A phase 1 study of regorafenib and sildenafil in adults with advanced solid tumors.

IF 1.8 4区 医学 Q3 ONCOLOGY
Anti-Cancer Drugs Pub Date : 2024-06-01 Epub Date: 2024-03-08 DOI:10.1097/CAD.0000000000001584
Andrew S Poklepovic, Sarah W Gordon, Sejal Kothadia, William P McGuire, Leroy R Thacker, Xiaoyan Deng, Mary Beth Tombes, Ellen Shrader, Daniel Hudson, Dipankar Bandyopadhyay, Alison A Ryan, Maciej Kmieciak, Steven Smith, Paul Dent
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引用次数: 0

Abstract

The purpose of this study is to establish the recommended phase 2 dose for regorafenib in combination with sildenafil for patients with advanced solid tumors. Secondary outcomes included identification of antitumor effects of regorafenib and sildenafil, toxicity of the combination, determination of PDE5 expression in tumor samples, and the impact of sildenafil on the pharmacokinetics of regorafenib. This study was a phase 1, open-label single-arm dose-escalation trial using a 3 + 3 design. Additional patients were enrolled at the maximum tolerated dose (MTD) until a total of 12 patients were treated at the MTD. A total of 29 patients were treated in this study. The median duration of treatment was 8 weeks. The recommended phase 2 doses determined in this study are regorafenib 160 mg daily with sildenafil 100 mg daily. The most common toxicities included palmar-plantar erythrodysesthesia syndrome (20 patients, 69%) and hypophosphatemia (18 patients, 62%). Two patients (7%) experienced grade 4 lipase increase. Objective responses were not observed; however, 14 patients (48%) had a period of stable disease during the study. Stable disease for up to 12 months was observed in patients with ovarian cancer as well as up to 20 months for a patient with cervical cancer. The combination of regorafenib and sildenafil at the recommended phase 2 dose is safe and generally well tolerated. Disease control in patients with gynecologic malignancies was especially encouraging. Further evaluation of the combination of regorafenib and sildenafil in gynecologic malignancies is warranted. Clinical Trial Registration Number: NCT02466802.

一项针对晚期实体瘤成人患者的瑞戈非尼和西地那非的 1 期研究。
本研究旨在确定瑞戈非尼联合西地那非治疗晚期实体瘤患者的第二阶段推荐剂量。次要结果包括确定瑞戈非尼和西地那非的抗肿瘤效果、联合用药的毒性、确定肿瘤样本中PDE5的表达以及西地那非对瑞戈非尼药代动力学的影响。该研究是一项一期开放标签单臂剂量递增试验,采用 3+3 设计。其他患者按最大耐受剂量(MTD)接受治疗,直到共有12名患者按MTD接受治疗。这项研究共治疗了 29 名患者。中位治疗时间为 8 周。本研究确定的第二阶段推荐剂量为瑞戈非尼每天160毫克,西地那非每天100毫克。最常见的毒性反应包括掌跖红肌麻痹综合征(20例患者,69%)和低磷血症(18例患者,62%)。两名患者(7%)出现 4 级脂肪酶增高。未观察到客观反应;但有 14 名患者(48%)在研究期间病情稳定。卵巢癌患者的病情稳定期长达12个月,一名宫颈癌患者的病情稳定期长达20个月。按照第二阶段的推荐剂量联合使用瑞戈非尼和西地那非是安全的,而且耐受性普遍良好。妇科恶性肿瘤患者的疾病控制情况尤其令人鼓舞。有必要进一步评估瑞戈非尼和西地那非联合治疗妇科恶性肿瘤的效果。临床试验注册号:NCT02466802:NCT02466802。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Anti-Cancer Drugs
Anti-Cancer Drugs 医学-药学
CiteScore
3.80
自引率
0.00%
发文量
244
审稿时长
3 months
期刊介绍: Anti-Cancer Drugs reports both clinical and experimental results related to anti-cancer drugs, and welcomes contributions on anti-cancer drug design, drug delivery, pharmacology, hormonal and biological modalities and chemotherapy evaluation. An internationally refereed journal devoted to the fast publication of innovative investigations on therapeutic agents against cancer, Anti-Cancer Drugs aims to stimulate and report research on both toxic and non-toxic anti-cancer agents. Consequently, the scope on the journal will cover both conventional cytotoxic chemotherapy and hormonal or biological response modalities such as interleukins and immunotherapy. Submitted articles undergo a preliminary review by the editor. Some articles may be returned to authors without further consideration. Those being considered for publication will undergo further assessment and peer-review by the editors and those invited to do so from a reviewer pool.
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