학술논문

Results of a phase II clinical trial of 6-mercaptopurine (6MP) and methotrexate in patients with BRCA-defective tumours.
Document Type
Journal Article
Source
British Journal of Cancer. Feb2020, Vol. 122 Issue 4, p483-490. 8p. 1 Diagram, 4 Charts, 1 Graph.
Subject
*THERAPEUTIC use of antineoplastic agents
*PROTEINS
*RESEARCH
*OVARIAN tumors
*RESEARCH methodology
*CANCER relapse
*EVALUATION research
*MEDICAL cooperation
*METHOTREXATE
*COMPARATIVE studies
*RESEARCH funding
*SALVAGE therapy
*BREAST tumors
*DRUG resistance in cancer cells
Language
ISSN
0007-0920
Abstract
Background: Tumour cells with BRCA1/2 gene mutations demonstrate increased sensitivity to platinum and poly (ADP-ribose) polymerase (PARP) inhibitors. 6-mercaptopurine (6MP) was found to selectively kill BRCA-defective cells in a xenograft model as effectively as the PARP inhibitor AG014699, even after these cells acquired resistance to a PARP inhibitor or cisplatin.Methods: This phase II single-arm trial investigated the activity of 6MP 55-75 mg/m2 per day, and methotrexate 15-20 mg/m2 per week in advanced breast or platinum-resistant ovarian cancer patients with a BRCA1/2 germline mutation, who had progressed after ≥1 previous line of chemotherapy. The primary outcome was objective response including stable disease (SD) as an assessment of clinical benefit rate (CBR), at 8 weeks, by RECIST v1.1. Secondary outcomes included overall survival (OS) and progression-free survival (PFS).Results: In total, 67 evaluable patients were recruited; 55 ovarian and 11 breast cancer patients. In total, 21 patients had SD (31%), one had a partial response (1.5%); CBR was 33% at 8 weeks. In total, 12/67 patients (18%) had SD at 16 weeks. In total, five ovarian cancer patients had SD for over 200 days. Median OS was 10.3 months (95% CI 6.9-14.5), median PFS 1.9 months (1.7-2.8).Conclusions: The overall activity of 6MP and methotrexate in these patients was low; however, there was a small group of patients who appeared to derive longer-term clinical benefit.Trial Registration: NCT01432145 http://www.ClinicalTrials.gov. [ABSTRACT FROM AUTHOR]