Two-stage phase II study of imatinib mesylate in subjects with refractory or relapsing neuroblastoma

作者：Calafiore L; Amoroso L; Alberighi O Della Casa; Luksch R; Zanazzo G; Castellano A; Podda M; Dominici C; Haupt R; Corrias M V^*; Garaventa A

来源：Annals of Oncology, 2013, 24(5): 1406-1413.

DOI：10.1093/annonc/mds648

• imatinib mesylate
• neuroblastoma
• phase II study
• relapse
• tyrosine hydroxylase

Background: Cure rate for subjects with refractory or relapsing metastatic neuroblastoma is <5%. In the search for a novel therapy, continuous daily oral administration of imatinib mesylate was evaluated.
Patients and methods: Twenty-four subjects were enrolled in a two-stage study. Imatinib was administered for the first 4 weeks (cycle) at 170 mg/sqm b.i.d. If no major toxicity occurred, the dose was escalated to 300 mg/sqm b.i.d. for a maximum of 12 cycles. Clinical response and toxicity were evaluated according to international criteria. Pharmacokinetics (PK) profiles and tyrosine hydroxylase (TH) mRNA expression were also determined in a subset of subjects.
Results: Five (21%) complete responses, with one subject still alive at 68 months, and 2 (8%) partial responses lasting up to 29 months were obtained. No grade 4 toxicity was observed. At steady-state, PK exposure (69.7 mu g h/ml) was similar to that of adults receiving 1000 mg/die. Responses appear to correlate with the absence or presence of metastasis in the bone marrow (BM) alone, with low TH expression levels at study entry and low imatinib exposure.
Conclusions: Imatinib mesylate was well-tolerated and effective in the subset of subjects with low BM infiltration as only site of metastasis.
Study identifier: EudraCT: 2005-005778-63.

• 出版日期2013-5