Skip to main content

Advertisement

Log in

Vandetanib with docetaxel as second-line treatment for advanced breast cancer: a double-blind, placebo-controlled, randomized Phase II study

  • PHASE II STUDIES
  • Published:
Investigational New Drugs Aims and scope Submit manuscript

Summary

Purpose The aim of this Phase II study was to assess the efficacy and safety of vandetanib in combination with docetaxel in patients with pretreated advanced breast cancer. Methods The primary study objective was to compare the number of progression events in patients receiving once-daily oral vandetanib (100 mg) in combination with docetaxel (100 mg/m2 iv every 21 days) versus placebo plus docetaxel. Sixty-four patients were randomized to receive study treatment (n = 35, vandetanib; n = 29, placebo). Results A slightly greater number of patients had experienced a progression event by the data cut-off in the vandetanib group (24 [69%]) compared with the placebo group (18 [62%]); HR = 1.19, two-sided 80% CI: 0.79–1.81; two-sided P = 0.59), suggesting that the addition of vandetanib to docetaxel did not affect the risk of disease progression compared with placebo plus docetaxel. The safety and tolerability profile of the combination therapy reflected those of both drugs as monotherapy agents. Conclusions In patients with advanced breast cancer, vandetanib plus docetaxel was generally well tolerated. Clinical benefit was not different to that observed with placebo plus docetaxel. However, due to the small patient number it was not possible to yield robust results, further research is required to identify predictive factors for patient selection.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1

Similar content being viewed by others

References

  1. Gasparini G (2000) Prognostic value of vascular endothelial growth factor in breast cancer. Oncologist 5(Suppl 1):37–44

    Article  PubMed  CAS  Google Scholar 

  2. Atalay G, Cardoso F, Awada A, Piccart MJ (2003) Novel therapeutic strategies targeting the epidermal growth factor receptor (EGFR) family and its downstream effectors in breast cancer. Ann Oncol 14:1346–1363

    Article  PubMed  CAS  Google Scholar 

  3. Relf M, LeJeune S, Scott PA, Fox S, Smith K, Leek R, Moghaddam A, Whitehouse R, Bicknell R, Harris AL (1997) Expression of the angiogenic factors vascular endothelial cell growth factor, acidic and basic fibroblast growth factor, tumor growth factor beta-1, platelet-derived endothelial cell growth factor, placenta growth factor, and pleiotrophin in human primary breast cancer and its relation to angiogenesis. Cancer Res 57:963–969

    PubMed  CAS  Google Scholar 

  4. Gasparini G, Toi M, Gion M, Verderio P, Dittadi R, Hanatani M, Matsubara I, Vinante O, Bonoldi E, Boracchi P, Gatti C, Suzuki H, Tominaga T (1997) Prognostic significance of vascular endothelial growth factor protein in node-negative breast carcinoma. J Natl Cancer Inst 89:139–147

    Article  PubMed  CAS  Google Scholar 

  5. Toi M, Inada K, Suzuki H, Tominaga T (1995) Tumor angiogenesis in breast cancer: its importance as a prognostic indicator and the association with vascular endothelial growth factor expression. Breast Cancer Res Treat 36:193–204

    Article  PubMed  CAS  Google Scholar 

  6. Fox SB, Smith K, Hollyer J, Greenall M, Hastrich D, Harris AL (1994) The epidermal growth factor receptor as a prognostic marker: results of 370 patients and review of 3009 patients. Breast Cancer Res Treat 29:41–49

    Article  PubMed  CAS  Google Scholar 

  7. Klijn JG, Berns PM, Schmitz PI, Foekens JA (1992) The clinical significance of epidermal growth factor receptor (EGF-R) in human breast cancer: a review on 5232 patients. Endocr Rev 13:3–17

    PubMed  CAS  Google Scholar 

  8. Klijn JG, Look MP, Portengen H, exieva-Figusch J, van Putten WL, Foekens JA (1994) The prognostic value of epidermal growth factor receptor (EGF-R) in primary breast cancer: results of a 10 year follow-up study. Breast Cancer Res Treat 29:73–83

    Article  PubMed  CAS  Google Scholar 

  9. Miller K, Wang M, Gralow J, Dickler M, Cobleigh M, Perez EA, Shenkier T, Cella D, Davidson NE (2007) Paclitaxel plus bevacizumab versus paclitaxel alone for metastatic breast cancer. N Engl J Med 357:2666–2676

    Article  PubMed  CAS  Google Scholar 

  10. Modi S, D’Andrea G, Norton L, Yao TJ, Caravelli J, Rosen PP, Hudis C, Seidman AD (2006) A phase I study of cetuximab/paclitaxel in patients with advanced-stage breast cancer. Clin Breast Cancer 7:270–277

    Article  PubMed  CAS  Google Scholar 

  11. Burstein HJ, Storniolo AM, Franco S, Forster J, Stein S, Rubin S, Salazar VM, Blackwell KL (2008) A phase II study of lapatinib monotherapy in chemotherapy-refractory HER2-positive and HER2-negative advanced or metastatic breast cancer. Ann Oncol 19:1068–1074

    Article  PubMed  CAS  Google Scholar 

  12. Ciardiello F, Caputo R, Bianco R, Damiano V, Fontanini G, Cuccato S, De Placido S, Bianco AR, Tortora G (2001) Inhibition of growth factor production and angiogenesis in human cancer cells by ZD1839 (Iressa), a selective epidermal growth factor receptor tyrosine kinase inhibitor. Clin Cancer Res 7:1459–1465

    PubMed  CAS  Google Scholar 

  13. Riedel F, Gotte K, Li M, Hormann K, Grandis JR (2002) EGFR antisense treatment of human HNSCC cell lines down-regulates VEGF expression and endothelial cell migration. Int J Oncol 21:11–16

    PubMed  CAS  Google Scholar 

  14. Wedge SR, Ogilvie DJ, Dukes M, Kendrew J, Chester R, Jackson JA, Boffey SJ, Valentine PJ, Curwen JO, Musgrove HL, Graham GA, Hughes GD, Thomas AP, Stokes ES, Curry B, Richmond GH, Wadsworth PF, Bigley AL, Hennequin LF (2002) ZD6474 inhibits vascular endothelial growth factor signaling, angiogenesis, and tumor growth following oral administration. Cancer Res 62:4645–4655

    PubMed  CAS  Google Scholar 

  15. Ichihara M, Murakumo Y, Takahashi M (2004) RET and neuroendocrine tumors. Cancer Lett 204:197–211

    Article  PubMed  CAS  Google Scholar 

  16. Holden SN, Eckhardt SG, Basser R, de Boer R, Rischin D, Green M, Rosenthal MA, Wheeler C, Barge A, Hurwitz HI (2005) Clinical evaluation of ZD6474, an orally active inhibitor of VEGF and EGF receptor signaling, in patients with solid, malignant tumors. Ann Oncol 16:1391–1397

    Article  PubMed  CAS  Google Scholar 

  17. Tamura T, Minami H, Yamada Y, Yamamoto N, Shimoyama T, Murakami H, Horiike A, Fujisaka Y, Shinkai S, Tahara M, Kawada K, Ebi H, Sasaki Y, Jiang H, Saijo N (2006) A Phase I dose-escalation study of ZD6474 in Japanese patients with solid, malignant tumors. J Thorac Oncol 1:1002–1009

    Article  PubMed  Google Scholar 

  18. Miller KD, Trigo JM, Wheeler C, Barge A, Rowbottom J, Sledge G, Baselga J (2005) A multicenter phase II trial of ZD6474, a vascular endothelial growth factor receptor-2 and epidermal growth factor receptor tyrosine kinase inhibitor, in patients with previously treated metastatic breast cancer. Clin Cancer Res 11:3369–3376

    Article  PubMed  CAS  Google Scholar 

  19. Ramaswamy B, Elias AD, Kelbick NT, Dodley A, Morrow M, Hauger M, Allen J, Rhoades C, Kendra K, Chen HX, Eckhardt SG, Shapiro CL (2006) Phase II trial of bevacizumab in combination with weekly docetaxel in metastatic breast cancer patients. Clin Cancer Res 12:3124–3129

    Article  PubMed  CAS  Google Scholar 

  20. Nabholtz JM, Crown J (1998) Phase III studies of single-agent docetaxel in patients with metastatic breast cancer who have progressed despite previous chemotherapy regimens: preliminary results. Semin Oncol 25:4–9

    PubMed  CAS  Google Scholar 

  21. Heymach JV, Johnson BE, Prager D, Csada E, Roubec J, Pesek M, Spasova I, Belani CP, Bodrogi I, Gadgeel S, Kennedy SJ, Hou J, Herbst RS (2007) Randomized, placebo-controlled phase II study of vandetanib plus docetaxel in previously treated non-small-cell lung cancer. J Clin Oncol 25:4270–4277

    Article  PubMed  CAS  Google Scholar 

  22. Rubinstein LV, Korn EL, Freidlin B, Hunsberger S, Ivy SP, Smith MA (2005) Design issues of randomized phase II trials and a proposal for phase II screening trials. J Clin Oncol 23:7199–7206

    Article  PubMed  Google Scholar 

  23. Carroll KJ (2007) Analysis of progression-free survival in oncology trials: some common statistical issues. Pharm Stat 6:99–113

    Article  PubMed  Google Scholar 

  24. Natale RB, Bodkin D, Govindan R, Sleckman BG, Rizvi NA, Capo A, Germonpre P, Eberhardt WE, Stockman PK, Kennedy SJ, Ranson M (2009) Vandetanib versus gefitinib in patients with advanced non-small-cell lung cancer: Results from a two-part, double-blind, randomized Phase II study. J Clin Oncol 27:2523–2529

    Article  PubMed  CAS  Google Scholar 

  25. Cobleigh MA, Langmuir VK, Sledge GW, Miller KD, Haney L, Novotny WF, Reimann JD, Vassel A (2003) A phase I/II dose-escalation trial of bevacizumab in previously treated metastatic breast cancer. Semin Oncol 30:117–124

    Article  PubMed  CAS  Google Scholar 

  26. Miller KD, Chap LI, Holmes FA, Cobleigh MA, Marcom PK, Fehrenbacher L, Dickler M, Overmoyer BA, Reimann JD, Sing AP, Langmuir V, Rugo HS (2005) Randomized phase III trial of capecitabine compared with bevacizumab plus capecitabine in patients with previously treated metastatic breast cancer. J Clin Oncol 23:792–799

    Article  PubMed  CAS  Google Scholar 

  27. Albain K, Elledge R, Gradishar W, Hayes D, Rowinsky E, Hudis C, Pusztai L, Tripathy D, Modi S, Rubi S (2002) Open-label, phase II, multicenter trial of ZD1839 (‘Iressa') in patients with advanced breast cancer. Breast Cancer Res Treat 76:A20

    Google Scholar 

  28. Robertson J, Guttedridge E, Cheung K, Owens R, Koehler M, Hamilton L (2002) A phase II study of ZD1839 (Iressa) in tamoxifen-resistant ER-positive and endocrine-insensitive (ER-negative) breast cancer. Breast Cancer Res Treat 76:S96

    Google Scholar 

  29. Winer EP, Cobleigh M, Dickler M (2002) Phase II multicenter study to evaluate the efficacy and safety of Tarceva (erlotinib, OSI-774) in women with previously treated locally advanced or metastatic breast cancer. Breast Cancer Res Treat 76:S115

    Google Scholar 

  30. Ciardiello F, Troiani T, Caputo F, De Laurentiis M, Tortora G, Palmieri G, De VF, Diadema MR, Orditura M, Colantuoni G, Gridelli C, Catalano G, De PS, Bianco AR (2006) Phase II study of gefitinib in combination with docetaxel as first-line therapy in metastatic breast cancer. Br J Cancer 94:1604–1609

    PubMed  CAS  Google Scholar 

  31. Polychronis A, Sinnett HD, Hadjiminas D, Singhal H, Mansi JL, Shivapatham D, Shousha S, Jiang J, Peston D, Barrett N, Vigushin D, Morrison K, Beresford E, Ali S, Slade MJ, Coombes RC (2005) Preoperative gefitinib versus gefitinib and anastrozole in postmenopausal patients with oestrogen-receptor positive and epidermal-growth-factor-receptor-positive primary breast cancer: a double-blind placebo-controlled phase II randomised trial. Lancet Oncol 6:383–391

    Article  PubMed  CAS  Google Scholar 

Download references

Acknowledgements

This study, including editorial assistance provided by Chris Watson of Mudskipper Bioscience, was supported financially by AstraZeneca.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Katalin Boér.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Boér, K., Láng, I., Llombart-Cussac, A. et al. Vandetanib with docetaxel as second-line treatment for advanced breast cancer: a double-blind, placebo-controlled, randomized Phase II study. Invest New Drugs 30, 681–687 (2012). https://doi.org/10.1007/s10637-010-9538-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10637-010-9538-8

Keywords

Navigation