Cancer Chemotherapy and Pharmacology

, Volume 69, Issue 6, pp 1507–1518

Phase I study of AEE788, a novel multitarget inhibitor of ErbB- and VEGF-receptor-family tyrosine kinases, in recurrent glioblastoma patients

  • David A. Reardon
  • Charles A. Conrad
  • Timothy Cloughesy
  • Michael D. Prados
  • Henry S. Friedman
  • Kenneth D. Aldape
  • Paul Mischel
  • Jane Xia
  • Clifford DiLea
  • Jerry Huang
  • William Mietlowski
  • Margaret Dugan
  • Wei Chen
  • W. K. Alfred Yung
Original Article

DOI: 10.1007/s00280-012-1854-6

Cite this article as:
Reardon, D.A., Conrad, C.A., Cloughesy, T. et al. Cancer Chemother Pharmacol (2012) 69: 1507. doi:10.1007/s00280-012-1854-6

Abstract

Purpose

Vascular endothelial growth factor receptor (VEGFR) and epidermal growth factor receptor (EGFR) play a significant role in glioblastoma angiogenesis and proliferation, making tyrosine kinase (TK) receptors logical targets for treatment. We evaluated AEE788, a reversible TK inhibitor that inhibits EGFR and VEGFR, in recurrent glioblastoma patients.

Methods

In this dose-escalation, phase I study, patients with recurrent glioblastoma received AEE788 once daily in 28-day cycles in stratified subgroups: those receiving (1) non-enzyme-inducing anticonvulsants drugs or no anticonvulsants (Group A) and (2) enzyme-inducing anticonvulsant drugs (Group B). A dose-expansion phase stratified patients by surgical eligibility. Primary objectives were to determine dose-limiting toxicity (DLT) and maximum tolerated dose; secondary objectives included evaluating (1) safety/tolerability, (2) pharmacokinetics, and (3) preliminary antitumor activity.

Results

Sixty-four glioblastoma patients were enrolled. Two Group A patients experienced DLTs (proteinuria and stomatitis) at 550 mg; 550 mg was, therefore, the highest dose evaluated and dose limiting. One Group B patient receiving 800 mg experienced a DLT (diarrhea). The initially recommended dose for dose-expansion phase for Group A was 400 mg; additional patients received 250 mg to assess the hepatotoxicity. Most frequently reported adverse events (AEs) included diarrhea and rash. Serious AEs, most commonly grade 3/4 liver function test elevations, were responsible for treatment discontinuation in 17% of patients. AEE788 concentrations were reduced by EIACD. The best overall response was stable disease (17%).

Conclusions

Continuous, once-daily AEE788 was associated with unacceptable toxicity and minimal activity for the treatment of recurrent glioblastoma. The study was, therefore, discontinued prematurely.

Keywords

Glioblastoma Tyrosine kinase inhibitor Epidermal growth factor receptor Vascular endothelial growth factor receptor RAD001 

Copyright information

© Springer-Verlag 2012

Authors and Affiliations

  • David A. Reardon
    • 1
  • Charles A. Conrad
    • 2
  • Timothy Cloughesy
    • 3
  • Michael D. Prados
    • 4
  • Henry S. Friedman
    • 6
  • Kenneth D. Aldape
    • 2
  • Paul Mischel
    • 3
  • Jane Xia
    • 5
  • Clifford DiLea
    • 5
  • Jerry Huang
    • 5
  • William Mietlowski
    • 5
  • Margaret Dugan
    • 5
  • Wei Chen
    • 3
  • W. K. Alfred Yung
    • 2
  1. 1.Center for Neuro-OncologyDana-Farber Cancer InstituteBostonUSA
  2. 2.The University of Texas MD Anderson Cancer CenterHoustonUSA
  3. 3.University of California, Los AngelesLos AngelesUSA
  4. 4.University of California, San FranciscoSan FranciscoUSA
  5. 5.Novartis Pharmaceutical CorporationEast HanoverUSA
  6. 6.The Preston Robert Tisch Brain Tumor CenterDuke University Medical CenterDurhamUSA

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