BTG's Plevitrexed Shows Promising Efficacy and Tolerability in a Phase I/II study
Of the 28 patients who were evaluable for response at the recommended dose level of 130 mg/m2 taken into the Phase II part of the study, five patients had a partial response (17.9% response rate) and a further 15 patients (53.6%) had stable disease giving an overall disease control rate of 71.4%. One patient on the lower dose of 65 mg/m2 had a complete response and an additional five patients who received the higher dose of 165 mg/m2 had stable disease.
The use of nutritional supplements improved the dosing consistency and allowed for greater dose intensity. Only 30.6% of patients required dose interruptions or modifications compared with 61.8% of patients in a previous plevitrexed study. The maximum tolerated dose doubled to 130 mg/m2 and was given more consistently than in the previous study and with fewer missed doses, but no increase in grade 3/4 neutropenia was observed.
The overall efficacy of plevitrexed was in line with other single agent therapy and with that seen in a previous study of plevitrexed (17% response rate), as well as with the recently reported two-drug combination treatment of cisplatin and 5-FU in the V325 comparative study (25% response rate for the cisplatin/5FU arm). The Progression Free Survival of 120 days for plevitrexed in the current study was similar to the Time To Progression of 111 days for cisplatin/5-FU in the V325 study, and median overall survival was also similar (239 days versus 258 days). The number of treatment cycles of cisplatin/5-FU was the same (4) but plevitrexed showed less toxicity, especially neutropenia (reduction in circulating white blood cells). In the V325 study the incidence of grade 3/4 neutropenia was 57% with 12% febrile neutropenia (with accompanying fever), compared with an incidence of 39% grade 3/4 neutropenia with only 3% febrile neutropenia in the current plevitrexed study.
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