A phase 2 study of alisertib (MLN8237) in recurrent or persistent uterine leiomyosarcoma: An NRG Oncology/Gynecologic Oncology Group study 0231D |
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| Authors: | David M Hyman Michael W Sill Heather A Lankes Richard Piekarz Mark S Shahin Mildred R Ridgway Floor Backes Meaghen E Tenney Cara A. Mathews James S Hoffman Carol Aghajanian Martee L Hensley |
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| Affiliation: | 1. Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA;2. NRG Oncology Statistics and Data Management Center, Buffalo, NY 14263, USA;3. Cancer Therapy Evaluation Program, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892, USA;4. Abington Hospital, Jefferson Health, Abington, PA 19001, USA;5. University of Mississippi Medical Center, Jackson, MS 39216, USA;6. Ohio State University, Wexner Medical Center, Hilliard, OH 43026, USA;7. Gynecologic Oncology, The University of Chicago Medicine & Biological Sciences, Chicago, IL 60637, USA;8. Women & Infants Hospital, Providence, RI 02905, USA;9. Hospital of Central Connecticut, New Britain, CT 06050, USA;10. Weill Cornell Medical College, New York, NY 10065, USA |
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| Abstract: | ObjectiveThis two-stage Phase II study assessed the activity of single agent alisertib in patients with recurrent/persistent uterine leiomyosarcoma (uLMS).MethodsEligibility criteria included histologically-confirmed, recurrent or persistent uLMS, age ≥ 18, 1–2 prior cytotoxic regimens, and RECIST version 1.1 measurable disease. The primary objective of the study was to evaluate the efficacy of alisertib through the frequency of patients with objective tumor responses and the frequency who survived event-free for at least 6 months (EFS6). The endpoints for EFS were RECIST progression, death, or beginning a subsequent therapy. The null hypothesis jointly specified the probability of a patient experiencing a tumor response to less than or equal to 5% and the probability of a patient surviving event-free for at least 6 months to less than or equal to 20%. A two-stage design was used with a target accrual of 23 patients for stage 1 and 47 pts. cumulative for stage 2. Confidence intervals do not correct for multiplicity.ResultsTwenty-three patients were enrolled with two patients excluded on central histology review, yielding 21 eligible patients. Median age was 61 years. Prior treatment was either 1 cytotoxic regimen (71.4%) or 2 (28.6%). The most common treatment related AEs (grade 3 or worse) were anemia Hensley et al. (2008a) , leukopenia Hensley et al. (2008b) , neutropenia Maki et al. (2007) , thrombocytopenia Huang et al. (2012) , mucositis Hensley et al. (2008a) , diarrhea Huang et al. (2012) , and palmer-planter syndrome Zivanovic et al. (2012) . There were no objective responses (0%; 90% CI: 0–10.4%). Best response was stable disease (38.1%); 12 patients had progressive disease (57.1%). EFS6 was 0% (90% CI: 0–10.4%). Median PFS and OS were 1.7 (90% CI: 1.4–3.2) and 14.5 months (90% CI: 7.6 - NA), respectively.ConclusionAlisertib did not demonstrate clinically meaningful single agent activity in previously treated uLMS. |
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| Keywords: | Alisertib Aurora kinase Uterine leiomyosarcoma |
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