A phase 2 trial of dasatinib in patients with advanced HER2-positive and/or hormone receptor-positive breast cancer

Purpose: SRC-family kinases (SFKs) are involved in numerous oncogenic signaling pathways. A phase 2 trial of dasatinib, a potent oral tyrosine kinase inhibitor of SFKs, was performed in patients with human epidermal growth factor receptor 2-positive (HER2+) and/or hormone receptor-positive (HR+) advanced breast cancer. Experimental Design: Patients with measurable tumors and progression after chemotherapy and HER2 and/or HR-targeted agents in adjuvant or metastatic settings (maximum of two prior metastatic setting regimens), received twice-daily (BID) dasatinib. Primary endpoint was Response Evaluation Criteria In Solid Tumors-defined response rate. Secondary endpoints included toxicity and limited pharmacokinetics. Results: Seventy patients (55 years median age) were treated, 83% of HER2+ patients had received prior HER2-directed therapy and 61% of HR+ patients had received prior endocrine therapy in the advanced setting. Dasatinib starting dose was reduced from 100 mg BID to 70 mg BID to limit toxicity. Median therapy duration was 1.8 months in both dose groups and most discontinuations were due to progression. Of 69 evaluable patients, three had confirmed partial responses and six had stable disease for ≥16 weeks (disease control rate = 13.0%); all nine of these tumors were HR+ (two were also HER2+). The most common drug-related toxicities were gastrointestinal complaints, headache, asthenia, and pleural effusion. Grade 3-4 toxicity occurred in 37% of patients and was comparable between doses, drug-related serious adverse events were less frequent with 70 mg BID than 100 mg BID. Conclusions: Limited single-agent activity was observed with dasatinib in patients with advanced HR+ breast cancer.

Clinical Cancer Research

Voir le bulletin