Skip to main content
Log in

A Phase I study of cabazitaxel in patients with advanced gastric cancer who have failed prior chemotherapy (GASTANA)

  • Original Article
  • Published:
Cancer Chemotherapy and Pharmacology Aims and scope Submit manuscript

Abstract

Purpose

This Phase I dose-escalation study (GASTANA) evaluated the safety, tolerability, pharmacokinetics and preliminary antitumor activity of cabazitaxel in Asian patients with advanced gastric adenocarcinoma failing two prior chemotherapy regimens.

Methods

Cabazitaxel safety/tolerability was determined using a standard 3 + 3 dose-escalation design based on dose-limiting toxicities (DLTs) in Cycle 1. Three dose levels (DL) were planned: 20, 25 and 15 mg/m2 (DL 1, DL 2 and DL −1).

Results

Fifteen patients were evaluable for DLTs. At DL 1, no DLTs occurred in three patients. At DL 2, four patients were enrolled (one patient discontinued), with only one DLT observed [Grade 4 febrile neutropenia (FN)]; however, all four patients experienced FN, hence three more patients were enrolled at DL 1 who experienced two DLTs (Grade 4 neutropenia >7 days). In response, DL −1 was opened, with no DLTs observed in six patients. In the total population (n = 16), frequent Grade 3/4 toxicities included neutropenia (63 %) and FN (38 %), best overall responses included one partial response (6.3 %; DL −1) and eight stable disease (50 %), and median progression-free survival was 83 days.

Conclusions

No unexpected safety findings were observed. Significant toxicities included neutropenia and FN, potentially due to patients being heavily pretreated and the accumulated toxicity of prior taxane therapy.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Ferlay J, Soerjomataram I, Ervik M, Dikshit R, Eser S, Mathers C, Rebelo M, Parkin DM, Forman D, Bray F (2013) GLOBOCAN 2012 v1.0, cancer incidence and mortality worldwide: IARC CancerBase No. 11. International Agency for Research on Cancer, Lyon. http://globocan.iarc.fr

  2. Shen L, Shan YS, Hu HM, Price TJ, Sirohi B, Yeh KH, Yang YH, Sano T, Yang HK, Zhang X, Park SR, Fujii M, Kang YK, Chen LT (2013) Management of gastric cancer in Asia: resource-stratified guidelines. Lancet Oncol 14:e535–e547

    Article  PubMed  Google Scholar 

  3. Van Cutsem E, Dicato M, Geva R, Arber N, Bang Y, Benson A, Cervantes A, Diaz-Rubio E, Ducreux M, Glynne-Jones R, Grothey A, Haller D, Haustermans K, Kerr D, Nordlinger B, Marshall J, Minsky BD, Kang YK, Labianca R, Lordick F, Ohtsu A, Pavlidis N, Roth A, Rougier P, Schmoll HJ, Sobrero A, Tabernero J, Van de Velde C, Zalcberg J (2011) The diagnosis and management of gastric cancer: expert discussion and recommendations from the 12th ESMO/World Congress on Gastrointestinal Cancer, Barcelona, 2010. Ann Oncol 22(Suppl 5):v1–v9

    Article  PubMed  Google Scholar 

  4. Ford H, Marshall A, Wadsley J, Coxon FY, Mansoor W, Bridgewater JA, Madhusudan S, Falk S, Middleton GW, Swinson D, Chau I, Thompson J, Blazeby JM, Cunningham D, Kareclas P, Dunn JA (2012) Cougar-02: a randomized phase III study of docetaxel versus active symptom control in advanced esophagogastric adenocarcinoma. J Clin Oncol 30. abstract LBA4

  5. Kang JH, Lee SI, Lim DH, Park KW, Oh SY, Kwon HC, Hwang IG, Lee SC, Nam E, Shin DB, Lee J, Park JO, Park YS, Lim HY, Kang WK, Park SH (2012) Salvage chemotherapy for pretreated gastric cancer: a randomized phase III trial comparing chemotherapy plus best supportive care with best supportive care alone. J Clin Oncol 30:1513–1518

    Article  CAS  PubMed  Google Scholar 

  6. Thuss-Patience PC, Kretzschmar A, Bichev D, Deist T, Hinke A, Breithaupt K, Dogan Y, Gebauer B, Schumacher G, Reichardt P (2011) Survival advantage for irinotecan versus best supportive care as second-line chemotherapy in gastric cancer—a randomised phase III study of the Arbeitsgemeinschaft Internistische Onkologie (AIO). Eur J Cancer 47:2306–2314

    Article  CAS  PubMed  Google Scholar 

  7. National Comprehensive Cancer Network: Gastric Cancer. NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) Gastric Cancer (Version 1.2014). http://www.nccn.org/professionals/physician_gls/pdf/gastric.pdf

  8. Vrignaud P, Sémiond D, Lejeune P, Bouchard H, Calvet L, Combeau C, Riou J-F, Commercon A, Lavelle F, Bissery M-C (2013) Preclinical antitumor activity of cabazitaxel, a semi-synthetic taxane active in taxane-resistant tumors. Clin Cancer Res 19:2973–2983

    Article  CAS  PubMed  Google Scholar 

  9. de Bono JS, Oudard S, Ozguroglu M, Hansen S, Machiels JP, Kocak I, Gravis G, Bodrogi I, Mackenzie MJ, Shen L, Roessner M, Gupta S, Sartor AO (2010) Prednisone plus cabazitaxel or mitoxantrone for metastatic castration-resistant prostate cancer progressing after docetaxel treatment: a randomised open-label trial. Lancet 376:1147–1154

    Article  PubMed  Google Scholar 

  10. National Comprehensive Cancer Network: Prostate Cancer. The NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines) Prostate Cancer (Version 2.2014). http://www.nccn.org/professionals/physician_gls/pdf/prostate.pdf

  11. Pean E, Demolis P, Moreau A, Hemmings RJ, O’Connor D, Brown D, Shepard T, Abadie E, Pignatti F (2012) The European Medicines Agency review of cabazitaxel (Jevtana(R)) for the treatment of hormone-refractory metastatic prostate cancer: summary of the scientific assessment of the committee for medicinal products for human use. Oncologist 17:543–549

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  12. Sanofi (2011) JEVTANA® (cabazitaxel) injection, summary of product characteristics. EMA, London, UK

  13. Sanofi U.S. LLC (2013) JEVTANA® (cabazitaxel) injection, prescribing information. FDA, USA

  14. National Cancer Institute (2010) Common terminology criteria for adverse events (CTCAE) version 4.03. http://evs.nci.nih.gov/ftp1/CTCAE/About.html

  15. Eisenhauer EA, Therasse P, Bogaerts J, Schwartz LH, Sargent D, Ford R, Dancey J, Arbuck S, Gwyther S, Mooney M, Rubinstein L, Shankar L, Dodd L, Kaplan R, Lacombe D, Verweij J (2009) New response evaluation criteria in solid tumours: revised RECIST guideline (version 1.1). Eur J Cancer 2:228–247

    Article  Google Scholar 

  16. Mita AC, Denis LJ, Rowinsky EK, de Bono JS, Goetz AD, Ochoa L, Forouzesh B, Beeram M, Patnaik A, Molpus K, Semiond D, Besenval M, Tolcher AW (2009) Phase I and pharmacokinetic study of XRP6258 (RPR 116258A), a novel taxane, administered as a 1-hour infusion every 3 weeks in patients with advanced solid tumors. Clin Cancer Res 15:723–730

    Article  CAS  PubMed  Google Scholar 

  17. Dieras V, Lortholary A, Laurence V, Delva R, Girre V, Livartowski A, Assadourian S, Semiond D, Pierga JY (2013) Cabazitaxel in patients with advanced solid tumours: results of a phase I and pharmacokinetic study. Eur J Cancer 49:25–34

    Article  CAS  PubMed  Google Scholar 

  18. Yano R, Konno A, Watanabe K, Tsukamoto H, Kayano Y, Ohnaka H, Goto N, Nakamura T, Masada M (2013) Pharmacoethnicity of docetaxel-induced severe neutropenia: integrated analysis of published phase II and III trials. Int J Clin Oncol 18:96–104

    Article  CAS  PubMed  Google Scholar 

  19. Fumoleau P, Trigo JM, Isambert N, Semiond D, Gupta S, Campone M (2013) Phase I dose-finding study of cabazitaxel administered weekly in patients with advanced solid tumours. BMC Cancer 13:460

    Article  PubMed Central  PubMed  Google Scholar 

  20. Mukai H, Takahashi S, Nozawa M, Onozawa Y, Miyazaki J, Ohno K, Suzuki K (2014) Phase I dose-escalation and pharmacokinetic study (TED 11576) of cabazitaxel in Japanese patients with castration-resistant prostate cancer. Cancer Chemother Pharmacol 73:703–710

    Article  CAS  PubMed  Google Scholar 

  21. Kang EJ, Im SA, Oh DY, Han SW, Kim JS, Choi IS, Kim JW, Kim YJ, Kim JH, Kim TY, Lee JS, Bang YJ, Lee KW (2013) Irinotecan combined with 5-fluorouracil and leucovorin third-line chemotherapy after failure of fluoropyrimidine, platinum, and taxane in gastric cancer: treatment outcomes and a prognostic model to predict survival. Gastric Cancer 16:581–589

    Article  CAS  PubMed  Google Scholar 

  22. Kang YK, Muro K, Ryu MH, Yasui H, Nishina T, Ryoo BY, Kamiya Y, Akinaga S, Boku N (2014) A phase II trial of a selective c-Met inhibitor tivantinib (ARQ 197) monotherapy as a second- or third-line therapy in the patients with metastatic gastric cancer. Invest New Drugs 32:355–361

    Article  CAS  PubMed  Google Scholar 

  23. Lee MJ, Hwang IG, Jang JS, Choi JH, Park BB, Chang MH, Kim ST, Park SH, Kang MH, Kang JH (2012) Outcomes of third-line docetaxel-based chemotherapy in advanced gastric cancer who failed previous oxaliplatin-based and irinotecan-based chemotherapies. Cancer Res Treat 44:235–241

    Article  PubMed Central  PubMed  Google Scholar 

Download references

Acknowledgments

This study was funded by Sanofi. The authors received editorial support from Paul Scutt of MediTech Media Ltd, funded by Sanofi. This study was funded by Sanofi.

Conflict of interest

Yoon-Koo Kang has a consultancy/advisory role with Sanofi, Roche, Daiho and Novartis and has received funding from Sanofi, Roche, Jeil, Novartis and Bayer. Lin Shen has received remuneration from Roche, Novartis and Amgen, funding from Celgene, Taiho, Heng Rui, Sanofi and Roche, and has a consultant/advisory role with Roche and Novartis. Yu Zhou, Jooyun Lee and Chenlu Wei are employees of Sanofi. Baek-Yeol Ryoo, Shinkyo Yoon and Min-Hee Ryu have no conflicts to disclose.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Yoon-Koo Kang.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Kang, YK., Ryoo, BY., Yoon, S. et al. A Phase I study of cabazitaxel in patients with advanced gastric cancer who have failed prior chemotherapy (GASTANA). Cancer Chemother Pharmacol 75, 309–318 (2015). https://doi.org/10.1007/s00280-014-2638-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00280-014-2638-y

Keywords

Navigation