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Published in: Investigational New Drugs 2/2012

01-04-2012 | PHASE II STUDIES

Vandetanib with docetaxel as second-line treatment for advanced breast cancer: a double-blind, placebo-controlled, randomized Phase II study

Authors: Katalin Boér, István Láng, Antonio Llombart-Cussac, Inger Andreasson, Guillermo L. Vivanco, Nick Sanders, Gillian M. Pover, Elizabeth Murray

Published in: Investigational New Drugs | Issue 2/2012

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Summary

Purpose The aim of this Phase II study was to assess the efficacy and safety of vandetanib in combination with docetaxel in patients with pretreated advanced breast cancer. Methods The primary study objective was to compare the number of progression events in patients receiving once-daily oral vandetanib (100 mg) in combination with docetaxel (100 mg/m2 iv every 21 days) versus placebo plus docetaxel. Sixty-four patients were randomized to receive study treatment (n = 35, vandetanib; n = 29, placebo). Results A slightly greater number of patients had experienced a progression event by the data cut-off in the vandetanib group (24 [69%]) compared with the placebo group (18 [62%]); HR = 1.19, two-sided 80% CI: 0.79–1.81; two-sided P = 0.59), suggesting that the addition of vandetanib to docetaxel did not affect the risk of disease progression compared with placebo plus docetaxel. The safety and tolerability profile of the combination therapy reflected those of both drugs as monotherapy agents. Conclusions In patients with advanced breast cancer, vandetanib plus docetaxel was generally well tolerated. Clinical benefit was not different to that observed with placebo plus docetaxel. However, due to the small patient number it was not possible to yield robust results, further research is required to identify predictive factors for patient selection.
Literature
1.
go back to reference Gasparini G (2000) Prognostic value of vascular endothelial growth factor in breast cancer. Oncologist 5(Suppl 1):37–44PubMedCrossRef Gasparini G (2000) Prognostic value of vascular endothelial growth factor in breast cancer. Oncologist 5(Suppl 1):37–44PubMedCrossRef
2.
go back to reference Atalay G, Cardoso F, Awada A, Piccart MJ (2003) Novel therapeutic strategies targeting the epidermal growth factor receptor (EGFR) family and its downstream effectors in breast cancer. Ann Oncol 14:1346–1363PubMedCrossRef Atalay G, Cardoso F, Awada A, Piccart MJ (2003) Novel therapeutic strategies targeting the epidermal growth factor receptor (EGFR) family and its downstream effectors in breast cancer. Ann Oncol 14:1346–1363PubMedCrossRef
3.
go back to reference Relf M, LeJeune S, Scott PA, Fox S, Smith K, Leek R, Moghaddam A, Whitehouse R, Bicknell R, Harris AL (1997) Expression of the angiogenic factors vascular endothelial cell growth factor, acidic and basic fibroblast growth factor, tumor growth factor beta-1, platelet-derived endothelial cell growth factor, placenta growth factor, and pleiotrophin in human primary breast cancer and its relation to angiogenesis. Cancer Res 57:963–969PubMed Relf M, LeJeune S, Scott PA, Fox S, Smith K, Leek R, Moghaddam A, Whitehouse R, Bicknell R, Harris AL (1997) Expression of the angiogenic factors vascular endothelial cell growth factor, acidic and basic fibroblast growth factor, tumor growth factor beta-1, platelet-derived endothelial cell growth factor, placenta growth factor, and pleiotrophin in human primary breast cancer and its relation to angiogenesis. Cancer Res 57:963–969PubMed
4.
go back to reference Gasparini G, Toi M, Gion M, Verderio P, Dittadi R, Hanatani M, Matsubara I, Vinante O, Bonoldi E, Boracchi P, Gatti C, Suzuki H, Tominaga T (1997) Prognostic significance of vascular endothelial growth factor protein in node-negative breast carcinoma. J Natl Cancer Inst 89:139–147PubMedCrossRef Gasparini G, Toi M, Gion M, Verderio P, Dittadi R, Hanatani M, Matsubara I, Vinante O, Bonoldi E, Boracchi P, Gatti C, Suzuki H, Tominaga T (1997) Prognostic significance of vascular endothelial growth factor protein in node-negative breast carcinoma. J Natl Cancer Inst 89:139–147PubMedCrossRef
5.
go back to reference Toi M, Inada K, Suzuki H, Tominaga T (1995) Tumor angiogenesis in breast cancer: its importance as a prognostic indicator and the association with vascular endothelial growth factor expression. Breast Cancer Res Treat 36:193–204PubMedCrossRef Toi M, Inada K, Suzuki H, Tominaga T (1995) Tumor angiogenesis in breast cancer: its importance as a prognostic indicator and the association with vascular endothelial growth factor expression. Breast Cancer Res Treat 36:193–204PubMedCrossRef
6.
go back to reference Fox SB, Smith K, Hollyer J, Greenall M, Hastrich D, Harris AL (1994) The epidermal growth factor receptor as a prognostic marker: results of 370 patients and review of 3009 patients. Breast Cancer Res Treat 29:41–49PubMedCrossRef Fox SB, Smith K, Hollyer J, Greenall M, Hastrich D, Harris AL (1994) The epidermal growth factor receptor as a prognostic marker: results of 370 patients and review of 3009 patients. Breast Cancer Res Treat 29:41–49PubMedCrossRef
7.
go back to reference Klijn JG, Berns PM, Schmitz PI, Foekens JA (1992) The clinical significance of epidermal growth factor receptor (EGF-R) in human breast cancer: a review on 5232 patients. Endocr Rev 13:3–17PubMed Klijn JG, Berns PM, Schmitz PI, Foekens JA (1992) The clinical significance of epidermal growth factor receptor (EGF-R) in human breast cancer: a review on 5232 patients. Endocr Rev 13:3–17PubMed
8.
go back to reference Klijn JG, Look MP, Portengen H, exieva-Figusch J, van Putten WL, Foekens JA (1994) The prognostic value of epidermal growth factor receptor (EGF-R) in primary breast cancer: results of a 10 year follow-up study. Breast Cancer Res Treat 29:73–83PubMedCrossRef Klijn JG, Look MP, Portengen H, exieva-Figusch J, van Putten WL, Foekens JA (1994) The prognostic value of epidermal growth factor receptor (EGF-R) in primary breast cancer: results of a 10 year follow-up study. Breast Cancer Res Treat 29:73–83PubMedCrossRef
9.
go back to reference Miller K, Wang M, Gralow J, Dickler M, Cobleigh M, Perez EA, Shenkier T, Cella D, Davidson NE (2007) Paclitaxel plus bevacizumab versus paclitaxel alone for metastatic breast cancer. N Engl J Med 357:2666–2676PubMedCrossRef Miller K, Wang M, Gralow J, Dickler M, Cobleigh M, Perez EA, Shenkier T, Cella D, Davidson NE (2007) Paclitaxel plus bevacizumab versus paclitaxel alone for metastatic breast cancer. N Engl J Med 357:2666–2676PubMedCrossRef
10.
go back to reference Modi S, D’Andrea G, Norton L, Yao TJ, Caravelli J, Rosen PP, Hudis C, Seidman AD (2006) A phase I study of cetuximab/paclitaxel in patients with advanced-stage breast cancer. Clin Breast Cancer 7:270–277PubMedCrossRef Modi S, D’Andrea G, Norton L, Yao TJ, Caravelli J, Rosen PP, Hudis C, Seidman AD (2006) A phase I study of cetuximab/paclitaxel in patients with advanced-stage breast cancer. Clin Breast Cancer 7:270–277PubMedCrossRef
11.
go back to reference Burstein HJ, Storniolo AM, Franco S, Forster J, Stein S, Rubin S, Salazar VM, Blackwell KL (2008) A phase II study of lapatinib monotherapy in chemotherapy-refractory HER2-positive and HER2-negative advanced or metastatic breast cancer. Ann Oncol 19:1068–1074PubMedCrossRef Burstein HJ, Storniolo AM, Franco S, Forster J, Stein S, Rubin S, Salazar VM, Blackwell KL (2008) A phase II study of lapatinib monotherapy in chemotherapy-refractory HER2-positive and HER2-negative advanced or metastatic breast cancer. Ann Oncol 19:1068–1074PubMedCrossRef
12.
go back to reference Ciardiello F, Caputo R, Bianco R, Damiano V, Fontanini G, Cuccato S, De Placido S, Bianco AR, Tortora G (2001) Inhibition of growth factor production and angiogenesis in human cancer cells by ZD1839 (Iressa), a selective epidermal growth factor receptor tyrosine kinase inhibitor. Clin Cancer Res 7:1459–1465PubMed Ciardiello F, Caputo R, Bianco R, Damiano V, Fontanini G, Cuccato S, De Placido S, Bianco AR, Tortora G (2001) Inhibition of growth factor production and angiogenesis in human cancer cells by ZD1839 (Iressa), a selective epidermal growth factor receptor tyrosine kinase inhibitor. Clin Cancer Res 7:1459–1465PubMed
13.
go back to reference Riedel F, Gotte K, Li M, Hormann K, Grandis JR (2002) EGFR antisense treatment of human HNSCC cell lines down-regulates VEGF expression and endothelial cell migration. Int J Oncol 21:11–16PubMed Riedel F, Gotte K, Li M, Hormann K, Grandis JR (2002) EGFR antisense treatment of human HNSCC cell lines down-regulates VEGF expression and endothelial cell migration. Int J Oncol 21:11–16PubMed
14.
go back to reference Wedge SR, Ogilvie DJ, Dukes M, Kendrew J, Chester R, Jackson JA, Boffey SJ, Valentine PJ, Curwen JO, Musgrove HL, Graham GA, Hughes GD, Thomas AP, Stokes ES, Curry B, Richmond GH, Wadsworth PF, Bigley AL, Hennequin LF (2002) ZD6474 inhibits vascular endothelial growth factor signaling, angiogenesis, and tumor growth following oral administration. Cancer Res 62:4645–4655PubMed Wedge SR, Ogilvie DJ, Dukes M, Kendrew J, Chester R, Jackson JA, Boffey SJ, Valentine PJ, Curwen JO, Musgrove HL, Graham GA, Hughes GD, Thomas AP, Stokes ES, Curry B, Richmond GH, Wadsworth PF, Bigley AL, Hennequin LF (2002) ZD6474 inhibits vascular endothelial growth factor signaling, angiogenesis, and tumor growth following oral administration. Cancer Res 62:4645–4655PubMed
15.
go back to reference Ichihara M, Murakumo Y, Takahashi M (2004) RET and neuroendocrine tumors. Cancer Lett 204:197–211PubMedCrossRef Ichihara M, Murakumo Y, Takahashi M (2004) RET and neuroendocrine tumors. Cancer Lett 204:197–211PubMedCrossRef
16.
go back to reference Holden SN, Eckhardt SG, Basser R, de Boer R, Rischin D, Green M, Rosenthal MA, Wheeler C, Barge A, Hurwitz HI (2005) Clinical evaluation of ZD6474, an orally active inhibitor of VEGF and EGF receptor signaling, in patients with solid, malignant tumors. Ann Oncol 16:1391–1397PubMedCrossRef Holden SN, Eckhardt SG, Basser R, de Boer R, Rischin D, Green M, Rosenthal MA, Wheeler C, Barge A, Hurwitz HI (2005) Clinical evaluation of ZD6474, an orally active inhibitor of VEGF and EGF receptor signaling, in patients with solid, malignant tumors. Ann Oncol 16:1391–1397PubMedCrossRef
17.
go back to reference Tamura T, Minami H, Yamada Y, Yamamoto N, Shimoyama T, Murakami H, Horiike A, Fujisaka Y, Shinkai S, Tahara M, Kawada K, Ebi H, Sasaki Y, Jiang H, Saijo N (2006) A Phase I dose-escalation study of ZD6474 in Japanese patients with solid, malignant tumors. J Thorac Oncol 1:1002–1009PubMedCrossRef Tamura T, Minami H, Yamada Y, Yamamoto N, Shimoyama T, Murakami H, Horiike A, Fujisaka Y, Shinkai S, Tahara M, Kawada K, Ebi H, Sasaki Y, Jiang H, Saijo N (2006) A Phase I dose-escalation study of ZD6474 in Japanese patients with solid, malignant tumors. J Thorac Oncol 1:1002–1009PubMedCrossRef
18.
go back to reference Miller KD, Trigo JM, Wheeler C, Barge A, Rowbottom J, Sledge G, Baselga J (2005) A multicenter phase II trial of ZD6474, a vascular endothelial growth factor receptor-2 and epidermal growth factor receptor tyrosine kinase inhibitor, in patients with previously treated metastatic breast cancer. Clin Cancer Res 11:3369–3376PubMedCrossRef Miller KD, Trigo JM, Wheeler C, Barge A, Rowbottom J, Sledge G, Baselga J (2005) A multicenter phase II trial of ZD6474, a vascular endothelial growth factor receptor-2 and epidermal growth factor receptor tyrosine kinase inhibitor, in patients with previously treated metastatic breast cancer. Clin Cancer Res 11:3369–3376PubMedCrossRef
19.
go back to reference Ramaswamy B, Elias AD, Kelbick NT, Dodley A, Morrow M, Hauger M, Allen J, Rhoades C, Kendra K, Chen HX, Eckhardt SG, Shapiro CL (2006) Phase II trial of bevacizumab in combination with weekly docetaxel in metastatic breast cancer patients. Clin Cancer Res 12:3124–3129PubMedCrossRef Ramaswamy B, Elias AD, Kelbick NT, Dodley A, Morrow M, Hauger M, Allen J, Rhoades C, Kendra K, Chen HX, Eckhardt SG, Shapiro CL (2006) Phase II trial of bevacizumab in combination with weekly docetaxel in metastatic breast cancer patients. Clin Cancer Res 12:3124–3129PubMedCrossRef
20.
go back to reference Nabholtz JM, Crown J (1998) Phase III studies of single-agent docetaxel in patients with metastatic breast cancer who have progressed despite previous chemotherapy regimens: preliminary results. Semin Oncol 25:4–9PubMed Nabholtz JM, Crown J (1998) Phase III studies of single-agent docetaxel in patients with metastatic breast cancer who have progressed despite previous chemotherapy regimens: preliminary results. Semin Oncol 25:4–9PubMed
21.
go back to reference Heymach JV, Johnson BE, Prager D, Csada E, Roubec J, Pesek M, Spasova I, Belani CP, Bodrogi I, Gadgeel S, Kennedy SJ, Hou J, Herbst RS (2007) Randomized, placebo-controlled phase II study of vandetanib plus docetaxel in previously treated non-small-cell lung cancer. J Clin Oncol 25:4270–4277PubMedCrossRef Heymach JV, Johnson BE, Prager D, Csada E, Roubec J, Pesek M, Spasova I, Belani CP, Bodrogi I, Gadgeel S, Kennedy SJ, Hou J, Herbst RS (2007) Randomized, placebo-controlled phase II study of vandetanib plus docetaxel in previously treated non-small-cell lung cancer. J Clin Oncol 25:4270–4277PubMedCrossRef
22.
go back to reference Rubinstein LV, Korn EL, Freidlin B, Hunsberger S, Ivy SP, Smith MA (2005) Design issues of randomized phase II trials and a proposal for phase II screening trials. J Clin Oncol 23:7199–7206PubMedCrossRef Rubinstein LV, Korn EL, Freidlin B, Hunsberger S, Ivy SP, Smith MA (2005) Design issues of randomized phase II trials and a proposal for phase II screening trials. J Clin Oncol 23:7199–7206PubMedCrossRef
23.
go back to reference Carroll KJ (2007) Analysis of progression-free survival in oncology trials: some common statistical issues. Pharm Stat 6:99–113PubMedCrossRef Carroll KJ (2007) Analysis of progression-free survival in oncology trials: some common statistical issues. Pharm Stat 6:99–113PubMedCrossRef
24.
go back to reference Natale RB, Bodkin D, Govindan R, Sleckman BG, Rizvi NA, Capo A, Germonpre P, Eberhardt WE, Stockman PK, Kennedy SJ, Ranson M (2009) Vandetanib versus gefitinib in patients with advanced non-small-cell lung cancer: Results from a two-part, double-blind, randomized Phase II study. J Clin Oncol 27:2523–2529PubMedCrossRef Natale RB, Bodkin D, Govindan R, Sleckman BG, Rizvi NA, Capo A, Germonpre P, Eberhardt WE, Stockman PK, Kennedy SJ, Ranson M (2009) Vandetanib versus gefitinib in patients with advanced non-small-cell lung cancer: Results from a two-part, double-blind, randomized Phase II study. J Clin Oncol 27:2523–2529PubMedCrossRef
25.
go back to reference Cobleigh MA, Langmuir VK, Sledge GW, Miller KD, Haney L, Novotny WF, Reimann JD, Vassel A (2003) A phase I/II dose-escalation trial of bevacizumab in previously treated metastatic breast cancer. Semin Oncol 30:117–124PubMedCrossRef Cobleigh MA, Langmuir VK, Sledge GW, Miller KD, Haney L, Novotny WF, Reimann JD, Vassel A (2003) A phase I/II dose-escalation trial of bevacizumab in previously treated metastatic breast cancer. Semin Oncol 30:117–124PubMedCrossRef
26.
go back to reference Miller KD, Chap LI, Holmes FA, Cobleigh MA, Marcom PK, Fehrenbacher L, Dickler M, Overmoyer BA, Reimann JD, Sing AP, Langmuir V, Rugo HS (2005) Randomized phase III trial of capecitabine compared with bevacizumab plus capecitabine in patients with previously treated metastatic breast cancer. J Clin Oncol 23:792–799PubMedCrossRef Miller KD, Chap LI, Holmes FA, Cobleigh MA, Marcom PK, Fehrenbacher L, Dickler M, Overmoyer BA, Reimann JD, Sing AP, Langmuir V, Rugo HS (2005) Randomized phase III trial of capecitabine compared with bevacizumab plus capecitabine in patients with previously treated metastatic breast cancer. J Clin Oncol 23:792–799PubMedCrossRef
27.
go back to reference Albain K, Elledge R, Gradishar W, Hayes D, Rowinsky E, Hudis C, Pusztai L, Tripathy D, Modi S, Rubi S (2002) Open-label, phase II, multicenter trial of ZD1839 (‘Iressa') in patients with advanced breast cancer. Breast Cancer Res Treat 76:A20 Albain K, Elledge R, Gradishar W, Hayes D, Rowinsky E, Hudis C, Pusztai L, Tripathy D, Modi S, Rubi S (2002) Open-label, phase II, multicenter trial of ZD1839 (‘Iressa') in patients with advanced breast cancer. Breast Cancer Res Treat 76:A20
28.
go back to reference Robertson J, Guttedridge E, Cheung K, Owens R, Koehler M, Hamilton L (2002) A phase II study of ZD1839 (Iressa) in tamoxifen-resistant ER-positive and endocrine-insensitive (ER-negative) breast cancer. Breast Cancer Res Treat 76:S96 Robertson J, Guttedridge E, Cheung K, Owens R, Koehler M, Hamilton L (2002) A phase II study of ZD1839 (Iressa) in tamoxifen-resistant ER-positive and endocrine-insensitive (ER-negative) breast cancer. Breast Cancer Res Treat 76:S96
29.
go back to reference Winer EP, Cobleigh M, Dickler M (2002) Phase II multicenter study to evaluate the efficacy and safety of Tarceva (erlotinib, OSI-774) in women with previously treated locally advanced or metastatic breast cancer. Breast Cancer Res Treat 76:S115 Winer EP, Cobleigh M, Dickler M (2002) Phase II multicenter study to evaluate the efficacy and safety of Tarceva (erlotinib, OSI-774) in women with previously treated locally advanced or metastatic breast cancer. Breast Cancer Res Treat 76:S115
30.
go back to reference Ciardiello F, Troiani T, Caputo F, De Laurentiis M, Tortora G, Palmieri G, De VF, Diadema MR, Orditura M, Colantuoni G, Gridelli C, Catalano G, De PS, Bianco AR (2006) Phase II study of gefitinib in combination with docetaxel as first-line therapy in metastatic breast cancer. Br J Cancer 94:1604–1609PubMed Ciardiello F, Troiani T, Caputo F, De Laurentiis M, Tortora G, Palmieri G, De VF, Diadema MR, Orditura M, Colantuoni G, Gridelli C, Catalano G, De PS, Bianco AR (2006) Phase II study of gefitinib in combination with docetaxel as first-line therapy in metastatic breast cancer. Br J Cancer 94:1604–1609PubMed
31.
go back to reference Polychronis A, Sinnett HD, Hadjiminas D, Singhal H, Mansi JL, Shivapatham D, Shousha S, Jiang J, Peston D, Barrett N, Vigushin D, Morrison K, Beresford E, Ali S, Slade MJ, Coombes RC (2005) Preoperative gefitinib versus gefitinib and anastrozole in postmenopausal patients with oestrogen-receptor positive and epidermal-growth-factor-receptor-positive primary breast cancer: a double-blind placebo-controlled phase II randomised trial. Lancet Oncol 6:383–391PubMedCrossRef Polychronis A, Sinnett HD, Hadjiminas D, Singhal H, Mansi JL, Shivapatham D, Shousha S, Jiang J, Peston D, Barrett N, Vigushin D, Morrison K, Beresford E, Ali S, Slade MJ, Coombes RC (2005) Preoperative gefitinib versus gefitinib and anastrozole in postmenopausal patients with oestrogen-receptor positive and epidermal-growth-factor-receptor-positive primary breast cancer: a double-blind placebo-controlled phase II randomised trial. Lancet Oncol 6:383–391PubMedCrossRef
Metadata
Title
Vandetanib with docetaxel as second-line treatment for advanced breast cancer: a double-blind, placebo-controlled, randomized Phase II study
Authors
Katalin Boér
István Láng
Antonio Llombart-Cussac
Inger Andreasson
Guillermo L. Vivanco
Nick Sanders
Gillian M. Pover
Elizabeth Murray
Publication date
01-04-2012
Publisher
Springer US
Published in
Investigational New Drugs / Issue 2/2012
Print ISSN: 0167-6997
Electronic ISSN: 1573-0646
DOI
https://doi.org/10.1007/s10637-010-9538-8

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