A phase I study of volasertib combined with afatinib, in advanced solid tumors

Machiels, Jean-Pascal;Peeters, Marc;Herremans , Catherine;Surmont, Veerle;Rottey, Sylvie;et.al.
(2015) Cancer Chemotherapy and Pharmacology — Vol. 76, n° 4, p. 843-851 (2015)

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  • Peeters, Marc
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  • Herremans , CatherineUCLouvain
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  • Surmont, Veerle
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  • Rottey, Sylvie
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Abstract
PURPOSE: To determine the maximum tolerated dose (MTD) of volasertib, a Polo-like kinase inhibitor, combined with afatinib, an oral irreversible ErbB family blocker, in patients with advanced solid tumors (NCT01206816; Study 1230.20). METHODS: Patients with advanced non-resectable and/or metastatic disease following failure of conventional treatment received intravenous volasertib 150-300 mg on day 1 every 21 days, combined with oral afatinib 30-40 mg on days 2-21 of a 3-week cycle (Schedule A), or 50-90 mg on days 2-6 of a 3-week cycle (Schedule B). The primary objective was to determine the MTD of volasertib in combination with afatinib. RESULTS: Fifty-seven patients (Schedule A, N = 29; Schedule B, N = 28) were treated. The MTDs were volasertib 300 mg plus afatinib 30 mg days 2-21 and 70 mg days 2-6 of a 3-week cycle for Schedules A and B, respectively. The most common Grade 3/4 adverse events were neutropenia (31.0 %), diarrhea (13.8 %), and thrombocytopenia (10.3 %) in Schedule A; neutropenia (39.3 %), thrombocytopenia (35.7 %), hypokalemia (14.3 %), febrile neutropenia, and nausea (each 10.7 %) in Schedule B. The best overall response was two partial responses (6.9 %; both in Schedule A); eight patients in each schedule achieved stable disease. Volasertib showed multi-exponential pharmacokinetic (PK) behavior; co-administration of volasertib and afatinib had no significant effects on the PK profile of either drug. CONCLUSIONS: Volasertib combined with afatinib had manageable adverse effects and limited antitumor activity in this heavily pretreated population.
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Machiels, J.-P., Peeters, M., Herremans, C., Surmont, V., Specenier, P., De Smet, M., Pilz, K., Strelkowa, N., Liu, D., & Rottey, S. (2015). A phase I study of volasertib combined with afatinib, in advanced solid tumors. Cancer Chemotherapy and Pharmacology, 76(4), 843-851. https://doi.org/10.1007/s00280-015-2860-2 (Original work published 2015)