Phase I trial of vandetanib and bevacizumab evaluating the VEGF and EGF signal transduction pathways in adults with solid tumours and lymphomas

Shivaani Kummar, Martin E. Gutierrez, Alice Chen, Ismail B. Turkbey, Deborah Allen, Yvonne R. Horneffer, Lamin Juwara, Liang Cao, Yunkai Yu, Yeong Sang Kim, Jane Trepel, Helen Chen, Peter Choyke, Giovanni Melillo, Anthony J. Murgo, Jerry Collins, James H. Doroshow

Research output: Contribution to journalArticlepeer-review

19 Scopus citations

Abstract

Purpose: Inhibition of epidermal growth factor (EGF) and vascular endothelial growth factor (VEGF) pathways may result in synergistic antitumour activity. We designed a phase I study to evaluate the combination of vandetanib, an investigational agent with activity against EGF receptor and VEGF receptor 2, and bevacizumab, a monoclonal antibody against VEGF. Experimental design: Patients with advanced solid tumours and lymphomas were enrolled. Objectives were to determine the safety and maximum tolerated dose of the combination, characterise pharmacokinetics, measure angiogenic marker changes in blood, and assess tumour blood flow using dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI). Vandetanib was given orally once daily and bevacizumab intravenously once in every 3 weeks in 21-day cycles utilising a standard dose-escalation design. Results: Fifteen patients were enrolled, and a total of 94 cycles of therapy were administered. No protocol-defined dose-limiting toxicities were observed; due to toxicities associated with chronic dosing, hypertension, proteinuria, diarrhoea and anorexia, dose escalation was stopped at the second dose level. We observed one partial response and one minor response; 9 patients experienced stable disease. There were significant changes in plasma VEGF and placental-derived growth factor levels, and decreases in Ktrans and kep were observed by DCE-MRI. Conclusion: In this trial, we safely combined two targeted agents that cause dual blockade of the VEGF pathway, demonstrated preliminary evidence of clinical activity, and conducted correlative studies demonstrating anti-angiogenic effect. The recommended phase II dose was established as vandetanib 200 mg daily and bevacizumab 7.5 mg/kg every 3 weeks.

Original languageEnglish (US)
Pages (from-to)997-1005
Number of pages9
JournalEuropean Journal of Cancer
Volume47
Issue number7
DOIs
StatePublished - May 2011
Externally publishedYes

Keywords

  • Bevacizumab
  • Clinical trial
  • EGF inhibitor
  • Phase I
  • Vandetanib
  • VEGF inhibitor
  • ZD6474

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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