학술논문

Phase I Results from a Study of Crizotinib in Combination with Erlotinib in Patients with Advanced Nonsquamous Non–Small Cell Lung Cancer
Document Type
article
Source
Journal of Thoracic Oncology. 12(1)
Subject
Biomedical and Clinical Sciences
Clinical Sciences
Oncology and Carcinogenesis
Clinical Research
Clinical Trials and Supportive Activities
Lung
Lung Cancer
Cancer
Evaluation of treatments and therapeutic interventions
6.1 Pharmaceuticals
Adenocarcinoma
Adenocarcinoma
Bronchiolo-Alveolar
Adult
Aged
Antineoplastic Combined Chemotherapy Protocols
Carcinoma
Non-Small-Cell Lung
Carcinoma
Papillary
Crizotinib
Erlotinib Hydrochloride
Female
Follow-Up Studies
Humans
Lung Neoplasms
Lymphatic Metastasis
Male
Maximum Tolerated Dose
Middle Aged
Neoplasm Staging
Prognosis
Pyrazoles
Pyridines
Survival Rate
Tissue Distribution
Erlotinib
Phase I combination trial
MET inhibitor
EGFR inhibitor
Cardiorespiratory Medicine and Haematology
Oncology & Carcinogenesis
Clinical sciences
Oncology and carcinogenesis
Language
Abstract
IntroductionThis phase I trial was conducted to determine the safety, maximum tolerated dose (MTD)/recommended phase II dose, and efficacy of crizotinib plus erlotinib in patients with advanced NSCLC.MethodsPatients with NSCLC and an Eastern Cooperative Oncology Group performance status of 0 to 2 after failure of one or two prior chemotherapy regimens were eligible. Erlotinib, 100 mg, was given continuously once daily starting between day -14 and -7; crizotinib, 200 mg twice daily (dose level 1) or 150 mg twice daily (dose level -1), was added continuously beginning on day 1 of treatment cycle 1. Potential pharmacokinetic interactions between crizotinib and erlotinib were evaluated.ResultsTwenty-seven patients received treatment; 26 received crizotinib plus erlotinib. Frequent adverse events were diarrhea, rash, decreased appetite, and fatigue. Dose-limiting toxicities were dehydration, diarrhea, dry eye, dysphagia, dyspepsia, esophagitis and vomiting. The MTD was crizotinib, 150 mg twice daily, with erlotinib, 100 mg once daily. Crizotinib increased the erlotinib area under the concentration-time curve 1.5-fold (dose level -1) and 1.8-fold (dose level 1). The plasma level of crizotinib appeared to be unaffected by coadministration of erlotinib. Two patients whose tumors harbored activating EGFR mutations achieved confirmed partial responses, one at each crizotinib dose level.ConclusionsThe MTD of the combination of crizotinib and erlotinib in patients with advanced NSCLC was crizotinib, 150 mg twice daily, with erlotinib, 100 mg once daily, which is less than the approved dose of either agent. The phase II portion of the study was not initiated.