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Published in: Cancer Chemotherapy and Pharmacology 6/2013

01-12-2013 | Original Article

Phase II, open-label trial to assess QTcF effects, pharmacokinetics and antitumor activity of afatinib in patients with relapsed or refractory solid tumors

Authors: L. Rhoda Molife, Sarah M. Rudman, Salma Alam, Daniel S.-W. Tan, Hartmut Kristeleit, Gary Middleton, David Propper, Liz Bent, Peter Stopfer, Martina Uttenreuther-Fischer, Gudrun Wallenstein, Johann de Bono, James Spicer

Published in: Cancer Chemotherapy and Pharmacology | Issue 6/2013

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Abstract

Purpose

Afatinib is an irreversible ErbB family blocker currently under evaluation in late-stage clinical trials. This study primarily assessed the cardiac safety, pharmacokinetics and antitumor activity of afatinib in cancer patients.

Methods

In this multicenter, Phase II, open-label, single-arm trial, 60 patients with solid tumors who were expected to express epidermal growth factor receptor-1 and HER2 received oral afatinib 50 mg daily. QTcF intervals (QT interval corrected by the Fridericia formula) were evaluated based on electrocardiogram recordings time-matched with pharmacokinetic blood samples after single (Day 1) and continuous (Day 14; steady state) administration. Adverse events were classified according to the National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE), version 3.0; antitumor activity was assessed using RECIST 1.0.

Results

There was a nonsignificant decrease of 0.3 ms (90 % confidence interval −2.8, 2.3; N = 49) in the mean of the average time-matched QTcF interval from baseline to steady state. The maximum plasma concentration for afatinib was seen at median t max 3 h after both single dose and at steady state. No relationship between afatinib plasma concentrations and time-matched QTcF, QT and heart rate change was found. The overall adverse event profile was consistent with the known safety profile of afatinib. One patient demonstrated a partial response (PR) and two patients unconfirmed PRs.

Conclusions

Afatinib had no impact on cardiac repolarization, had a manageable safety profile and demonstrated antitumor activity in this uncontrolled study.
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Metadata
Title
Phase II, open-label trial to assess QTcF effects, pharmacokinetics and antitumor activity of afatinib in patients with relapsed or refractory solid tumors
Authors
L. Rhoda Molife
Sarah M. Rudman
Salma Alam
Daniel S.-W. Tan
Hartmut Kristeleit
Gary Middleton
David Propper
Liz Bent
Peter Stopfer
Martina Uttenreuther-Fischer
Gudrun Wallenstein
Johann de Bono
James Spicer
Publication date
01-12-2013
Publisher
Springer Berlin Heidelberg
Published in
Cancer Chemotherapy and Pharmacology / Issue 6/2013
Print ISSN: 0344-5704
Electronic ISSN: 1432-0843
DOI
https://doi.org/10.1007/s00280-013-2286-7

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