Phase I study of imatinib, cisplatin and 5-fluoruracil or capecitabine in advanced esophageal and gastric adenocarcinoma.

Abstract:

BACKGROUND:Despite all benefit provided by established therapies prognosis of gastric cancer remains poor. Targeted inhibition of platelet derived growth factor receptor (PDGFR) by imatinib may influence tumor growth and amplify chemotherapeutic effects. METHODS:This phase I study evaluated dose limiting toxicity (DLT) of imatinib combinated with chemotherapy according to a 3-patient cohort dose-escalating design. Thirty-five patients received cisplatin (60 mg/m(2) d1 q 3w)/ capecitabine (1250 mg/m(2) bid d1-14 q 21) or cisplatin (50 mg/m(2) d1 q 2w)/ 5-fluoruracil (2 g/m(2) d1, q 1w). Imatinib was started d - 4 with dose escalation from 300 to 700 mg QD in 100 mg steps. RESULTS:At imatinib dose level 1 (300mg) one DLT was observed, three more patients were enrolled without further DLT. At dose level 5 (700 mg) two gastric perforations occurred, so 600 mg imatinib emerged as the maximum tolerated dose. Major grade 3/4 toxicities were nausea (6%), anemia (6%) and fatigue (3%). Response evaluation revealed partial response in 27% and stable disease in 43% of the assessable patients. CONCLUSIONS:Combination of imatinib and chemotherapy is well tolerated. Response rates were not superior to those of standard therapy. Further investigations of a larger group of patients are required to confirm the amplification of chemotherapy effects by imatinib. TRIAL REGISTRATION:European Clinical Trials Database: Eudra-CT2006-005792-17 and Clinical Trials Database: NCT00601510.

journal_name

BMC Cancer

journal_title

BMC cancer

authors

Mayr M,Becker K,Schulte N,Belle S,Hofheinz R,Krause A,Schmid RM,Röcken C,Ebert MP

doi

10.1186/1471-2407-12-587

subject

Has Abstract

pub_date

2012-12-10 00:00:00

pages

587

issn

1471-2407

pii

1471-2407-12-587

journal_volume

12

pub_type

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