A phase II trial of Dovitinib in previously-treated advanced pleural mesothelioma: the Ontario Clinical Oncology Group
Mené sur 12 patients atteints d'un mésothéliome pleural malin de stade avancé (âge médian : 67 ans), cet essai de phase II évalue l'efficacité, du point de vue de la survie sans progression à 3 mois, et la toxicité du dovitinib, après l'échec d'une chimiothérapie combinant sels de platine et antifolates
Objectives : Following failure of a platinum-antifolate combination regimen, there is no standard therapy for advanced malignant pleural mesothelioma (MPM). The fibroblast growth factor receptor (FGFR) signaling pathways may be a relevant target in MPM. Dovitinib inhibits multiple tyrosine receptor kinases, predominantly the vascular endothelial growth factor receptors (VEGFR), but also FGFRs, and could be active in MPM. Methods : This open-label multicentre phase II trial [NCT01769547] enrolled fit, consenting adult patients with advanced MPM who had previously received platinum-antifolate combination chemotherapy and up to one additional line of systemic therapy. Dovitinib was administered orally at 500 mg/day for 5 days on, 2 days off, in 28-day cycles. Response was assessed every 2 cycles using RECIST 1.1 criteria modified for MPM. Correlative studies included FGFR-1 amplification on archival tumour and serum samples for circulating angiogenesis factors. The primary end-point was the proportion of patients progression-free at 3 months (PF3) using a two-stage design. Results : 12 patients (10 males, median age 67) were enrolled. The median number of cycles administered was 2.5 (range 1-8). One unconfirmed partial response was observed. PF3 was 50% (95% confidence interval 28.4% to 88.0%); although the criterion for proceeding to stage II accrual was met, the trial was halted due to a combination of minimal activity with several early progression events and poor tolerability in this patient population. One of 12 tumour specimens had low amplification of FGFR-1. Conclusions : Dovitinib has minimal activity in previously-treated MPM. The role of the FGFR pathway in MPM remains unclear.