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Phase II Study of Iniparib with Concurrent Chemoradiation in Patients with Newly Diagnosed Glioblastoma.

Al's Comment:

 This drug has a strange past - it did very good in early trials for breast cancer but failied in the large phase 3 trial.  It seems to have lottle toxcicity and the early brain tumor trial showed good results so it is worth a try again


Posted on: 08/23/2018

Clin Cancer Res. 2018 Aug 21. pii: clincanres.0110.2018. doi: 10.1158/1078-0432.CCR-18-0110. [Epub ahead of print]

Phase II Study of Iniparib with Concurrent Chemoradiation in Patients with Newly Diagnosed Glioblastoma.

Blakeley JO1, Grossman SA2, Chi AS3, Mikkelsen T4, Rosenfeld MR5, Ahluwalia MS6, Nabors LB7, Eichler A8, Garcia-Ribas I9, Desideri S 10, Ye X2.
 
Author information:
1. Neurology, Johns Hopkins jblakel3@jhmi.edu.
2. Oncology, Johns Hopkins.
3. Laura and Isaac Perlmutter Cancer Center, NYU School of Medicine.
4. Head Office, Ontario Brain Institute.
5. Neuroimmunology, Institute for Biomedical Research (IDIBAPS).
6. Oncology, Cleveland Clinic.
7. Department of Neurology, University of Alabama at Birmingham.
8. Massachusetts General Hospital.
9. Early Oncology Development, Sanofi Oncology.
10. Neuro-Oncology, Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins.
Abstract
PURPOSE:
 
Iniparib is a purported prodrug causing cell death through intracellular conversion to nitro radical ions. We assessed the efficacy and safety of iniparib with standard radiation therapy (RT) and temozolomide (TMZ) in patients with newly diagnosed glioblastoma (GBM).
EXPERIMENTAL DESIGN:
 
Adults meeting eligibility criteria were enrolled in this prospective, single arm, open-label multi-institution phase II trial with median overall survival (mOS) compared to a historical control as the primary objective. A safety run-in component of RT+TMZ+iniparib (n=5) was followed by an efficacy study (n=76) with the recommended phase II doses of iniparib (8.0 mg/kg IV twice/week with RT + daily TMZ followed by 8.6 mg/kg IV twice/week with 5/28 day TMZ).
RESULTS:
 
The median age of the 81 evaluable participants was 58 years (63% male). Baseline KPS was ≥80% in 87% of participants. The mOS was 22 months (95%CI: 17-24) and the hazard rate was 0.44 (95%CI: 0.35-0.55) per-person year of follow-up. The 2 and 3 year survival rates were 38% and 25%, respectively. Treatment-related grade 3 adverse events (AE) occurred in 27% of patients; nine patients had AEs requiring drug discontinuation including: infusion-related reaction, rash, gastritis, increased liver enzymes, and thrombocytopenia.
CONCLUSIONS:
 
Iniparib is well tolerated with RT and TMZ in patients with newly diagnosed GBM at up to 17.2mg/kg weekly. The primary objective of improved mOS compared with historical a control was met, indicating potential antitumor activity of iniparib in this setting. Dosing optimization (frequency and sequence) is needed prior to additional efficacy studies.
 
Copyright ©2018, American Association for Cancer Research.

 


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