Skip to main content
Erschienen in: Investigational New Drugs 4/2020

09.11.2019 | PHASE I STUDIES

A phase I study of vistusertib (dual mTORC1/2 inhibitor) in patients with previously treated glioblastoma multiforme: a CCTG study

verfasst von: Sarah Lapointe, Warren Mason, Mary MacNeil, Craig Harlos, Roger Tsang, Joana Sederias, H. Artee Luchman, Samuel Weiss, John P. Rossiter, Dongsheng Tu, Lesley Seymour, Martin Smoragiewicz

Erschienen in: Investigational New Drugs | Ausgabe 4/2020

Einloggen, um Zugang zu erhalten

Summary

The PI3K/AKT/mTOR pathway activation plays a central role in glioblastoma multiforme (GBM) development and progression, and in resistance to anti-cancer therapies. Inhibition of the PI3K pathway has been shown to sensitize cultured glioma cells and tumor xenografts to the effects of temozolomide (TMZ) and radiation. Vistusertib is an oral inhibitor of mTORC1/2 complexes. The primary objective of this Canadian Cancer Trials Group phase I study was to determine the recommended phase II dose (RP2D) of vistusertib in patients with GBM receiving TMZ at first progression following primary treatment. Vistusertib was administered at a starting dose of 100 mg bid 2 days on/5 days off weekly with TMZ 150 mg/m2 daily for 5 days/28-days cycle. Dose escalation was according to a 3 + 3 design. Secondary objectives included assessment of vistusertib safety and toxicity profile, and preliminary efficacy. 15 patients were enrolled in the study (median age 66 (range 51–77), females 8). Vistusertib 125 mg BID in combination with TMZ 150 mg/m2 daily for 5 days was well tolerated. Vistusertib treatment-related adverse events were generally grade 1–2, with the most frequently reported being fatigue, gastrointestinal symptoms, and rash. Of 13 response evaluable patients, 1 patient (8%) had a partial response ongoing at 7.6 months of follow-up, and 5 patients had stable disease (38%) as best response (median duration 9.6 months, range 3.7-not yet reached). Six-month progression-free survival (PFS) rate was 26.6%. Combination of vistusertib with TMZ in GBM patients at first recurrence demonstrated a favorable safety profile at the tested dose levels.
Literatur
5.
Zurück zum Zitat Schiff D, Jaeckle KA, Anderson SK et al (2018) Phase 1 / 2 trial of temsirolimus and sorafenib in the treatment of patients with recurrent glioblastoma : north central cancer treatment group study / alliance N0572. Cancer 1455–1463. https://doi.org/10.1002/cncr.31219 Schiff D, Jaeckle KA, Anderson SK et al (2018) Phase 1 / 2 trial of temsirolimus and sorafenib in the treatment of patients with recurrent glioblastoma : north central cancer treatment group study / alliance N0572. Cancer 1455–1463. https://​doi.​org/​10.​1002/​cncr.​31219
11.
Zurück zum Zitat Choe G, Horvath S, Cloughesy TF et al (2003) Analysis of the PI3K signaling pathway in glioblastoma patients in vivo. Cancer Res 63:2742–2746PubMed Choe G, Horvath S, Cloughesy TF et al (2003) Analysis of the PI3K signaling pathway in glioblastoma patients in vivo. Cancer Res 63:2742–2746PubMed
18.
Zurück zum Zitat Sano T, Lin H, Chen X et al (1999) Differential expression of MMAC/PTEN in glioblastoma multiforme: relationship to localization and prognosis. Cancer Res 59:1820–1824PubMed Sano T, Lin H, Chen X et al (1999) Differential expression of MMAC/PTEN in glioblastoma multiforme: relationship to localization and prognosis. Cancer Res 59:1820–1824PubMed
19.
Zurück zum Zitat Smith JS, Tachibana I, Passe SM et al (2001) PTEN mutation, EGFR amplification, and outcome in patients with anaplastic astrocytoma and glioblastoma multiforme. J Natl Cancer Inst 93:1246–1256 Smith JS, Tachibana I, Passe SM et al (2001) PTEN mutation, EGFR amplification, and outcome in patients with anaplastic astrocytoma and glioblastoma multiforme. J Natl Cancer Inst 93:1246–1256
24.
Zurück zum Zitat Chang SM, Wen P, Cloughesy T, Greenberg H, Schiff D, Conrad C, Karen F, Ian Robins H, De Angelis L, Raizer J, Hess K, Aldape K, Lamborn KR, Kuhn J, Janet Dancey MDP (2005) Phase II study of CCI-779 in patients with recurrent glioblastoma multiforme. Investig New Drugs 23:357–361. https://doi.org/10.1007/s11523-018-0605-y CrossRef Chang SM, Wen P, Cloughesy T, Greenberg H, Schiff D, Conrad C, Karen F, Ian Robins H, De Angelis L, Raizer J, Hess K, Aldape K, Lamborn KR, Kuhn J, Janet Dancey MDP (2005) Phase II study of CCI-779 in patients with recurrent glioblastoma multiforme. Investig New Drugs 23:357–361. https://​doi.​org/​10.​1007/​s11523-018-0605-y CrossRef
25.
38.
Zurück zum Zitat Schmid P, Zaiss M, Harper-Wynne C et al (2018) MANTA - a randomized phase II study of fulvestrant in combination with the dual mTOR inhibitor AZD2014 or everolimus or fulvestrant alone in estrogen receptor-positive advanced or metastatic breast cancer. Cancer Res 78:GS2-07-GS2-07. https://doi.org/10.1158/1538-7445.SABCS17-GS2-07 Schmid P, Zaiss M, Harper-Wynne C et al (2018) MANTA - a randomized phase II study of fulvestrant in combination with the dual mTOR inhibitor AZD2014 or everolimus or fulvestrant alone in estrogen receptor-positive advanced or metastatic breast cancer. Cancer Res 78:GS2-07-GS2-07. https://​doi.​org/​10.​1158/​1538-7445.​SABCS17-GS2-07
Metadaten
Titel
A phase I study of vistusertib (dual mTORC1/2 inhibitor) in patients with previously treated glioblastoma multiforme: a CCTG study
verfasst von
Sarah Lapointe
Warren Mason
Mary MacNeil
Craig Harlos
Roger Tsang
Joana Sederias
H. Artee Luchman
Samuel Weiss
John P. Rossiter
Dongsheng Tu
Lesley Seymour
Martin Smoragiewicz
Publikationsdatum
09.11.2019
Verlag
Springer US
Erschienen in
Investigational New Drugs / Ausgabe 4/2020
Print ISSN: 0167-6997
Elektronische ISSN: 1573-0646
DOI
https://doi.org/10.1007/s10637-019-00875-4

Weitere Artikel der Ausgabe 4/2020

Investigational New Drugs 4/2020 Zur Ausgabe

Update Onkologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.