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Selumetinib in women with recurrent low-grade serous carcinoma of the ovary or peritoneum: an open-label, single-arm, phase 2 study - 29/01/13

Doi : 10.1016/S1470-2045(12)70572-7 
John Farley, ProfMD a, , William E Brady, PhD b, Vinod Vathipadiekal, PhD c, Heather A Lankes, PhD b, Robert Coleman, ProfMD d, Mark A Morgan, ProfMD e, Robert Mannel, ProfMD f, S Diane Yamada, ProfMD g, David Mutch, ProfMD h, William H Rodgers, ProfMD i, Michael Birrer, MD c, David M Gershenson, MD d
a Creighton University School of Medicine at St Joseph’s Hospital and Medical Center, Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Phoenix, AZ, USA 
b Gynecologic Oncology Group Statistical and Data Center, Roswell Park Cancer Institute, Buffalo, NY, USA 
c Massachusetts General Hospital, Department of Medicine, Boston, MA, USA 
d University of Texas, MD Anderson Cancer Center, Department of Gynecology and Oncology, Houston, TX, USA 
e Fox Chase Cancer Center, Surgical Oncology, Philadelphia, PA, USA 
f University of Oklahoma, Health Sciences Center, Obstetrics and Gynecology, Oklahoma City, OK, USA 
g University of Chicago, Section of Gynecologic Oncology, Chicago, IL, USA 
h Washington University School of Medicine, Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, St Louis, MO, USA 
i Lenox Hill Hospital, Department of Pathology, New York, NY, USA 

* Correspondence to: Prof John Farley, Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Creighton University School of Medicine at St Joseph’s Hospital and Medical Center, 500 W Thomas Road, Suite 600, Phoenix, AZ 85013, USA

Summary

Background

Low-grade serous carcinoma of the ovary is chemoresistant but mutations in the MAPK pathway could be targeted to control tumour growth. We therefore assessed the safety and activity of selumetinib, an inhibitor of MEK1/2, for patients with this cancer.

Methods

In this open-label, single-arm phase 2 study, women (aged ≥18 years) with recurrent low-grade serous ovarian or peritoneal carcinoma were given selumetinib (50 mg twice daily, orally) until progression. The primary endpoint was the proportion of patients who had an objective tumour response according to RECIST version 1.1, assessed for all the treated patients. Analysis was by intention to treat. This study is registered with ClinicalTrials.gov, number NCT00551070.

Findings

52 patients were enrolled between Dec 17, 2007, and Nov 23, 2009. All were eligible for analyses. Eight (15%) patients had an objective response to treatment—one patient had a complete response and seven had partial responses. 34 (65%) patients had stable disease. There were no treatment-related deaths. Grade 4 toxicities were cardiac (one), pain (one), and pulmonary events (one). Grade 3 toxicities that occurred in more than one patient were gastrointestinal (13), dermatological (nine), metabolic (seven), fatigue (six), anaemia (four), pain (four), constitutional (three), and cardiac events (two).

Interpretation

Selumetinib is well tolerated, and is active in the treatment of recurrent low-grade serous carcinoma of the ovary or peritoneum. The findings suggest that inhibitors of the MAPK pathway warrant further investigation in these patients.

Funding

National Cancer Institute.

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Vol 14 - N° 2

P. 134-140 - février 2013 Retour au numéro
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