Phase II clinical and exploratory biomarker study of dacomitinib in patients with recurrent and/or metastatic squamous cell carcinoma of head and neck

Han Sang Kim, Hyeong Ju Kwon, Inkyung Jung, Mi Ran Yun, Myung Ju Ahn, Byung Woog Kang, Jong Mu Sun, Sung Bae Kim, Dok Hyun Yoon, Keon Uk Park, Se Hoon Lee, Yoon Woo Koh, Se Hun Kim, Eun Chang Choi, Dong Hoe Koo, Jin Hee Sohn, Bomi Kim, Nak Jung Kwon, Hwan Jung Yun, Min Goo LeeJi Hyun Lee, Tae Min Kim, Hye Ryun Kim, Joo Hang Kim, Soonmyung Paik, Byoung Chul Cho

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Abstract

Purpose: The goals of this study were to investigate the clinical activity, safety, and biomarkers of dacomitinib, an irreversible tyrosine kinase inhibitor of EGFR, HER2, and HER4, in recurrent and/or metastatic squamous cell carcinoma of the head and neck (R/M-SCCHN). Experimental Design: Patients were eligible if the diseases were not amenable to curative treatment and had progressed on platinum-based chemotherapy, and were treated with dacomitinib 45 mg/day. The primary endpoint was objective response rate by RECISTv1.1. Exploratory analysis included the characterization of somatic mutation, gene copy number, gene expression, p16INK4A expression by IHC, and investigation of their relationship with clinical outcomes. Results: Forty-eight patients were evaluable for efficacy and toxicity. Ten patients (20.8%) had partial responses and 31 patients (65%) had stable diseases. The median progressionfree survival (PFS) and overall survival (OS) were 3.9 months [95% confidence interval (CI), 2.9-5.0] and 6.6 months (95% CI, 5.4-10.3). Adverse events were mostly grade 1-2. Mutations in the PI3K pathway (PIK3CA, PTEN ) and high expression of inflammatory cytokines (IL6, IL8, IL1A, IL1B, IL4, and TNF) were significantly associated with shorter PFS (2.9 vs. 4.9 months without mutations, P = 0.013; 2.8 vs. 9.9 months with low expression, P = 0.004). Those harboring PI3K pathway mutations or high inflammatory cytokine expression had shorter median OS (6.1 vs. 12.5 months lacking PI3K pathway mutations and with low inflammatory cytokine expression, P = 0.005). Conclusions: Dacomitinib demonstrated clinical efficacy with manageable toxicity in platinum-failed R/M-SCCHN patients. Screening of PI3K pathway mutation and inflammatory cytokine expression may help identify which R/M-SCCHN patients are likely to gain benefit from dacomitinib.

Original languageEnglish
Pages (from-to)544-552
Number of pages9
JournalClinical Cancer Research
Volume21
Issue number3
DOIs
Publication statusPublished - 2015 Feb 1

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All Science Journal Classification (ASJC) codes

  • Oncology
  • Cancer Research

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Kim, H. S., Kwon, H. J., Jung, I., Yun, M. R., Ahn, M. J., Kang, B. W., Sun, J. M., Kim, S. B., Yoon, D. H., Park, K. U., Lee, S. H., Koh, Y. W., Kim, S. H., Choi, E. C., Koo, D. H., Sohn, J. H., Kim, B., Kwon, N. J., Yun, H. J., ... Cho, B. C. (2015). Phase II clinical and exploratory biomarker study of dacomitinib in patients with recurrent and/or metastatic squamous cell carcinoma of head and neck. Clinical Cancer Research, 21(3), 544-552. https://doi.org/10.1158/1078-0432.CCR-14-1756