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2015 ; 21
(11
): 2480-6
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Phase I Trial of Arginine Deprivation Therapy with ADI-PEG 20 Plus Docetaxel in
Patients with Advanced Malignant Solid Tumors
#MMPMID25739672
Tomlinson BK
; Thomson JA
; Bomalaski JS
; Diaz M
; Akande T
; Mahaffey N
; Li T
; Dutia MP
; Kelly K
; Gong IY
; Semrad T
; Gandara DR
; Pan CX
; Lara PN Jr
Clin Cancer Res
2015[Jun]; 21
(11
): 2480-6
PMID25739672
show ga
PURPOSE: This phase I study examined the toxicity and tolerability of pegylated
arginine deiminase (ADI-PEG 20) in combination with docetaxel in patients with
advanced solid malignancies. EXPERIMENTAL DESIGN: Eligible patients had
histologically proven advanced solid malignancies, with any number of prior
therapies, Zubrod performance status 0-2, and adequate organ function. Patients
received ADI-PEG 20 weekly intramuscular injection ranging from 4.5 to 36 mg/m(2)
and up to 10 doses of docetaxel (75 mg/m(2)) every 3 weeks. Primary endpoints
were safety, toxicity, and a recommended phase II dose. Circulating arginine
levels were measured before each cycle. Tumor response was measured as a
secondary endpoint every 6 weeks on study. RESULTS: Eighteen patients received a
total of 116 cycles of therapy through four dose levels of ADI-PEG 20. A single
dose-limiting toxicity (grade 3 urticarial rash) was observed at the 1st dose
level, with no additional dose-limiting toxicities observed. Hematologic
toxicities were common with 14 patients experiencing at least one grade 3 to 4
leukopenia. Fatigue was the most prevalent toxicity reported by 16 patients.
Arginine was variably suppressed with 10 patients achieving at least a 50%
reduction in baseline values. In 14 patients with evaluable disease, four partial
responses (including 2 patients with PSA response) were documented, and 7
patients had stable disease. CONCLUSIONS: ADI-PEG 20 demonstrated reasonable
toxicity in combination with docetaxel. Promising clinical activity was noted,
and expansion cohorts are now accruing for both castrate-resistant prostate
cancer and non-small cell lung cancer at a recommended phase II dose of 36
mg/m(2).