Phase I study of dasatinib in combination with capecitabine, oxaliplatin, and bevacizumab followed by an expanded cohort in previously untreated metastatic colorectal cancer.
3586 Background: SRC is a non-receptor tyrosine kinase involved in normal and tumor cell signaling functions including cell proliferation, angiogenesis and survival. Dasatinib (D) is a potent inhibitor of SRC kinase activity. Preclinical data suggests the addition of D to standard chemotherapy agents for colon cancer may increase anti-tumor activity. We evaluated D in combination with capecitabine (C), oxaliplatin (O) and bevacizumab (B) in a phase I dose escalation study followed by an expanded cohort in first-line colorectal.For dose escalation, eligible patients had advanced solid tumors with adequate organ function and no increased risk for class-related toxicities. B and O were given intravenously, and C and D were orally administered; cycle length was 21 days. C was dosed at 850 mg/m2 on days 1-14; O was dosed at 130 mg/m2 and B was dosed at 7.5 mg/kg on day one of each cycle. D was dosed at 50 mg twice daily in cohort one and 70 mg once daily in cohort -1. Dose limiting toxicity (DLT) was assessed in cycle 1.Dose escalation is complete with 10 subjects evaluable for DLT toxicity and 11 subjects evaluable for efficacy. Two DLTs were observed out of 4 evaluable subjects in cohort one. Six evaluable subjects were enrolled in the -1 cohort with 1 DLT. Two subjects have been enrolled in the expanded cohort. Possible grade ≥3 treatment-related adverse events (AEs) included neutropenia, febrile neutropenia, anorexia, diarrhea, fatigue, anemia, dehydration and grade 5 GI-perforation. One non-treatment related death was due to disease progression. D-related nausea, anorexia and fatigue were responsive to low dose oral steroids; fluid retention was responsive to diuretics. Of 13 subjects evaluable for efficacy, 3 subjects had a partial response (PR), 6 had stable disease (SD) as best response.D in combination with C, O and B is well-tolerated with a toxicity profile similar to standard C, O and B.The recommended phase II dose is C at 850 mg/m2 on days 1-14, O at 130 mg/m2 and B at 7.5 mg/kg on day one of each cycle, and D at 70 mg once daily. Enrollment in the expanded cohort of first-line colorectal is nearing completion.
Strickler, JH; Cohn, AL; Arrowood, C; Haley, S; Morse, M; Uronis, H; Blobe, GC; Hsu, SD; Zafar, Y; Hurwitz, H
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