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Prospective multicenter phase II trial of systemic ADH-1 in combination with melphalan via isolated limb infusion in patients with advanced extremity melanoma.

Publication ,  Journal Article
Beasley, GM; Riboh, JC; Augustine, CK; Zager, JS; Hochwald, SN; Grobmyer, SR; Peterson, B; Royal, R; Ross, MI; Tyler, DS
Published in: J Clin Oncol
March 20, 2011

PURPOSE: Isolated limb infusion (ILI) with melphalan (M-ILI) dosing corrected for ideal body weight (IBW) is a well-tolerated treatment for patients with in-transit melanoma with a 29% complete response rate. ADH-1 is a cyclic pentapeptide that disrupts N-cadherin adhesion complexes. In a preclinical animal model, systemic ADH-1 given with regional melphalan demonstrated synergistic antitumor activity, and in a phase I trial with M-ILI it had minimal toxicity. PATIENTS AND METHODS: Patients with American Joint Committee on Cancer (AJCC) stage IIIB or IIIC extremity melanoma were treated with 4,000 mg of ADH-1, administered systemically on days 1 and 8, and with M-ILI corrected for IBW on day 1. Drug pharmacokinetics and N-cadherin immunohistochemical staining were performed on pretreatment tumor. The primary end point was response at 12 weeks determined by Response Evaluation Criteria in Solid Tumors (RECIST) criteria. RESULTS: In all, 45 patients were enrolled over 15 months at four institutions. In-field responses included 17 patients with complete responses (CRs; 38%), 10 with partial responses (22%), six with stable disease (13%), eight with progressive disease (18%), and four (9%) who were not evaluable. Median duration of in-field response among the 17 CRs was 5 months, and median time to in-field progression among 41 evaluable patients was 4.6 months (95% CI, 4.0 to 7.1 months). N-cadherin was detected in 20 (69%) of 29 tumor samples. Grade 4 toxicities included creatinine phosphokinase increase (four patients), arterial injury (one), neutropenia (one), and pneumonitis (one). CONCLUSION: To the best of our knowledge, this phase II trial is the first prospective multicenter ILI trial and the first to incorporate a targeted agent in an attempt to augment antitumor responses to regional chemotherapy. Although targeting N-cadherin may improve melanoma sensitivity to chemotherapy, no difference in response to treatment was seen in this study.

Duke Scholars

Published In

J Clin Oncol

DOI

EISSN

1527-7755

Publication Date

March 20, 2011

Volume

29

Issue

9

Start / End Page

1210 / 1215

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Survival Rate
  • Skin Neoplasms
  • Reverse Transcriptase Polymerase Chain Reaction
  • RNA, Messenger
  • Prospective Studies
  • Peptides, Cyclic
  • Oncology & Carcinogenesis
  • Oligopeptides
  • Oligonucleotide Array Sequence Analysis
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Beasley, G. M., Riboh, J. C., Augustine, C. K., Zager, J. S., Hochwald, S. N., Grobmyer, S. R., … Tyler, D. S. (2011). Prospective multicenter phase II trial of systemic ADH-1 in combination with melphalan via isolated limb infusion in patients with advanced extremity melanoma. J Clin Oncol, 29(9), 1210–1215. https://doi.org/10.1200/JCO.2010.32.1224
Beasley, Georgia M., Jonathan C. Riboh, Christina K. Augustine, Jonathan S. Zager, Steven N. Hochwald, Stephen R. Grobmyer, Bercedis Peterson, Richard Royal, Merrick I. Ross, and Douglas S. Tyler. “Prospective multicenter phase II trial of systemic ADH-1 in combination with melphalan via isolated limb infusion in patients with advanced extremity melanoma.J Clin Oncol 29, no. 9 (March 20, 2011): 1210–15. https://doi.org/10.1200/JCO.2010.32.1224.
Beasley GM, Riboh JC, Augustine CK, Zager JS, Hochwald SN, Grobmyer SR, et al. Prospective multicenter phase II trial of systemic ADH-1 in combination with melphalan via isolated limb infusion in patients with advanced extremity melanoma. J Clin Oncol. 2011 Mar 20;29(9):1210–5.
Beasley, Georgia M., et al. “Prospective multicenter phase II trial of systemic ADH-1 in combination with melphalan via isolated limb infusion in patients with advanced extremity melanoma.J Clin Oncol, vol. 29, no. 9, Mar. 2011, pp. 1210–15. Pubmed, doi:10.1200/JCO.2010.32.1224.
Beasley GM, Riboh JC, Augustine CK, Zager JS, Hochwald SN, Grobmyer SR, Peterson B, Royal R, Ross MI, Tyler DS. Prospective multicenter phase II trial of systemic ADH-1 in combination with melphalan via isolated limb infusion in patients with advanced extremity melanoma. J Clin Oncol. 2011 Mar 20;29(9):1210–1215.

Published In

J Clin Oncol

DOI

EISSN

1527-7755

Publication Date

March 20, 2011

Volume

29

Issue

9

Start / End Page

1210 / 1215

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Survival Rate
  • Skin Neoplasms
  • Reverse Transcriptase Polymerase Chain Reaction
  • RNA, Messenger
  • Prospective Studies
  • Peptides, Cyclic
  • Oncology & Carcinogenesis
  • Oligopeptides
  • Oligonucleotide Array Sequence Analysis