Phase I/II study of imatinib mesylate for recurrent malignant gliomas: North American Brain Tumor Consortium Study 99-08 Journal Article
| Authors: | Wen, P. Y.; Yung, W. K. A.; Lamborn, K. R.; Dahia, P. L.; Wang, Y.; Peng, B.; Abrey, L. E.; Raizer, J.; Cloughesy, T. F.; Fink, K.; Gilbert, M.; Chang, S.; Junck, L.; Schiff, D.; Lieberman, F.; Fine, H. A.; Mehta, M.; Robins, H. I.; Deangelis, L. M.; Groves, M. D.; Puduvalli, V. K.; Levin, V.; Conrad, C.; Maher, E. A.; Aldape, K.; Hayes, M.; Letvak, L.; Egorin, M. J.; Capdeville, R.; Kaplan, R.; Murgo, A. J.; Stiles, C.; Prados, M. D. |
| Article Title: | Phase I/II study of imatinib mesylate for recurrent malignant gliomas: North American Brain Tumor Consortium Study 99-08 |
| Abstract: | Purpose: Phase I: To determine the maximum tolerated doses, toxicities, and pharmacokinetics of imatinib mesylate (Gleevec) in patients with malignant gliomas taking enzyme-inducing antiepileptic drugs (EIAED) or not taking EIAED. Phase II: To determine the therapeutic efficacy of imatinib. Experimental Design: Phase I component used an interpatient dose escalation scheme. End points of the phase II component were 6-month progression-free survival and response. Results: Fifty patients enrolled in the phase I component (27 EIAED and 23 non-EIAED). The maximum tolerated dose for non-EIAED patients was 800 mg/d. Dose-limiting toxicities were neutropenia, rash, and elevated alanine aminotransferase. EIAED patients received up to 1,200 mg/d imatinib without developing dose-limiting toxicity. Plasma exposure of imatinib was reduced by ∼68% in EIAED patients compared with non-EIAED patients. Fifty-five non-EIAED patients (34 glioblastoma multiforme and 21 anaplastic glioma) enrolled in the phase II component. Patients initially received 800 mg/d imatinib; 15 anaplastic glioma patients received 600 mg/d after hemorrhages were observed. There were 2 partial response and 6 stable disease among glioblastoma multiforme patients and 0 partial response and 5 stable disease among anaplastic glioma patients. Six-month progression-free survival was 3% for glioblastoma multiforme and 10% for anaplastic glioma patients. Five phase II patients developed intratumoral hemorrhages. Conclusions: Single-agent imatinib has minimal activity in malignant gliomas. CYP3A4 inducers, such as EIAEDs, substantially decreased plasma exposure of imatinib and should be avoided in patients receiving imatinib for chronic myelogenous leukemia and gastrointestinal stromal tumors. The evaluation of the activity of combination regimens incorporating imatinib is under way in phase II trials. © 2006 American Association for Cancer Research. |
| Keywords: | survival; adolescent; adult; controlled study; aged; middle aged; unclassified drug; major clinical study; clinical trial; drug activity; area under the curve; dose response; hypophosphatemia; antineoplastic agents; glioma; brain neoplasms; imatinib; controlled clinical trial; bleeding; thrombocytopenia; genotype; pyrimidines; alanine aminotransferase; glioblastoma; drug response; drug metabolism; drug blood level; piperazines; anticonvulsive agent; drug interactions; anticonvulsants; granulocytopenia; myeloid leukemia; gastrointestinal tumor; cgp 74588 |
| Journal Title: | Clinical Cancer Research |
| Volume: | 12 |
| Issue: | 16 |
| ISSN: | 1078-0432 |
| Publisher: | American Association for Cancer Research |
| Date Published: | 2006-08-15 |
| Start Page: | 4899 |
| End Page: | 4907 |
| Language: | English |
| DOI: | 10.1158/1078-0432.ccr-06-0773 |
| PUBMED: | 16914578 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | --- - "Cited By (since 1996): 171" - "Export Date: 4 June 2012" - "CODEN: CCREF" - "Source: Scopus" |
Altmetric
Citation Impact
BMJ Impact Analytics
MSK Authors
-
576De Angelis -
22Raizer -
278
Abrey
Related MSK Work