A randomized, phase 2 trial of docetaxel with or without PX-866, an irreversible oral phosphatidylinositol 3-kinase inhibitor, in patients with relapsed or metastatic non-small-cell lung cancer

Benjamin Levy, Alexander Spira, Daniel Becker, Tracey Evans, Ian Schnadig, D. Ross Camidge, Julie E. Bauman, Diana Hausman, Luke Walker, John Nemunaitis, Charles M. Rudin, Balazs Halmos, Daniel W. Bowles

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23 Scopus citations

Abstract

Introduction: The phosphotidylinositol-3 kinase/serine-threonine kinase (AKT)/mammalian target of rapamycin signaling pathway is frequently altered in non-small-cell lung cancer (NSCLC). PX-866 is an oral, irreversible, pan-isoform inhibitor of phosphotidylinositol-3 kinase. Preclinical models revealed synergy with docetaxel and a phase 1 trial demonstrated tolerability of this combination. This randomized phase 2 study evaluated PX-866 combined with docetaxel in patients with advanced, refractory NSCLC. Methods: Patients with locally advanced, recurrent, or metastatic NSCLC who had received at least one and no more than two prior systemic treatment regimens were randomized (1:1) to a combination of docetaxel (75 mg/m intravenous every 21 days) with or without PX-866 (8 mg orally daily; arms A and B, respectively). The primary end point was progression-free survival (PFS). Secondary end points included objective response rate, overall survival (OS), toxicity, and correlation of biomarker analyses with efficacy outcomes. Results: A total of 95 patients were enrolled. Median PFS was 2 months in arm A and 2.9 months in arm B (p = 0.65). Objective response rates were 6% and 0% in arms A and B, respectively (p = 0.4). There was no difference in OS between the two arms (7.0 versus 9.2 months; p = 0.9). Grade 3 or higher adverse events were infrequent, but more common in the combination arm with respect to diarrhea (7% versus 2%), nausea (4% versus 0%), and vomiting (7% versus 0%). PIK3CA mutations or PTEN loss were infrequently observed. CONCLUSION: The addition of PX-866 to docetaxel did not improve PFS, response rate, or OS in patients with advanced, refractory NSCLC without molecular preselection.

Original languageEnglish (US)
Pages (from-to)1031-1035
Number of pages5
JournalJournal of Thoracic Oncology
Volume9
Issue number7
DOIs
StatePublished - Jul 2014

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Keywords

  • Combination therapy
  • Docetaxel
  • Non-small-cell lung cancer
  • PIK3CA
  • Phosphotidylinositol-3 kinase

ASJC Scopus subject areas

  • Oncology
  • Pulmonary and Respiratory Medicine

Cite this

Levy, B., Spira, A., Becker, D., Evans, T., Schnadig, I., Camidge, D. R., Bauman, J. E., Hausman, D., Walker, L., Nemunaitis, J., Rudin, C. M., Halmos, B., & Bowles, D. W. (2014). A randomized, phase 2 trial of docetaxel with or without PX-866, an irreversible oral phosphatidylinositol 3-kinase inhibitor, in patients with relapsed or metastatic non-small-cell lung cancer. Journal of Thoracic Oncology, 9(7), 1031-1035. https://doi.org/10.1097/JTO.0000000000000183