Phase i pharmacokinetic and pharmacodynamic study of cetuximab, irinotecan and sorafenib in advanced colorectal cancer

Nilofer Azad, Arvind Dasari, John Arcaroli, Gretchen E. Taylor, Daniel A. Laheru, Michael A. Carducci, Martine McManus, Kevin Quackenbush, John J. Wright, Manuel Hidalgo, Luis A. Diaz, Ross C. Donehower, Ming Zhao, Michelle A. Rudek, Wells A. Messersmith

Research output: Contribution to journalArticlepeer-review

Abstract

Summary: Background This phase Ib study was designed to determine the maximum tolerated doses (MTD) and dose limiting toxicities (DLTs) of irinotecan and cetuximab with sorafenib. Secondary objectives included characterizing the pharmacokinetics and pharmacodynamics and evaluating preliminary antitumor activity in patients with advanced colorectal cancer (CRC). Methods Patients with metastatic, pretreated CRC were treated at five dose levels. Results Eighteen patients were recruited with median age 56.5 years. In the first five patients treated, 2 irinotecan related DLTs were observed. With reduced dose intensity irinotecan, there were no further DLTs. The most common toxicities were diarrhea, nausea/vomiting, fatigue, anorexia and rash. DLTs included neutropenia and thrombocytopenia. Two patients had partial responses (one with a KRAS mutation) and 8 had stable disease (8-36 weeks). The median progression free survival (PFS) and overall survival (OS) were 2.5 and 4.7 months respectively. Pharmacokinetic analyses suggest sorafenib and metabolite exposure correlate with OS and DLTs. Conclusions The recommended phase II dose (RP2D) is irinotecan 100 mg/m2 i.v. days 1, 8; cetuximab 400 mg/m2 i.v. days 1 and 250 mg/m2 i.v. weekly; and sorafenib 400 mg orally twice daily in advanced, pretreated CRC. The combination resulted in a modest response rate.

Original languageEnglish (US)
Pages (from-to)345-354
Number of pages10
JournalInvestigational New Drugs
Volume31
Issue number2
DOIs
StatePublished - Apr 2013

Keywords

  • Cetuximab
  • Colorectal cancer
  • Irinotecan
  • Pharmacokinetics
  • Sorafenib

ASJC Scopus subject areas

  • Oncology
  • Pharmacology
  • Pharmacology (medical)

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