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    Phase I trial of oral mTOR inhibitor everolimus in combination with trastuzumab and vinorelbine in pre-treated patients with HER2-overexpressing metastatic breast cancer.

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    Authors
    Jerusalem, G
    Fasolo, A
    Dieras, V
    Cardoso, F
    Bergh, Jonas
    Vittori, L
    Zhang, Y
    Massacesi, C
    Sahmoud, T
    Gianni, L
    Affiliation
    CHU Sart-Tilman, Liège, Belgium.
    Issue Date
    2011-01
    
    Metadata
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    Abstract
    To determine the feasible dose and schedule for everolimus, an oral mTOR inhibitor, combined with vinorelbine and trastuzumab for patients with HER2-overexpressing metastatic breast cancer pretreated with trastuzumab. In this phase Ib multicenter, Bayesian dose-escalation study, 50 patients received everolimus 5 mg/day, 20 mg/week, or 30 mg/week plus vinorelbine (25 mg/m² on day 1 and 8 every 3 weeks) and trastuzumab (2 mg/kg weekly). Endpoints included end-of-cycle-1 dose-limiting toxicity (DLT) rate (primary endpoint), safety, relative dose intensity, overall response rate (ORR), and pharmacokinetics. Grade 3/4 neutropenia was the most common end-of-cycle-1 DLT and occurred in 10 of 30 and 4 of 14 patients in the 5 mg/day and 30 mg/week cohorts, respectively. Other end-of-cycle-1 DLTs included single cases of febrile neutropenia, grade 3 stomatitis with concomitant fatigue, grade 2 stomatitis, grade 3 anorexia, and grade 2 acneiform dermatitis, all in the 5-mg/day cohort. Based on the recorded DLTs and global safety, everolimus 5 mg/day and 30 mg/week were chosen as the optimal dose levels for the daily and weekly arms. Forty-seven patients were evaluable for efficacy. ORR was 19.1%, with a disease control rate of 83.0% and median progression-free survival of 30.7 weeks. No drug interaction was observed between everolimus and vinorelbine. Everolimus combined with weekly vinorelbine and trastuzumab generally was well tolerated and had encouraging antitumor activity in heavily pretreated patients with HER2-overexpressing metastatic breast cancer that progressed on trastuzumab (NCT00426530).
    Citation
    Phase I trial of oral mTOR inhibitor everolimus in combination with trastuzumab and vinorelbine in pre-treated patients with HER2-overexpressing metastatic breast cancer. 2011, 125 (2):447-55 Breast Cancer Res Treat
    Journal
    Breast Cancer Research and Treatment
    URI
    http://hdl.handle.net/10541/193229
    DOI
    10.1007/s10549-010-1260-x
    PubMed ID
    21107682
    Type
    Article
    Language
    en
    ISSN
    1573-7217
    ae974a485f413a2113503eed53cd6c53
    10.1007/s10549-010-1260-x
    Scopus Count
    Collections
    All Paterson Institute for Cancer Research

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