Author:

Keywords:

Science & Technology, Life Sciences & Biomedicine, Oncology, Pharmacology & Pharmacy, Capmatinib, Cetuximab, MET positive, Colorectal cancer, Phase I, ACQUIRED-RESISTANCE, 1ST-LINE TREATMENT, PLUS IRINOTECAN, RAS MUTATIONS, III TRIAL, FLUOROURACIL, LEUCOVORIN, AMPLIFICATION, CHEMOTHERAPY, BEVACIZUMAB, Adult, Aged, Antineoplastic Agents, Antineoplastic Combined Chemotherapy Protocols, Benzamides, Cell Line, Tumor, Colorectal Neoplasms, Disease Progression, Drug Resistance, Neoplasm, ErbB Receptors, Female, Head and Neck Neoplasms, Humans, Imidazoles, Male, Maximum Tolerated Dose, Middle Aged, Protein Kinase Inhibitors, Proto-Oncogene Proteins c-met, Response Evaluation Criteria in Solid Tumors, Squamous Cell Carcinoma of Head and Neck, Triazines, ras Proteins, 1115 Pharmacology and Pharmaceutical Sciences, Oncology & Carcinogenesis, 3211 Oncology and carcinogenesis, 3214 Pharmacology and pharmaceutical sciences

Abstract:

Background Overcoming resistance to anti-epidermal growth factor receptor (EGFR) monoclonal antibodies (mAbs) in patients with KRAS wildtype (WT) metastatic colorectal cancer (mCRC) could help meet the needs of patients with limited treatment options. Methods In this phase 1b study, patients with N/KRAS WT, MET-positive mCRC who had progressed following anti-EGFR mAb treatment received escalating oral doses of capmatinib (150, 300, and 400 mg) twice daily plus weekly intravenous cetuximab (at the approved dose). The primary objective was to establish a recommended dose for expansion (RDE) of capmatinib in combination with cetuximab. Safety, preliminary activity, pharmacokinetics, and pharmacodynamics were also explored. Results Thirteen patients were enrolled. No patients experienced a dose-limiting toxicity at investigated doses; the RDE was established as capmatinib 400 mg twice daily plus cetuximab. All patients experienced adverse events (AEs) suspected to be related to the study treatment. Five patients (38.5%) reported study-drug-related AEs of grade 3/4 in severity. No patients achieved a complete or partial response according to RECIST v1.1; however, tumor shrinkage of 29-44% was observed in 4 patients. Conclusions Capmatinib plus cetuximab was well tolerated. Preliminary signs of activity were observed. Further investigation is warranted to obtain efficacy data and refine predictive biomarkers of response. Clinical trial registration NCT02205398.