Oncologist. 2023 Feb 18. pii: oyad002. [Epub ahead of print]
Kimberly Perez,
Anna M Chiarella,
James M Cleary,
Nora Horick,
Colin Weekes,
Thomas Abrams,
Lawrence Blaszkowsky,
Peter Enzinger,
Marios Giannakis,
Lipika Goyal,
Jeffrey A Meyerhardt,
Douglas Rubinson,
Matthew B Yurgelun,
Wolfram Goessling,
Bruce J Giantonio,
Lauren Brais,
Victoria Germon,
Danielle Stonely,
Srivatsan Raghavan,
Basil Bakir,
Koushik Das,
Jason R Pitarresi,
Andrew J Aguirre,
Michael Needle,
Anil K Rustgi,
Brian M Wolpin.
BACKGROUND: In preclinical pancreatic ductal adenocarcinoma (PDAC) models, inhibition of hepatocyte growth factor (HGF) signaling using ficlatuzumab, a recombinant humanized anti-HGF antibody, and gemcitabine reduced tumor burden.METHODS: Patients with previously untreated metastatic PDAC enrolled in a phase Ib dose escalation study with 3 + 3 design of 2 dose cohorts of ficlatuzumab 10 and 20 mg/kg administered intravenously every other week with gemcitabine 1000 mg/m2 and albumin-bound paclitaxel 125 mg/m2 given 3 weeks on and 1 week off. This was followed by an expansion phase at the maximally tolerated dose of the combination.
RESULTS: Twenty-six patients (sex, 12 male:14 female; median age, 68 years [range, 49-83 years]) were enrolled, 22 patients were evaluable. No dose-limiting toxicities were identified (N = 7 pts) and ficlatuzumab at 20 mg/kg was chosen as the maximum tolerated dose. Among the 21 patients treated at the MTD, best response by RECISTv1.1: 6 (29%) partial response, 12 (57%) stable disease, 1 (5%) progressive disease, and 2 (9%) not evaluable. Median progression-free survival and overall survival times were 11.0 months (95% CI, 7.6-11.4 months) and 16.2 months (95% CI, 9.1 months to not reached), respectively. Toxicities attributed to ficlatuzumab included hypoalbuminemia (grade 3, 16%; any grade, 52%) and edema (grade 3, 8%; any grade, 48%). Immunohistochemistry for c-Met pathway activation demonstrated higher tumor cell p-Met levels in patients who experienced response to therapy.
CONCLUSION: In this phase Ib trial, ficlatuzumab, gemcitabine, and albumin-bound paclitaxel were associated with durable treatment responses and increased rates of hypoalbuminemia and edema.
Keywords:
nab-paclitaxel; ficlatuzumab; gemcitabine; metastatic pancreatic cancer; phase Ib clinical trial