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2013 ; 49
(13
): 2841-50
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Phase Ib study of tivozanib (AV-951) in combination with temsirolimus in patients
with renal cell carcinoma
#MMPMID23726267
Fishman MN
; Srinivas S
; Hauke RJ
; Amato RJ
; Esteves B
; Cotreau MM
; Strahs AL
; Slichenmyer WJ
; Bhargava P
; Kabbinavar FF
Eur J Cancer
2013[Sep]; 49
(13
): 2841-50
PMID23726267
show ga
BACKGROUND: Tivozanib is a potent and selective tyrosine kinase inhibitor of
vascular endothelial growth factor receptors (VEGFR)-1, -2 and -3, with a long
half-life. Tivozanib has demonstrated clinical activity and acceptable
tolerability in renal cell carcinoma (RCC). This phase Ib study determined the
recommended phase II dose (RP2D) and evaluated the safety and clinical activity
of tivozanib plus temsirolimus, a mammalian target of rapamycin inhibitor.
PATIENTS AND METHODS: Patients with advanced RCC were administered open-label
tivozanib 0.5, 1.0 or 1.5mg/d orally (3 weeks on/1 week off) and temsirolimus 15
or 25 mg/week intravenously in a 3+3 dose-escalation design and subsequent
expansion cohort. RESULTS: Of 27 patients treated, 20 patients had received ? 1
prior VEGF-targeted therapy. No dose-limiting toxicities occurred; the RP2D was
determined to be tivozanib 1.5mg/d plus temsirolimus 25mg/week. Combination of
tivozanib plus temsirolimus demonstrated acceptable tolerability and suggested no
synergistic toxicity. The most common grade ? 3 adverse events were fatigue and
thrombocytopenia (15% each). One patient each required dose reduction of
tivozanib or temsirolimus due to an adverse event. Confirmed partial responses
and stable disease were achieved at 23% and 68%, respectively. Pharmacokinetic
analyses may suggest lack of an interaction between tivozanib and temsirolimus.
CONCLUSIONS: In this small phase Ib study, tivozanib and temsirolimus were safely
combined at the fully recommended dose and schedule of both agents. The observed
clinical activity and manageable toxicity profile of this combination warrant
further exploration in patients with RCC.