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Bagegni NA, Park H, Kraft K, O-Toole M, Gao F, Waqar SN, Ratner L, Morgensztern D, Devarakonda S, Amin M, Baggstrom MQ, Liang C, Selvaggi G, Wang-Gillam A. Phase 1b trial of anti-VEGF/PDGFR vorolanib combined with immune checkpoint inhibitors in patients with advanced solid tumors. Cancer Chemother Pharmacol 2022; 89:487-497. [PMID: 35247086 PMCID: PMC8956523 DOI: 10.1007/s00280-022-04406-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Accepted: 01/31/2022] [Indexed: 12/30/2022]
Abstract
Purpose Vorolanib is a multi-target tyrosine kinase inhibitor with anti-angiogenic properties. This study aimed to evaluate the tolerability, safety and efficacy of vorolanib when added to checkpoint inhibitors (CPIs) in patients with advanced solid tumors. Methods We conducted a phase 1b study of vorolanib (300 or 400 mg orally once daily) plus pembrolizumab or nivolumab using a standard 3 + 3 design to determine the dose-limiting toxicity (DLT), maximum tolerated dose (MTD) and recommended phase 2 dose (RP2D). The endpoints included safety, toxicity and objective response rate, according to Response Evaluation Criteria in Solid Tumors, version 1.1 (RECIST 1.1). Results Sixteen patients (9 in pembrolizumab arm, 7 in nivolumab arm) with gastrointestinal or lung cancers were enrolled. All patients had at least 1 treatment-related adverse event (TRAE). The most common TRAEs across all cohorts were lymphopenia (n = 7), leukopenia (n = 5), fatigue (n = 5), and alanine aminotransferase elevation (n = 5); most toxicities were grade (G) 1–2. DLTs were reported in 3 patients at vorolanib 400 mg dose level, with G3 aspartate aminotransferase elevation, G3 rectal hemorrhage, and G3 rash. Of 13 total response-evaluable patients, 2 patients had confirmed partial responses (1 rectal squamous cell cancer and 1 small cell lung cancer). Two patients achieved prolonged stable disease. Vorolanib 300 mg daily was determined to be the RP2D for either pembrolizumab or nivolumab. Conclusion Combination vorolanib 300 mg orally once daily plus CPI appears to be a feasible regimen with manageable toxicity and promising efficacy in select tumor types. NCT03511222. Date of Registration: April 18, 2018.
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Affiliation(s)
- Nusayba A Bagegni
- Division of Oncology, Washington University in St. Louis School of Medicine, St Louis, MO, USA
| | - Haeseong Park
- Division of Oncology, Washington University in St. Louis School of Medicine, St Louis, MO, USA
| | - Katlyn Kraft
- Division of Oncology, Washington University in St. Louis School of Medicine, St Louis, MO, USA
| | - Maura O-Toole
- Division of Oncology, Washington University in St. Louis School of Medicine, St Louis, MO, USA
| | - Feng Gao
- Department of Surgery, Washington University in St. Louis School of Medicine, St Louis, MO, USA
| | - Saiama N Waqar
- Division of Oncology, Washington University in St. Louis School of Medicine, St Louis, MO, USA
| | - Lee Ratner
- Division of Oncology, Washington University in St. Louis School of Medicine, St Louis, MO, USA
| | - Daniel Morgensztern
- Division of Oncology, Washington University in St. Louis School of Medicine, St Louis, MO, USA
| | - Siddhartha Devarakonda
- Division of Oncology, Washington University in St. Louis School of Medicine, St Louis, MO, USA
| | - Manik Amin
- Division of Hematology/Oncology, Dartmouth Giesel School of Medicine, Hanover, NH, USA
| | - Maria Q Baggstrom
- Division of Oncology, Washington University in St. Louis School of Medicine, St Louis, MO, USA
| | - Chris Liang
- Xcovery Holdings, Inc., North Palm Beach, USA
| | | | - Andrea Wang-Gillam
- Division of Oncology, Washington University in St. Louis School of Medicine, St Louis, MO, USA.
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