A multicenter phase II study of bortezomib in ecurrent or metastatic sarcomas

Robert G. Maki, Andrew S. Kraft, Kelly Scheu, Jennifer Yamada, Scott Wadler, Cristina R. Antonescu, John J. Wright, Gary K. Schwartz

Research output: Contribution to journalArticlepeer-review

67 Scopus citations

Abstract

BACKGROUND. Based on evidence of activity in preclinical and Phase studies, the authors undertook a study of bortezomib, a reversible proteasome inhibitor, for patients with metastatic sarcomas. METHODS. Two arms were opened, each using a Simon two-stage design. Arm A included patients with osteogenic sarcoma, Ewing sarcoma, and rhabdomyosarcoma. Arm B accrued patients with other types of soft tissue sarcomas. Patients were not allowed to have received previous chemotherapy for metastatic disease. The initial dose of bortezomib was a 1.5 mg/m2 intravenous push twice weekly followed by a rest week. The dose was escalated to 1.7 mg/m2 if patients tolerated Cycle 1 well. The dose escalation was eliminated due to toxicity observed in the first six patients. RESULTS. Painful neuropathy, myalgias, and asthenia were the most significant observed toxicities. The most frequent toxicities included fatigue, diarrhea, con-stipation, and nausea. Pharmacodynamic data from 18 patients with complete data collection did not show consistent differences between patients with or without Grade 2 or Grade 3 neuropathy (toxicity graded according the National Cancer Institute Common Toxicity Criteria). Arm A had low accrual and was closed. One confirmed partial response among 21 evaluable patients was observed on Arm B in a patient with leiomyosarcoma. Due to the inactivity of this agent, the study was closed after the first stage of accrual. CONCLUSIONS. Bortezomib has minimal activity in soft tissue sarcoma as a single agent. If studied further in sarcomas, bortezomib should be investigated in combination with agents with demonstrated preclinical synergy.

Original languageEnglish (US)
Pages (from-to)1431-1438
Number of pages8
JournalCancer
Volume103
Issue number7
DOIs
StatePublished - Apr 1 2005

Keywords

  • Bortezomib
  • Pharmacokinetics
  • Phase II
  • Proteasome
  • Sarcoma

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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