Tanespimycin and bortezomib combination treatment in patients with relapsed or relapsed and refractory multiple myeloma: Results of a phase 1/2 study

Paul G. Richardson, Asher A Chanan Khan, Sagar Lonial, Amrita Y. Krishnan, Michael P. Carroll, Melissa Alsina, Maher Albitar, David Berman, Marianne Messina, Kenneth C. Anderson

Research output: Contribution to journalArticle

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Abstract

This open-label, dose escalation, multicentre phase 1/2 trial was undertaken to determine the safety and tolerability of the heat shock protein 90 (HSP90) inhibitor tanespimycin (100-340mg/m2)+bortezomib (0·7-1·3mg/m2) given on days 1, 4, 8 and 11 in each 21-d cycle. Phase 2 expansion occurred at the highest tested dose of tanespimycin at 340mg/m2 and bortezomib at 1·3mg/m2. Seventy-two patients (median age, 60years) with relapsed or relapsed and refractory multiple myeloma (MM) were enrolled; 63 patients (89%) completed the study. Tanespimycin in combination with bortezomib was well tolerated; few patients experienced significant neutropenia, constipation and anorexia (<10%), and no patients developed severe peripheral neuropathy. Among 67 efficacy-evaluable patients, there were 2 (3%) complete responses and 8 (12%) partial responses, for an objective response rate (ORR) of 27%, including 8 (12%) minimal responses. Response rates were highest among bortezomib-naive patients and proved durable in all patient subgroups, including those with bortezomib-refractory disease. Pharmacodynamic analyses indicated that tanespimycin plus bortezomib effectively inhibited the proteasome, as evidenced by decreased 20S proteasome activity, and inhibited HSP90, as reflected by increased HSP70 expression. The results of this study support additional studies of this combination approach in MM.

Original languageEnglish (US)
Pages (from-to)729-740
Number of pages12
JournalBritish Journal of Haematology
Volume153
Issue number6
DOIs
StatePublished - Jun 2011
Externally publishedYes

Fingerprint

tanespimycin
Multiple Myeloma
HSP90 Heat-Shock Proteins
Proteasome Endopeptidase Complex
Therapeutics
Anorexia
Peripheral Nervous System Diseases
Constipation
Bortezomib
Neutropenia

Keywords

  • Bortezomib
  • Heat shock protein 90
  • Myeloma
  • Proteasome
  • Tanespimycin

ASJC Scopus subject areas

  • Hematology

Cite this

Tanespimycin and bortezomib combination treatment in patients with relapsed or relapsed and refractory multiple myeloma : Results of a phase 1/2 study. / Richardson, Paul G.; Chanan Khan, Asher A; Lonial, Sagar; Krishnan, Amrita Y.; Carroll, Michael P.; Alsina, Melissa; Albitar, Maher; Berman, David; Messina, Marianne; Anderson, Kenneth C.

In: British Journal of Haematology, Vol. 153, No. 6, 06.2011, p. 729-740.

Research output: Contribution to journalArticle

Richardson, Paul G. ; Chanan Khan, Asher A ; Lonial, Sagar ; Krishnan, Amrita Y. ; Carroll, Michael P. ; Alsina, Melissa ; Albitar, Maher ; Berman, David ; Messina, Marianne ; Anderson, Kenneth C. / Tanespimycin and bortezomib combination treatment in patients with relapsed or relapsed and refractory multiple myeloma : Results of a phase 1/2 study. In: British Journal of Haematology. 2011 ; Vol. 153, No. 6. pp. 729-740.
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