A Phase 1/2 trial of ruxolitinib and erlotinib in patients with EGFR-mutant lung adenocarcinomas with acquired resistance to erlotinib Journal Article


Authors: Yu, H. A.; Perez, L.; Chang, Q.; Gao, S. P.; Kris, M. G.; Riely, G. J.; Bromberg, J.
Article Title: A Phase 1/2 trial of ruxolitinib and erlotinib in patients with EGFR-mutant lung adenocarcinomas with acquired resistance to erlotinib
Abstract: Introduction Resistance to EGFR tyrosine kinase inhibitors develops in patients with EGFR-mutant lung cancers. New treatments are needed to address resistance not mediated by EGFR T790M; preclinical evidence suggests that the Janus kinase/signal transducers and activators of transcription signaling pathway is important in acquired resistance to EGFR-directed therapy. Methods We evaluated the toxicity and efficacy of erlotinib and ruxolitinib in patients with EGFR-mutant lung cancers with acquired resistance to erlotinib. Exosomes were analyzed to assess changes in relevant protein expression during treatment. Results We enrolled 22 patients: 12 patients in the phase 1 portion of the study and 10 patients in the phase 2 portion. We did not observe any dose-limiting toxicities. The maximum tolerated dose of erlotinib was 150 mg daily and that of ruxolitinib was 20 mg twice daily. The most frequent toxicities (any grade) were anemia, diarrhea, and elevation of liver function test results. One partial response was observed (5% [95% confidence interval: 0–13]). The median progression-free survival was 2.2 months (95% confidence interval: 1.4–4.1). Conclusion This is the first study assessing the combination of EGFR and Janus kinase inhibition in patients with EGFR-mutant lung cancers. The combination was well tolerated but ineffective. Exosomal EGFR levels may reflect changes in tumor EGFR expression in response to therapy. © 2016 International Association for the Study of Lung Cancer
Keywords: erlotinib; egfr; acquired resistance; jak; stat; ruxolitinib
Journal Title: Journal of Thoracic Oncology
Volume: 12
Issue: 1
ISSN: 1556-0864
Publisher: Elsevier Inc.  
Date Published: 2017-01-01
Start Page: 102
End Page: 109
Language: English
DOI: 10.1016/j.jtho.2016.08.140
PROVIDER: scopus
PUBMED: 27613527
PMCID: PMC5552054
DOI/URL:
Notes: Conference Paper -- Export Date: 3 April 2017 -- Source: Scopus
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  1. Jacqueline Bromberg
    141 Bromberg
  2. Helena Alexandra Yu
    281 Yu
  3. Gregory J Riely
    599 Riely
  4. Qing Chang
    36 Chang
  5. Sizhi Gao
    47 Gao
  6. Mark Kris
    869 Kris
  7. Leslie Ann Perez
    15 Perez