A phase I study of bortezomib plus irinotecan in patients with advanced solid tumors

David P. Ryan, Bert H. O'Neil, Jeffrey G. Supko, Carlo M.Rocha Lima, E. Claire Dees, Leonard J. Appleman, Jeffrey Clark, Phinos Fidias, Robert Z. Orlowski, Oscar Kashala, Joseph P. Eder, James C. Cusack

Research output: Contribution to journalArticle

51 Scopus citations

Abstract

BACKGROUND. The authors conducted a Phase I dose-finding trial to study the use of combined bortezomib plus irinotecan in patients with advanced solid tumors. METHODS. Patients who had received ≥1 prior chemotherapy regimen were eligible. Patients received bortezomib (1.0 mg/m2, 1.3 mg/m 2, or 1.5 mg/m2) on Days 1, 4, 8, and 11 and received irinotecan (from 50 mg/m2 to 125 mg/m2) on Days 1 and 8 of each 21-day cycle for a maximum of 8 cycles. Bortezomib followed irinotecan on coadministration days in Cycle 1 and Cycles 3 through 8 but preceded irinotecan in Cycle 2 to assess the effect of administration sequence on bortezomib pharmacodynamics. RESULTS. Fifty-one enrolled patients with malignancies, including colorectal cancer (n = 23 patients), lung cancer (n = 6 patients), gastroesophageal cancer (n = 6 patients), and pancreatic cancer (n = 3 patients), received ≥1 dose of study drug. Nausea, vomiting, and diarrhea were the principal dose-limiting toxicities and led to the maximum tolerated doses of 1.3 mg/m2 bortezomib and 125 mg/m2 irinotecan. The most common grade ≥3 bortezomib-related nonhematologic adverse events were fatigue (n = 5 episodes), diarrhea (n = 4 episodes), and nausea (n = 4 episodes), grade ≥3 bortezomib-related hematologic adverse events included neutropenia (n = 6 episodes) and thrombocytopenia (n = 4 episodes) and rarely were dose limiting. Of 34 evaluable patients, no objective responses according to the Response Evaluation Criteria in Solid Tumors were seen; 10 patients achieved stable disease. The degree of proteasome inhibition in whole blood indicated that the biologic activity of bortezomib was unaffected by irinotecan coadministration. CONCLUSIONS. The results of this Phase I study in patients with solid tumors indicated that bortezomib at a dose of 1.3 mg/m2 on Days 1, 4, 8, and 11 plus irinotecan at a dose of 125 mg/m2 on Days 1 and 8 every 21 days were the recommended Phase II doses.

Original languageEnglish (US)
Pages (from-to)2688-2697
Number of pages10
JournalCancer
Volume107
Issue number11
DOIs
StatePublished - Dec 1 2006

Keywords

  • Bortezomib
  • Colorectal cancer
  • Irinotecan
  • Proteasome inhibitor
  • Solid tumors

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

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