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Clinical Trial
. 2010 Nov 9;103(10):1554-61.
doi: 10.1038/sj.bjc.6605941. Epub 2010 Oct 19.

Phase Ib study of CP-868,596, a PDGFR inhibitor, combined with docetaxel with or without axitinib, a VEGFR inhibitor

Affiliations
Clinical Trial

Phase Ib study of CP-868,596, a PDGFR inhibitor, combined with docetaxel with or without axitinib, a VEGFR inhibitor

M Michael et al. Br J Cancer. .

Abstract

Background: Tumoural interstitial hypertension, possibly modulated by platelet-derived and vascular endothelial growth factor receptors (PDGFR and VEGFR), may mediate resistance to chemotherapy.

Methods: Forty-eight patients with advanced solid tumours received oral PDGFR inhibitor CP-868,596 (60-100 mg twice daily (BID)) and docetaxel (75-100 mg m⁻²), or CP-868,596 (60 mg BID), docetaxel (75 mg m⁻²), and VEGFR inhibitor axitinib (5 mg BID).

Results: The CP-868,596/docetaxel was escalated as above. The CP-868,596/docetaxel/axitinib was not dose escalated because of increased incidence of mucositis-like adverse events (AEs) with concurrent neutropenia relative to that expected for docetaxel. All tested regimens were tolerable, including 100 mg BID CP-868,596 (recommended phase II dose) plus 100 mg m⁻² docetaxel (maximum approved dose). Most treatment-emergent AEs were mild-moderate and reversible, commonly including nausea, diarrhoea, vomiting, constipation, fatigue, and anaemia (CP-868,596/docetaxel), and hypertension, lethargy, diarrhoea, and fatigue (CP-868,596/docetaxel/axitnib). Pharmacokinetics were unaffected by co-administration. Twenty-one patients achieved stable disease, including all seven evaluable on CP-868,596/docetaxel/axitinib. All nine CP-868,596/docetaxel/axitinib patients received therapy for a median of six (range, 3-16) cycles.

Conclusions: The CP-868,596/docetaxel was well tolerated, but increased efficacy was not observed. Addition of axitinib delivered greater benefits than expected in the number of patients achieving prolonged stable disease with a moderate increase in AEs.

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Figures

Figure 1
Figure 1
Dermatologic and metabolic responses in a 39-year-old male with metastatic epithelioid sarcoma. (A) Baseline PET scan. (B) Partial metabolic PET response following 14 days of CP-868,596 single-agent therapy. (C) Skin lesions prior to and (D) dermatologic response following 35 days of CP-868,596 single-agent therapy.
Figure 2
Figure 2
(A) Serum concentration profiles of CP-868,596 (CP) when administered alone or in combination with axitinib or axitinib and docetaxel. Reference data for single-agent CP-868,596 are derived from Lewis et al (2009). (B, C) Pharmacokinetic parameters of 60 mg CP-868,596 (CP) and axitinib when administered alone or in triple combination with docetaxel. Reference data for single-agent CP-868,596 are derived from Lewis et al (2009) and Pfizer data on file. Reference data for single-agent axitinib are derived from Rugo et al (2005). (D) Clearance of docetaxel when administered alone and in combination with CP-868,596 (CP) and CP-868,596 plus axitinib. Reference data for single-agent docetaxel are derived from Bruno and Sanderink (1993) and Bruno et al (1996).

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