Phase IB dose escalation and expansion study of AKT inhibitor afuresertib with carboplatin and paclitaxel in recurrent platinum-resistant ovarian cancer

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Title: Phase IB dose escalation and expansion study of AKT inhibitor afuresertib with carboplatin and paclitaxel in recurrent platinum-resistant ovarian cancer
Authors: Blagden, SP
Hamilton, AL
Mileshkin, L
Wong, S
Michael, A
Hall, M
Goh, JC
Lisyanskaya, AS
DeSilvio, M
Frangou, E
Stronach, EA
Gopalakrishna, P
Meniawy, TM
Gabra, H
Item Type: Journal Article
Abstract: Purpose: Preclinically, AKT kinase inhibition restores drug sensitivity in platinum-resistant tumors. Here the pan-AKT kinase inhibitor afuresertib was given in combination with paclitaxel and carboplatin (PC) in patients with recurrent platinum-resistant epithelial ovarian cancer (PROC) and primary platinum-refractory ovarian cancer (PPROC). Patients and Methods: Part I was a combination 3+3 dose escalation study for recurrent ovarian cancer. Patients received daily continuous oral afuresertib at 50–150 mg/day with intravenous paclitaxel (175 mg/m2) and carboplatin (AUC5) every 3 weeks for six cycles followed by maintenance afuresertib at 125 mg/day until progression or toxicity. Part II was a single-arm evaluation of the clinical activity of this combination in recurrent PROC (Cohort A) or PPROC (Cohort B). Patients received oral afuresertib at the MTD defined in Part I in combination with PC for six cycles, followed by maintenance afuresertib. Primary endpoints were safety and tolerability of afuresertib in combination with PC (Part I, dose escalation), and investigator-assessed overall response rate (ORR) as per RECIST version 1.1 (Part II). Results: Twenty-nine patients enrolled into Part I, and 30 into Part II. Three dose-limiting toxicities of grade 3 rash were observed, one at 125 mg and two at 150 mg afuresertib. The MTD of afuresertib in combination with PC was therefore identified as 125 mg/day. The most common (≥50%) drug-related adverse events observed in Part I of the study were nausea, diarrhea, vomiting, alopecia, fatigue, and neutropenia and, in Part II, were diarrhea, fatigue, nausea, and alopecia. The Part II ORR in the intention to treat patients was 32% [95% confidence interval (CI), 15.9–52.4] by RECIST 1.1 and 52% (95% CI, 31.3–72.2) by GCIG CA125 criteria. Median progression-free survival was 7.1 months (95% CI, 6.3–9.0 months). Conclusions: Afuresertib plus PC demonstrated efficacy in recurrent PROC with the MTD of afuresertib defined as 125 mg/day.
Issue Date: 1-Mar-2019
Date of Acceptance: 30-Nov-2018
URI: http://hdl.handle.net/10044/1/70592
DOI: https://doi.org/10.1158/1078-0432.CCR-18-2277
ISSN: 1078-0432
Publisher: American Association for Cancer Research
Start Page: 1472
End Page: 1478
Journal / Book Title: Clinical Cancer Research
Volume: 25
Issue: 5
Copyright Statement: © 2018 American Association for Cancer Research.
Keywords: Science & Technology
Life Sciences & Biomedicine
Oncology
CLINICAL-TRIALS
II TRIAL
Science & Technology
Life Sciences & Biomedicine
Oncology
CLINICAL-TRIALS
II TRIAL
1112 Oncology and Carcinogenesis
Oncology & Carcinogenesis
Publication Status: Published
Embargo Date: 2019-12-18
Online Publication Date: 2018-12-18
Appears in Collections:Division of Surgery
Division of Cancer



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