Efficacy and Safety of Ceritinib (450 mg/d or 600 mg/d) With Food Versus 750-mg/d Fasted in Patients With ALK Receptor Tyrosine Kinase (ALK)-Positive NSCLC: Primary Efficacy Results From the ASCEND-8 Study

Carregando...
Imagem de Miniatura
Citações na Scopus
66
Tipo de produção
article
Data de publicação
2019
Editora
ELSEVIER SCIENCE INC
Indexadores
Título da Revista
ISSN da Revista
Título do Volume
Autores
CHO, Byoung Chul
OBERMANNOVA, Radka
BEARZ, Alessandra
MCKEAGE, Mark
KIM, Dong-Wang
BATRA, Ullas
BORRA, Gloria
ORLOV, Sergey
KIM, Sang-We
GEATER, Sarayut L.
Autor de Grupo de pesquisa
Editores
Coordenadores
Organizadores
Citação
JOURNAL OF THORACIC ONCOLOGY, v.14, n.7, p.1255-1265, 2019
Projetos de Pesquisa
Unidades Organizacionais
Fascículo
Resumo
Introduction: In an earlier report of the ASCEND-8 study (open-label, phase I, three-arm study, treatment-naive patients and pre-treated patients with advanced/metastatic NSCLC), it was shown that ceritinib 450 mg with food had comparable exposure and better gastrointestinal tolerability than 750-mg fasted. Methods: Here, we report efficacy and updated safety data from primary efficacy analysis of the ASCEND-8 study. Key secondary endpoints were overall response rate and duration of response, assessed by blinded independent review committee (BIRC) using Response Evaluation Criteria in Solid Tumors 1.1. Results: In total, 306 patients were randomized to ceritinib 450-mg fed (n = 108) or 600-mg fed (n = 87) or 750-mg fasted (n = 111), of which 304 patients were included in safety analysis and 198 treatment-naive patients (ALK receptor tyrosine kinase [ALK]-positive by immunohistochemistry) were included in the efficacy analysis (450-mg fed [n = 73], 600-mg fed [n = 51], and 750-mg fasted [n = 74]). The BIRC-assessed overall response rate was 78.1% (95% confidence interval [CI]: 66.9-86.9), 72.5% (95% CI: 58.3-84.1), and 75.7% (95% CI: 64.3-84.9), respectively; and the median duration of response (months) by BIRC was not estimable (NE) (95% CI: 11.2-NE), 20.7 (95% CI: 15.8-NE), and 15.4 (95% CI: 8.3-NE), respectively. Based on the safety analysis (n = 304), the 450-mg fed arm showed the highest median relative dose intensity (100% versus 78.5% versus 83.7%), lowest proportion of patients with dose reductions (24.1% versus 65.1% versus 60.9%), and lowest proportion of patients with gastrointestinal toxicities (75.9% versus 82.6% versus 91.8%). Conclusion: Ceritinib at a dose of 450 mg with food compared to 750-mg fasted showed consistent efficacy and less gastrointestinal toxicity. (C) 2019 International Association for the Study of Lung Cancer.
Palavras-chave
Ceritinib, ALK receptor tyrosine kinase, NSCLC, Food effect
Referências
  1. Abbas R, 2012, CANCER CHEMOTH PHARM, V69, P221, DOI 10.1007/s00280-011-1688-7
  2. BROOKMEYER R, 1982, BIOMETRICS, V38, P29, DOI 10.2307/2530286
  3. Cho BC, 2017, J THORAC ONCOL, V12, P1357, DOI 10.1016/j.jtho.2017.07.005
  4. European Medical Agency, ZYK EUR PUBL ASS REP
  5. Hong Y, 2017, J CLIN PHARMACOL, V57, P652, DOI 10.1002/jcph.849
  6. Khozin S, 2015, CLIN CANCER RES, V21, P2436, DOI 10.1158/1078-0432.CCR-14-3157
  7. Lau YY, 2016, J CLIN PHARMACOL, V56, P559, DOI 10.1002/jcph.619
  8. Novartis Pharmaceuticals Corporation, ZYK DOS ADM
  9. Novartis Pharmaceuticals Corporation, GLEEV PRESCR INF
  10. Peters S, 2017, NEW ENGL J MED, V377, P829, DOI 10.1056/NEJMoa1704795
  11. Shaw AT, 2017, LANCET ONCOL, V18, P874, DOI 10.1016/S1470-2045(17)30339-X
  12. Soda M, 2007, NATURE, V448, P561, DOI 10.1038/nature05945
  13. Solomon BJ, 2014, NEW ENGL J MED, V371, P2167, DOI [10.1056/NEJMoa1408440, 10.1056/NEJMx150034]
  14. Soria JC, 2017, LANCET, V389, P917, DOI 10.1016/S0140-6736(17)30123-X
  15. US Food and Drug Administration, CER HIGHL PRESCR INF
  16. US Food and Drug Administration, CER PRESCR INF