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A phase II and pharmacodynamic study of gefitinib in patients with refractory or recurrent epithelial ovarian cancer
Author(s) -
Posadas Edwin M.,
Liel Meghan S.,
Kwitkowski Virginia,
Minasian Lori,
Godwin Andrew K.,
Hussain Mahrukh M.,
Espina Virginia,
Wood Bradford J.,
Steinberg Seth M.,
Kohn Elise C.
Publication year - 2007
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/cncr.22545
Subject(s) - gefitinib , medicine , epidermal growth factor receptor , protein kinase b , oncology , phosphorylation , targeted therapy , mapk/erk pathway , cancer research , cancer , biology , biochemistry
BACKGROUND The primary objective of this study was to evaluate the biochemical effects of gefitinib on its target signal‐transduction pathways in patients with recurrent epithelial ovarian cancer (EOC). The secondary objectives included assessing clinical activity and toxicity and determining the association between biochemical and clinical outcomes. METHODS Twenty‐four heavily pretreated patients with EOC who had good end‐organ function and performance status and who had measurable disease received gefitinib 500 mg daily. Prospectively planned core‐needle tumor biopsies were obtained before treatment and after 4 weeks. Protein expression of total and phosphorylated (p) epidermal growth factor receptor (EGFR), protein kinase B (AKT), and extracellular regulated kinase (ERK) was quantified in microdissected tumor cells using tissue lysate array proteomics. RESULTS All tumor samples had detectable levels of EGFR and p‐EGFR. A decrease in the quantity of both EGFR and p‐EGFR was observed with gefitinib therapy in >50% of patients. This was not associated with clinical benefit, nor were responses observed. However, trends for increased gastrointestinal and skin toxicity were observed with greater phosphorylation or quantities of EGFR, ERK, and AKT in tumor samples ( P ≤ .05). Gefitinib had limited clinical activity as monotherapy despite documented target inhibition. CONCLUSIONS The results from this study demonstrated that gefitinib inhibited the phosphorylation of EGFR in EOC tumor cells, providing proof of target in a clinical setting. Combinatorial therapy with molecular therapeutics against complementary targets may prove successful. Cancer 2007. Published 2007 by the American Cancer Society.