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Investigational New Drugs

, Volume 30, Issue 5, pp 1934–1941 | Cite as

Phase I study of temsirolimus in combination with EKB-569 in patients with advanced solid tumors

  • Alan H. BryceEmail author
  • Ravi Rao
  • Jann Sarkaria
  • Joel M. Reid
  • Yingwei Qi
  • Rui Qin
  • C. David James
  • Robert B. Jenkins
  • Joseph Boni
  • Charles Erlichman
  • Paul Haluska
PHASE I STUDIES

Summary

Purpose Activation of EGFR can stimulate proliferative and survival signaling through mTOR. Preclinical data demonstrates synergistic activity of combined EGFR and mTOR inhibition. We undertook a phase I trial of temsirolimus (T, an mTOR inhibitor) and EKB-569 (E, an EGFR inhibitor) to determine the safety and tolerability. Methods The primary aim was to determine the maximally tolerated dose (MTD) of this combination in adults with solid tumors. Following the dose-escalation phase, (Cohort A), two subsequent cohorts were used to assess any pharmacokinetic (PK) interaction between the agents. Results Forty eight patients were enrolled. The MTD of this combination was E, 35 mg daily and T, 30 mg on days 1–3 and 15–17 using a 28-day cycle. The most common toxicities were nausea, diarrhea, fatigue, anorexia, stomatitis, rash, anemia, neutropenia, thrombocytopenia, and hypertriglyceridemia. Sixteen patients (36%) had at least one grade 3 toxicity. The most frequent grade 3/4 toxicities were diarrhea, dehydration, and nausea and vomiting (19% each). No grade 5 events were seen. Four patients had a partial response and 15 had stable disease. Clinical benefit was seen across a range of tumor types and in all cohorts. PK analysis revealed no significant interaction between E and T. Conclusions This combination of agents is associated with tolerable toxicities at doses that induced responses. PK studies revealed no interaction between the drugs. Further investigations of this targeting strategy may be attractive in renal cell carcinoma, non-small cell lung cancer, alveolar sarcoma, and carcinoid tumor.

Keywords

CCI-779. EKB-569 Temsirolimus Phase I Pharmacokinetics Solid tumors 

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Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  • Alan H. Bryce
    • 1
    Email author
  • Ravi Rao
    • 2
    • 5
  • Jann Sarkaria
    • 2
  • Joel M. Reid
    • 2
  • Yingwei Qi
    • 2
  • Rui Qin
    • 2
  • C. David James
    • 3
  • Robert B. Jenkins
    • 2
  • Joseph Boni
    • 4
  • Charles Erlichman
    • 2
  • Paul Haluska
    • 2
  1. 1.Mayo ClinicScottsdaleUSA
  2. 2.Mayo ClinicRochesterUSA
  3. 3.University of California, San FranciscoSan FranciscoUSA
  4. 4.Pfizer OncologyCollegevilleUSA
  5. 5.Cancer Center at St AgnesFresnoUSA

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