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Journal of Neuro-Oncology

, Volume 103, Issue 2, pp 325–332 | Cite as

Phase I trial with biomarker studies of vatalanib (PTK787) in patients with newly diagnosed glioblastoma treated with enzyme inducing anti-epileptic drugs and standard radiation and temozolomide

  • Elizabeth R. GerstnerEmail author
  • April F. Eichler
  • Scott R. Plotkin
  • Jan Drappatz
  • Colin L. Doyle
  • Lei Xu
  • Dan G. Duda
  • Patrick Y. Wen
  • Rakesh K. Jain
  • Tracy T. Batchelor
Clinical Study – Patient Study

Abstract

Targeting angiogenesis in glioblastoma (GBM) may improve patient outcome by normalizing tumor vasculature and improving delivery of chemotherapeutics and oxygen. Consequently, concomitant administration of small molecule inhibitors of the VEGF pathway will likely have a positive impact on chemoradiation treatment outcome. We conducted a Phase I study of vatalanib, a small molecule inhibitor of VEGFR, PDGFR, and c-kit in patients with newly diagnosed GBM receiving radiation, temozolomide, and an enzyme-inducing anti-epileptic drug in order to determine the MTD of vatalanib in this patient population. We incorporated circulating biomarker and SNP analyses and pharmacokinetic studies. Nineteen patients were enrolled and the MTD was not reached at the time of study termination. Vatalanib was well tolerated with only 2 DLTs (thrombocytopenia and elevated transaminases). Other grade 3/4 toxicities included leukopenia, lymphopenia, neutropenia, and hand-foot syndrome. There were no wound-healing complications. Of the 13 patients evaluable for a radiographic response, 2 had a partial response and 9 had stable disease. Vatalanib significantly increased PlGF and sVEGFR1 in plasma circulation and decreased sVEGFR2 and sTie2. Plasma collagen IV increased significantly by day 50 of treatment. Vatalanib was well tolerated and this study demonstrates the safety of oral small molecule inhibitors in newly diagnosed GBM patients. Blood biomarkers may be useful as pharmacodynamic markers of response to anti-angiogenic therapies.

Keywords

Angiogenesis Biomarkers Clinical trial Glioblastoma Treatment 

Supplementary material

11060_2010_390_MOESM1_ESM.doc (148 kb)
Supplementary material 1 (DOC 148 kb)

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Copyright information

© Springer Science+Business Media, LLC. 2010

Authors and Affiliations

  • Elizabeth R. Gerstner
    • 1
    Email author
  • April F. Eichler
    • 1
  • Scott R. Plotkin
    • 1
  • Jan Drappatz
    • 2
  • Colin L. Doyle
    • 1
  • Lei Xu
    • 3
  • Dan G. Duda
    • 3
  • Patrick Y. Wen
    • 2
  • Rakesh K. Jain
    • 3
  • Tracy T. Batchelor
    • 1
  1. 1.Stephen E. & Catherine Pappas Center for Neuro-Oncology, Massachusetts General Hospital Cancer CenterHarvard Medical SchoolBostonUSA
  2. 2.Department of Adult Oncology, Dana-Farber Cancer InstituteHarvard Medical SchoolBostonUSA
  3. 3.Steele Laboratory, Department of Radiation OncologyMassachusetts General HospitalBostonUSA

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