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Phase I trial of vandetanib and bevacizumab evaluating the VEGF and EGF signal transduction pathways in adults with solid tumours and lymphomas

  1. Author:
    Kummar, S.
    Gutierrez, M. E.
    Chen, A.
    Turkbey, I. B.
    Allen, D.
    Horneffer, Y. R.
    Juwara, L.
    Cao, L.
    Yu, Y. K.
    Kim, Y. S.
    Trepel, J.
    Chen, H.
    Choyke, P.
    Melillo, G.
    Murgo, A. J.
    Collins, J.
    Doroshow, J. H.

  2. Author Address

    [Kummar, S; Gutierrez, ME; Turkbey, IB; Allen, D; Horneffer, YR; Cao, L; Yu, YK; Kim, YS; Trepel, J; Choyke, P; Murgo, AJ; Doroshow, JH] NCI, Ctr Canc Res, Bethesda, MD 20892 USA [Kummar, S; Chen, A; Chen, H; Murgo, AJ; Collins, J; Doroshow, JH] NCI, Div Canc Treatment & Diag, Bethesda, MD 20892 USA [Juwara, L; Melillo, G] NCI, Sci Applicat Int Corp Frederick Inc, Frederick, MD 21702 USA;Kummar, S (reprint author), NCI, Ctr Canc Res, 10 Ctr Dr, Bethesda, MD 20892 USA;kummars@mail.nih.gov
    1. Year: 2011
    2. Date: May
  2. Journal: European Journal of Cancer
    1. 47
    2. 7
    3. Pages: 997-1005
  4. Type of Article: Article
  5. ISSN: 0959-8049
  1. Abstract:

    Purpose: Inhibition of epidermal growth factor (EGF) and vascular endothelial growth factor (VEGF) pathways may result in synergistic antitumour activity. We designed a phase I study to evaluate the combination of vandetanib, an investigational agent with activity against EGF receptor and VEGF receptor 2, and bevacizumab, a monoclonal antibody against VEGF. Experimental design: Patients with advanced solid tumours and lymphomas were enrolled. Objectives were to determine the safety and maximum tolerated dose of the combination, characterise pharmacokinetics, measure angiogenic marker changes in blood, and assess tumour blood flow using dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI). Vandetanib was given orally once daily and bevacizumab intravenously once in every 3 weeks in 21-day cycles utilising a standard dose-escalation design. Results: Fifteen patients were enrolled, and a total of 94 cycles of therapy were administered. No protocol-defined dose-limiting toxicities were observed; due to toxicities associated with chronic dosing, hypertension, proteinuria, diarrhoea and anorexia, dose escalation was stopped at the second dose level. We observed one partial response and one minor response; 9 patients experienced stable disease. There were significant changes in plasma VEGF and placental-derived growth factor levels, and decreases in K(trans) and k(ep) were observed by DCE-MRI. Conclusion: In this trial, we safely combined two targeted agents that cause dual blockade of the VEGF pathway, demonstrated preliminary evidence of clinical activity, and conducted correlative studies demonstrating anti-angiogenic effect. The recommended phase II dose was established as vandetanib 200 mg daily and bevacizumab 7.5 mg/kg every 3 weeks. Published by Elsevier Ltd.

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External Sources

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  2. DOI: 10.1016/j.ejca.2010.12.016
  3. View record in Web of Science®
  4. WOS: 000290192600004

Library Notes

  1. Fiscal Year: FY2010-2011
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