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Guo J, Carvajal RD, Dummer R, Hauschild A, Daud A, Bastian BC, Markovic SN, Queirolo P, Arance A, Berking C, Camargo V, Herchenhorn D, Petrella TM, Schadendorf D, Sharfman W, Testori A, Novick S, Hertle S, Nourry C, Chen Q, Hodi FS. Efficacy and safety of nilotinib in patients with KIT-mutated metastatic or inoperable melanoma: final results from the global, single-arm, phase II TEAM trial. Ann Oncol 2018; 28:1380-1387. [PMID: 28327988 PMCID: PMC5452069 DOI: 10.1093/annonc/mdx079] [Citation(s) in RCA: 100] [Impact Index Per Article: 16.7] [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] [Indexed: 01/27/2023] Open
Abstract
Background The single-arm, phase II Tasigna Efficacy in Advanced Melanoma (TEAM) trial evaluated the KIT-selective tyrosine kinase inhibitor nilotinib in patients with KIT-mutated advanced melanoma without prior KIT inhibitor treatment. Patients and methods Forty-two patients with KIT-mutated advanced melanoma were enrolled and treated with nilotinib 400 mg twice daily. TEAM originally included a comparator arm of dacarbazine (DTIC)-treated patients; the design was amended to a single-arm trial due to an observed low number of KIT-mutated melanomas. Thirteen patients were randomized to DTIC before the protocol amendment removing this study arm. The primary endpoint was objective response rate (ORR), determined according to Response Evaluation Criteria In Solid Tumors. Results ORR was 26.2% (n = 11/42; 95% CI, 13.9%–42.0%), sufficient to reject the null hypothesis (ORR ≤10%). All observed responses were partial responses (PRs; median response duration, 7.1 months). Twenty patients (47.6%) had stable disease and 10 (23.8%) had progressive disease; 1 (2.4%) response was unknown. Ten of the 11 responding patients had exon 11 mutations, four with an L576P mutation. The median progression-free survival and overall survival were 4.2 and 18.0 months, respectively. Three of the 13 patients on DTIC achieved a PR, and another patient had a PR following switch to nilotinib. Conclusion Nilotinib activity in patients with advanced KIT-mutated melanoma was similar to historical data from imatinib-treated patients. DTIC treatment showed potential activity, although the low patient number limits interpretation. Similar to previously reported results with imatinib, nilotinib showed greater activity among patients with an exon 11 mutation, including L576P, suggesting that nilotinib may be an effective treatment option for patients with specific KIT mutations. Clinical Trial Registration ClinicalTrials.gov, NCT01028222.
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Affiliation(s)
- J Guo
- Department of Renal Cancer & Melanona, Peking University Cancer Hospital & Institute, Beijing, China
| | - R D Carvajal
- Division of Hematology/Oncology, Columbia University Medical Center, New York, USA
| | - R Dummer
- Skin Cancer Center, University Hospital of Zurich, Zurich, Switzerland
| | - A Hauschild
- Department of Dermatology, University Hospital Schleswig-Holstein (UKSH), Campus Kiel, Kiel, Germany
| | - A Daud
- Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, San Francisco
| | - B C Bastian
- Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, San Francisco
| | - S N Markovic
- Department of Hematology/Oncology, Mayo Clinic Cancer Center, Rochester, USA
| | - P Queirolo
- Department of Medical Oncology, National Research Institute for Cancer, Genova, Italy
| | - A Arance
- Department of Medical Oncology, Hospital Clinic, Barcelona, Spain
| | - C Berking
- Department of Dermatology & Allergology, University Hospital Munich (LMU), Munich, Germany
| | - V Camargo
- Department of Medical Oncology, Cancer Institute of São Paulo, São Paulo
| | - D Herchenhorn
- Department of Clinical Oncology, National Institute of Cancer, Rio de Janeiro, Brazil
| | - T M Petrella
- Department of Medical Oncology, Sunnybrook Health Sciences Center, Toronto, Canada
| | - D Schadendorf
- Department of Dermatology, Essen University Hospital, Essen, Germany
| | - W Sharfman
- Department of Oncology & Dermatology, Sidney Kimmel Comprehensive Cancer Center/Johns Hopkins Medicine, Lutherville, USA
| | - A Testori
- Melanoma and Muscle Cutaneous Sarcoma Division, European Institute of Oncology, Milano, Italy
| | - S Novick
- Oncology Business Unit, Novartis Pharmaceuticals Corporation, East Hanover, USA
| | - S Hertle
- Oncology Business Unit, Novartis Pharma AG, Basel, Switzerland
| | - C Nourry
- Oncology Business Unit, Novartis Pharma AG, Basel, Switzerland
| | - Q Chen
- Oncology Business Unit, Novartis Pharmaceuticals Corporation, East Hanover, USA
| | - F S Hodi
- Melanoma Center, Dana-Farber Cancer Institute, Boston, USA
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