Capecitabina / Aminopiridinas / Antimetabólitos Antineoplásicos Tipo de estudo: Clinical_trials / Prognostic_studies Limite: Adult / Female / Humans / Middle aged Idioma: En Ano de publicação: 2018 Tipo de documento: Article