TY - JOUR
T1 - Tanespimycin and bortezomib combination treatment in patients with relapsed or relapsed and refractory multiple myeloma
T2 - Results of a phase 1/2 study
AU - Richardson, Paul G.
AU - Chanan-Khan, Asher A.
AU - Lonial, Sagar
AU - Krishnan, Amrita Y.
AU - Carroll, Michael P.
AU - Alsina, Melissa
AU - Albitar, Maher
AU - Berman, David
AU - Messina, Marianne
AU - Anderson, Kenneth C.
PY - 2011/6
Y1 - 2011/6
N2 - 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.
AB - 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.
KW - Bortezomib
KW - Heat shock protein 90
KW - Myeloma
KW - Proteasome
KW - Tanespimycin
UR - http://www.scopus.com/inward/record.url?scp=79957539428&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=79957539428&partnerID=8YFLogxK
U2 - 10.1111/j.1365-2141.2011.08664.x
DO - 10.1111/j.1365-2141.2011.08664.x
M3 - Article
C2 - 21534941
AN - SCOPUS:79957539428
SN - 0007-1048
VL - 153
SP - 729
EP - 740
JO - British journal of haematology
JF - British journal of haematology
IS - 6
ER -