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Phase II study of the farnesyltransferase inhibitor R115777 in advanced melanoma: CALGB 500104.

Publication ,  Journal Article
Gajewski, TF; Niedzwiecki, D; Johnson, J; Linette, G; Bucher, C; Blaskovich, M; Sebti, S; Haluska, F
Published in: J Clin Oncol
June 20, 2006

8014 Background: Ras-based signaling is thought to be critical in the genesis of melanoma. Farneslytransferase (FT) inhibitors (FTIs) have been developed as a pharmacologic strategy to inhibit Ras function. Additional farnesylated proteins are also important for the malignant process, and FTIs inhibit melanoma cell line proliferation in vitro. These considerations motivated the development of a phase II trial of the FTI R115777 in patients with melanoma. Farnesylated proteins are also important for T cell activation. The interest in future combinations of targeted agents and immunotherapeutics in this disease prompted analysis of T cell function ex vivo. METHODS: A 3-stage design was pursued with a maximum of 40 patients planned and early stopping if there were no responders in the first 14, or fewer than 2 responders in the first 28 patients. Eligibility included intact organ function, PS≤1, no prior chemotherapy, at most 1 prior immunotherapy, no brain metastases, and presence of at least 2 cutaneous lesions amenable to excisional biopsy. R115777 (300 mg orally) was administered twice per day for 21 days of a 28-day cycle. Patients were evaluated every 2 cycles by RECIST criteria. Blood was obtained pre-treatment and during week 7 for analysis of HDJ-2 farnesylation and for T cell IFN-γ production in response to SEA. In addition, tumor biopsies were performed pre- and post-treatment when feasible to directly measure FT activity. RESULTS: 14 patients were enrolled. 2 patients had grade 3 toxicities, which included myelosuppression, nausea/vomiting, elevated BUN, and anorexia. There were no clinical responses, and only 4 patients went on to a second course of treatment. All analyzed patients showed HDJ-2 gel shift in peripheral blood cells, as well as marked inhibition of FT activity (by 85-98%) in tumor tissue. T cell production of IFN-γ was also suppressed. CONCLUSIONS: Despite potent target inhibition, the FTI R115777 showed no evidence for clinical activity as a single agent in this cohort of 14 metastatic melanoma patients. Inhibition of T cell function has implications for future combination therapies and suggests the possibility for FTIs as candidate immunosuppressive agents. New therapeutic approaches for melanoma, or logically selected combination therapies, are needed. [Table: see text].

Duke Scholars

Published In

J Clin Oncol

EISSN

1527-7755

Publication Date

June 20, 2006

Volume

24

Issue

18_suppl

Start / End Page

8014

Location

United States

Related Subject Headings

  • Oncology & Carcinogenesis
  • 1112 Oncology and Carcinogenesis
  • 1103 Clinical Sciences
 

Citation

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Gajewski, T. F., Niedzwiecki, D., Johnson, J., Linette, G., Bucher, C., Blaskovich, M., … Haluska, F. (2006). Phase II study of the farnesyltransferase inhibitor R115777 in advanced melanoma: CALGB 500104. J Clin Oncol, 24(18_suppl), 8014.
Gajewski, T. F., D. Niedzwiecki, J. Johnson, G. Linette, C. Bucher, M. Blaskovich, S. Sebti, and F. Haluska. “Phase II study of the farnesyltransferase inhibitor R115777 in advanced melanoma: CALGB 500104.J Clin Oncol 24, no. 18_suppl (June 20, 2006): 8014.
Gajewski TF, Niedzwiecki D, Johnson J, Linette G, Bucher C, Blaskovich M, et al. Phase II study of the farnesyltransferase inhibitor R115777 in advanced melanoma: CALGB 500104. J Clin Oncol. 2006 Jun 20;24(18_suppl):8014.
Gajewski, T. F., et al. “Phase II study of the farnesyltransferase inhibitor R115777 in advanced melanoma: CALGB 500104.J Clin Oncol, vol. 24, no. 18_suppl, June 2006, p. 8014.
Gajewski TF, Niedzwiecki D, Johnson J, Linette G, Bucher C, Blaskovich M, Sebti S, Haluska F. Phase II study of the farnesyltransferase inhibitor R115777 in advanced melanoma: CALGB 500104. J Clin Oncol. 2006 Jun 20;24(18_suppl):8014.

Published In

J Clin Oncol

EISSN

1527-7755

Publication Date

June 20, 2006

Volume

24

Issue

18_suppl

Start / End Page

8014

Location

United States

Related Subject Headings

  • Oncology & Carcinogenesis
  • 1112 Oncology and Carcinogenesis
  • 1103 Clinical Sciences