Phase II, open-label trial to assess QTcF effects, pharmacokinetics and antitumor activity of afatinib in patients with relapsed or refractory solid tumors

L Rhoda Molife, Sarah M Rudman, Salma Alam, Daniel S-W Tan, Hartmut Kristeleit, Gary Middleton, David Propper, Liz Bent, Peter Stopfer, Martina Uttenreuther-Fischer, Gudrun Wallenstein, Johann de Bono, James Spicer

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14 Citations (Scopus)

Abstract

PURPOSE: Afatinib is an irreversible ErbB family blocker currently under evaluation in late-stage clinical trials. This study primarily assessed the cardiac safety, pharmacokinetics and antitumor activity of afatinib in cancer patients.

METHODS: In this multicenter, Phase II, open-label, single-arm trial, 60 patients with solid tumors who were expected to express epidermal growth factor receptor-1 and HER2 received oral afatinib 50 mg daily. QTcF intervals (QT interval corrected by the Fridericia formula) were evaluated based on electrocardiogram recordings time-matched with pharmacokinetic blood samples after single (Day 1) and continuous (Day 14; steady state) administration. Adverse events were classified according to the National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE), version 3.0; antitumor activity was assessed using RECIST 1.0.

RESULTS: There was a nonsignificant decrease of 0.3 ms (90 % confidence interval -2.8, 2.3; N = 49) in the mean of the average time-matched QTcF interval from baseline to steady state. The maximum plasma concentration for afatinib was seen at median tmax 3 h after both single dose and at steady state. No relationship between afatinib plasma concentrations and time-matched QTcF, QT and heart rate change was found. The overall adverse event profile was consistent with the known safety profile of afatinib. One patient demonstrated a partial response (PR) and two patients unconfirmed PRs.

CONCLUSIONS: Afatinib had no impact on cardiac repolarization, had a manageable safety profile and demonstrated antitumor activity in this uncontrolled study.

Original languageEnglish
Pages (from-to)1213-22
Number of pages10
JournalCancer Chemotherapy and Pharmacology
Volume72
Issue number6
DOIs
Publication statusPublished - Dec 2013

Keywords

  • Administration, Oral
  • Aged
  • Antineoplastic Agents
  • Electrocardiography
  • Female
  • Humans
  • Male
  • Middle Aged
  • Neoplasms
  • Quinazolines
  • Receptor, Epidermal Growth Factor
  • Receptor, erbB-2
  • Treatment Outcome

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