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Published in: Cancer Chemotherapy and Pharmacology 6/2017

01-06-2017 | Original Article

Circularly permuted TRAIL plus thalidomide and dexamethasone versus thalidomide and dexamethasone for relapsed/refractory multiple myeloma: a phase 2 study

Authors: Yun Leng, Jian Hou, Jie Jin, Mei Zhang, Xiaoyan Ke, Bin Jiang, Ling Pan, Linhua Yang, Fang Zhou, Jianmin Wang, Zhao Wang, Li Liu, Wei Li, Zhixiang Shen, Lugui Qiu, Naibai Chang, Jianyong Li, Jing Liu, Hongyan Pang, Haitao Meng, Peng Wei, Hua Jiang, Yan Liu, Xiangjun Zheng, Shifang Yang, Wenming Chen

Published in: Cancer Chemotherapy and Pharmacology | Issue 6/2017

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Abstract

Purpose

Circularly permuted TRAIL (CPT) has exhibited promising efficacy as a mono-therapy or in combination with thalidomide for patients with multiple myeloma (MM). In this phase 2 study, the safety and efficacy of CPT in combination with thalidomide and dexamethasone (CPT + TD) was evaluated in patients with pretreated relapsed/refractory MM (RRMM).

Methods

Patients who received at least two previous therapies for MM were randomly assigned at a 2:1 ratio to receive treatment with CPT + TD or thalidomide and dexamethasone (TD). The primary endpoint was the overall response rate (ORR), and the secondary endpoints included progression-free survival (PFS), duration of response (DOR) and safety.

Results

Overall, 47 patients were assigned to the CPT + TD group, and 24 patients were recruited to the TD group. The ORR in the CPT + TD group was 38.3 vs. 25.0% in the TD group. The median PFS time was 6.7 months for the CPT + TD group and 3.1 months for the TD group. The median DORs for the CPT + TD and TD groups were 7.1 and 3.2 months, respectively. Most of the adverse effects (AEs) were grade 1 or 2. Serious AEs were reported in 19.7% of the patients. No treatment-related deaths were reported.

Conclusion

CPT plus TD could serve as a new therapeutic strategy for patients with RRMM. A randomized, double-blind, placebo-controlled confirmatory study is currently under way.
Literature
6.
go back to reference Kelley SK, Harris LA, Xie D et al (2001) Preclinical studies to predict the disposition of Apo2L/tumor necrosis factor-related apoptosis-inducing ligand in humans: characterization of in vivo efficacy, pharmacokinetics, and safety. J Pharmacol Exp Ther 299:31–38PubMed Kelley SK, Harris LA, Xie D et al (2001) Preclinical studies to predict the disposition of Apo2L/tumor necrosis factor-related apoptosis-inducing ligand in humans: characterization of in vivo efficacy, pharmacokinetics, and safety. J Pharmacol Exp Ther 299:31–38PubMed
7.
go back to reference Chen WM, Qiu LG, Hou J et al (2012) Phase Ib study of recombinant circularly permuted TRAIL (CPT) in relapsed or refractory multiple myeloma patients. Blood 120:1857 (ASH annual meeting abstracts) Chen WM, Qiu LG, Hou J et al (2012) Phase Ib study of recombinant circularly permuted TRAIL (CPT) in relapsed or refractory multiple myeloma patients. Blood 120:1857 (ASH annual meeting abstracts)
9.
go back to reference Geng C, Hou J, Zhao Y et al (2014) A multicenter, open-label phase II study of recombinant CPT (circularly permuted TRAIL) plus thalidomide in patients with relapsed and refractory multiple myeloma. Am J Hematol 89:1037–1042. doi:10.1002/ajh.23822 CrossRefPubMed Geng C, Hou J, Zhao Y et al (2014) A multicenter, open-label phase II study of recombinant CPT (circularly permuted TRAIL) plus thalidomide in patients with relapsed and refractory multiple myeloma. Am J Hematol 89:1037–1042. doi:10.​1002/​ajh.​23822 CrossRefPubMed
10.
go back to reference Anderson KC, Alsina M, Bensinger W et al (2013) Multiple myeloma, version 1, 2013. J Natl Compr Canc Netw 11:11–17CrossRefPubMed Anderson KC, Alsina M, Bensinger W et al (2013) Multiple myeloma, version 1, 2013. J Natl Compr Canc Netw 11:11–17CrossRefPubMed
14.
go back to reference Palumbo A, Giaccone L, Bertola A et al (2001) Low-dose thalidomide plus dexamethasone is an effective salvage therapy for advanced myeloma. Haematologica 86:399–403PubMed Palumbo A, Giaccone L, Bertola A et al (2001) Low-dose thalidomide plus dexamethasone is an effective salvage therapy for advanced myeloma. Haematologica 86:399–403PubMed
17.
go back to reference Chen WM, Wei P, Yang SF et al (2014) Transiently elevated AST/LDH are associated with clinical response to recombinant circularly permuted TRAIL (CPT) plus thalidomide in patients with relapsed and/or refractory multiple myeloma. Blood 124:3478 (ASH annual meeting abstracts) Chen WM, Wei P, Yang SF et al (2014) Transiently elevated AST/LDH are associated with clinical response to recombinant circularly permuted TRAIL (CPT) plus thalidomide in patients with relapsed and/or refractory multiple myeloma. Blood 124:3478 (ASH annual meeting abstracts)
18.
go back to reference Wei P, Yang S, Zheng X et al (2014) Transient elevation of AST or LDH as an early pharmacodynamic biomarker of recombinant circularly permuted trail (CPT) in treating patients with relapsed or refractory multiple myeloma. Haematologica 99:369 (19th congress of EHA Abstracts, Abstract P974) Wei P, Yang S, Zheng X et al (2014) Transient elevation of AST or LDH as an early pharmacodynamic biomarker of recombinant circularly permuted trail (CPT) in treating patients with relapsed or refractory multiple myeloma. Haematologica 99:369 (19th congress of EHA Abstracts, Abstract P974)
Metadata
Title
Circularly permuted TRAIL plus thalidomide and dexamethasone versus thalidomide and dexamethasone for relapsed/refractory multiple myeloma: a phase 2 study
Authors
Yun Leng
Jian Hou
Jie Jin
Mei Zhang
Xiaoyan Ke
Bin Jiang
Ling Pan
Linhua Yang
Fang Zhou
Jianmin Wang
Zhao Wang
Li Liu
Wei Li
Zhixiang Shen
Lugui Qiu
Naibai Chang
Jianyong Li
Jing Liu
Hongyan Pang
Haitao Meng
Peng Wei
Hua Jiang
Yan Liu
Xiangjun Zheng
Shifang Yang
Wenming Chen
Publication date
01-06-2017
Publisher
Springer Berlin Heidelberg
Published in
Cancer Chemotherapy and Pharmacology / Issue 6/2017
Print ISSN: 0344-5704
Electronic ISSN: 1432-0843
DOI
https://doi.org/10.1007/s00280-017-3310-0

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