Phase I and pharmacokinetic study of gefitinib in children with refractory solid tumors: A children's oncology group study

Najat C. Daw, Wayne L. Furman, Clinton F. Stewart, Lisa C. Iacono, Mark Krailo, Mark L. Bernstein, Janet E. Dancey, Rose Anne Speights, Susan M. Blaney, James Croop, Gregory H. Reaman, Peter C. Adamson

Research output: Contribution to journalArticle

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Abstract

Purpose: Epidermal growth factor receptor is expressed in pediatric malignant solid tumors. We conducted a phase I trial of gefitinib, an epidermal growth factor receptor tyrosine kinase inhibitor, in children with refractory solid tumors. Patients and Methods: Gefitinib (150, 300, 400, or 500 mg/m 2) was administered orally to cohorts of three to six patients once daily continuously until disease progression or significant toxicity. Pharmacokinetic studies were performed during course one (day 1 through 28). Results: Of the 25 enrolled patients, 19 (median age, 15 years) were fully evaluable for toxicity and received 54 courses. Dose-limiting toxicity was rash in two patients treated with 500 mg/m2 and elevated ALT and AST in one patient treated with 400 mg/m2. The maximum-tolerated dose was 400 mg/m2/d. The most frequent non-dose-limiting toxicities were grade 1 or 2 dry skin, anemia, diarrhea, nausea, and vomiting. One patient with Ewing's sarcoma had a partial response. Disease stabilized for 8 to ≥ 60 weeks in two patients with Wilms' tumor and two with brainstem glioma (one exophytic). At 400 mg/m2, the median peak gefitinib plasma concentration was 2.2 μg/mL (range, 1.2 to 3.6 μg/mL) and occurred at a median of 2.3 hours (range, 2.0 to 8.3 hours) after drug administration. The median apparent clearance and median half-life were 14.8 L/h/m2 (range, 3.8 to 24.8 L/h/m2) and 11.7 hours (range, 5.6 to 22.8 hours), respectively. Gefitinib systemic exposures were comparable with those associated with antitumor activity in adults. Conclusion: Oral gefitinib is well tolerated in children. Development of the drug in combination with cytotoxic chemotherapy will be pursued.

Original languageEnglish (US)
Pages (from-to)6172-6180
Number of pages9
JournalJournal of Clinical Oncology
Volume23
Issue number25
DOIs
StatePublished - 2005
Externally publishedYes

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Pharmacokinetics
Neoplasms
Epidermal Growth Factor Receptor
Ewing's Sarcoma
Maximum Tolerated Dose
Wilms Tumor
Drug Combinations
gefitinib
Exanthema
Glioma
Protein-Tyrosine Kinases
Nausea
Brain Stem
Vomiting
Half-Life
Disease Progression
Anemia
Diarrhea
Pediatrics
Drug Therapy

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Daw, N. C., Furman, W. L., Stewart, C. F., Iacono, L. C., Krailo, M., Bernstein, M. L., ... Adamson, P. C. (2005). Phase I and pharmacokinetic study of gefitinib in children with refractory solid tumors: A children's oncology group study. Journal of Clinical Oncology, 23(25), 6172-6180. https://doi.org/10.1200/JCO.2005.11.429

Phase I and pharmacokinetic study of gefitinib in children with refractory solid tumors : A children's oncology group study. / Daw, Najat C.; Furman, Wayne L.; Stewart, Clinton F.; Iacono, Lisa C.; Krailo, Mark; Bernstein, Mark L.; Dancey, Janet E.; Speights, Rose Anne; Blaney, Susan M.; Croop, James; Reaman, Gregory H.; Adamson, Peter C.

In: Journal of Clinical Oncology, Vol. 23, No. 25, 2005, p. 6172-6180.

Research output: Contribution to journalArticle

Daw, NC, Furman, WL, Stewart, CF, Iacono, LC, Krailo, M, Bernstein, ML, Dancey, JE, Speights, RA, Blaney, SM, Croop, J, Reaman, GH & Adamson, PC 2005, 'Phase I and pharmacokinetic study of gefitinib in children with refractory solid tumors: A children's oncology group study', Journal of Clinical Oncology, vol. 23, no. 25, pp. 6172-6180. https://doi.org/10.1200/JCO.2005.11.429
Daw, Najat C. ; Furman, Wayne L. ; Stewart, Clinton F. ; Iacono, Lisa C. ; Krailo, Mark ; Bernstein, Mark L. ; Dancey, Janet E. ; Speights, Rose Anne ; Blaney, Susan M. ; Croop, James ; Reaman, Gregory H. ; Adamson, Peter C. / Phase I and pharmacokinetic study of gefitinib in children with refractory solid tumors : A children's oncology group study. In: Journal of Clinical Oncology. 2005 ; Vol. 23, No. 25. pp. 6172-6180.
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abstract = "Purpose: Epidermal growth factor receptor is expressed in pediatric malignant solid tumors. We conducted a phase I trial of gefitinib, an epidermal growth factor receptor tyrosine kinase inhibitor, in children with refractory solid tumors. Patients and Methods: Gefitinib (150, 300, 400, or 500 mg/m 2) was administered orally to cohorts of three to six patients once daily continuously until disease progression or significant toxicity. Pharmacokinetic studies were performed during course one (day 1 through 28). Results: Of the 25 enrolled patients, 19 (median age, 15 years) were fully evaluable for toxicity and received 54 courses. Dose-limiting toxicity was rash in two patients treated with 500 mg/m2 and elevated ALT and AST in one patient treated with 400 mg/m2. The maximum-tolerated dose was 400 mg/m2/d. The most frequent non-dose-limiting toxicities were grade 1 or 2 dry skin, anemia, diarrhea, nausea, and vomiting. One patient with Ewing's sarcoma had a partial response. Disease stabilized for 8 to ≥ 60 weeks in two patients with Wilms' tumor and two with brainstem glioma (one exophytic). At 400 mg/m2, the median peak gefitinib plasma concentration was 2.2 μg/mL (range, 1.2 to 3.6 μg/mL) and occurred at a median of 2.3 hours (range, 2.0 to 8.3 hours) after drug administration. The median apparent clearance and median half-life were 14.8 L/h/m2 (range, 3.8 to 24.8 L/h/m2) and 11.7 hours (range, 5.6 to 22.8 hours), respectively. Gefitinib systemic exposures were comparable with those associated with antitumor activity in adults. Conclusion: Oral gefitinib is well tolerated in children. Development of the drug in combination with cytotoxic chemotherapy will be pursued.",
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T1 - Phase I and pharmacokinetic study of gefitinib in children with refractory solid tumors

T2 - A children's oncology group study

AU - Daw, Najat C.

AU - Furman, Wayne L.

AU - Stewart, Clinton F.

AU - Iacono, Lisa C.

AU - Krailo, Mark

AU - Bernstein, Mark L.

AU - Dancey, Janet E.

AU - Speights, Rose Anne

AU - Blaney, Susan M.

AU - Croop, James

AU - Reaman, Gregory H.

AU - Adamson, Peter C.

PY - 2005

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N2 - Purpose: Epidermal growth factor receptor is expressed in pediatric malignant solid tumors. We conducted a phase I trial of gefitinib, an epidermal growth factor receptor tyrosine kinase inhibitor, in children with refractory solid tumors. Patients and Methods: Gefitinib (150, 300, 400, or 500 mg/m 2) was administered orally to cohorts of three to six patients once daily continuously until disease progression or significant toxicity. Pharmacokinetic studies were performed during course one (day 1 through 28). Results: Of the 25 enrolled patients, 19 (median age, 15 years) were fully evaluable for toxicity and received 54 courses. Dose-limiting toxicity was rash in two patients treated with 500 mg/m2 and elevated ALT and AST in one patient treated with 400 mg/m2. The maximum-tolerated dose was 400 mg/m2/d. The most frequent non-dose-limiting toxicities were grade 1 or 2 dry skin, anemia, diarrhea, nausea, and vomiting. One patient with Ewing's sarcoma had a partial response. Disease stabilized for 8 to ≥ 60 weeks in two patients with Wilms' tumor and two with brainstem glioma (one exophytic). At 400 mg/m2, the median peak gefitinib plasma concentration was 2.2 μg/mL (range, 1.2 to 3.6 μg/mL) and occurred at a median of 2.3 hours (range, 2.0 to 8.3 hours) after drug administration. The median apparent clearance and median half-life were 14.8 L/h/m2 (range, 3.8 to 24.8 L/h/m2) and 11.7 hours (range, 5.6 to 22.8 hours), respectively. Gefitinib systemic exposures were comparable with those associated with antitumor activity in adults. Conclusion: Oral gefitinib is well tolerated in children. Development of the drug in combination with cytotoxic chemotherapy will be pursued.

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