Cancer Chemotherapy and Pharmacology

, Volume 69, Issue 5, pp 1117–1126

Age-stratified phase I trial of a combination of bortezomib, gemcitabine, and liposomal doxorubicin in patients with advanced malignancies

  • G. S. Falchook
  • M. Duvic
  • D. S. Hong
  • J. Wheler
  • A. Naing
  • J. Lim
  • R. Kurzrock
Original Article

DOI: 10.1007/s00280-011-1808-4

Cite this article as:
Falchook, G.S., Duvic, M., Hong, D.S. et al. Cancer Chemother Pharmacol (2012) 69: 1117. doi:10.1007/s00280-011-1808-4

Abstract

Background

Preclinical data suggest synergistic activity of bortezomib, gemcitabine, and liposomal doxorubicin. Because tolerance to therapy may be attenuated in elderly patients, we performed an age-stratified phase I trial of this combination.

Patients and methods

Two parallel age-stratified arms (<65 and ≥65 years old) were accrued (3 + 3 design). Starting doses included bortezomib 0.7 mg/m2 (days 1 and 8), gemcitabine 500 mg/m2 (days 1 and 8), and liposomal doxorubicin 20 mg/m2 (day 1).

Results

In the <65-year-old group, 65 patients were treated; the maximum-tolerated dose was bortezomib 1.3 mg/m2, gemcitabine 800 mg/m2, and liposomal doxorubicin 35 mg/m2. In the ≥65-year-old group, 28 patients were treated; the recommended phase II dose was bortezomib 1.0 mg/m2, gemcitabine 800 mg/m2, and liposomal doxorubicin 20 mg/m2. Dose-limiting toxicities included thrombocytopenia and neutropenia. The most common toxicities were mild cytopenias, fatigue, and neuropathy. Ten patients achieved partial responses (6 of 7 patients with cutaneous T-cell lymphoma; 4 of 16 patients with small cell carcinomas, including lung, prostate, ovarian, and nasopharyngeal).

Conclusion

Combination of bortezomib, gemcitabine, and liposomal doxorubicin is well tolerated, but with a lower recommended phase II dose in elderly patients, and demonstrated antitumor activity, especially in T-cell and small cell histology malignancies.

Keywords

BortezomibGemcitabineLiposomal doxorubicinCutaneous T-cell lymphomaSmall cell carcinomaPhase I

Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  • G. S. Falchook
    • 1
  • M. Duvic
    • 2
  • D. S. Hong
    • 1
  • J. Wheler
    • 1
  • A. Naing
    • 1
  • J. Lim
    • 1
  • R. Kurzrock
    • 1
  1. 1.Division of Cancer Medicine, Department of Investigational Cancer Therapeutics (Phase I Clinical Trials Program)-Unit 455The University of Texas MD Anderson Cancer CenterHoustonUSA
  2. 2.Division of Internal Medicine, Department of DermatologyThe University of Texas MD Anderson Cancer CenterHoustonUSA