A phase II trial of the epothilone B analog ixabepilone (BMS-247550) in patients with metastatic melanoma.

<h4>Background</h4>Ixabepilone (BMS-247550), an epothilone B analog, is a microtubule stabilizing agent which has shown activity in several different tumor types and preclinical models in melanoma. In an open label, one-arm, multi-center phase II trial the efficacy and toxicity of this e...

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Main Authors: Patrick A Ott, Anne Hamilton, Amanda Jones, Naomi Haas, Tsiporah Shore, Sandra Liddell, Paul J Christos, L Austin Doyle, Michael Millward, Franco M Muggia, Anna C Pavlick
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2010-01-01
Series:PLoS ONE
Online Access:https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0008714&type=printable
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author Patrick A Ott
Anne Hamilton
Amanda Jones
Naomi Haas
Tsiporah Shore
Sandra Liddell
Paul J Christos
L Austin Doyle
Michael Millward
Franco M Muggia
Anna C Pavlick
author_facet Patrick A Ott
Anne Hamilton
Amanda Jones
Naomi Haas
Tsiporah Shore
Sandra Liddell
Paul J Christos
L Austin Doyle
Michael Millward
Franco M Muggia
Anna C Pavlick
author_sort Patrick A Ott
collection DOAJ
description <h4>Background</h4>Ixabepilone (BMS-247550), an epothilone B analog, is a microtubule stabilizing agent which has shown activity in several different tumor types and preclinical models in melanoma. In an open label, one-arm, multi-center phase II trial the efficacy and toxicity of this epothilone was investigated in two different cohorts: chemotherapy-naïve (previously untreated) and previously treated patients with metastatic melanoma.<h4>Methodology/principal findings</h4>Eligible patients had histologically-confirmed stage IV melanoma, with an ECOG performance status of 0 to 2. Ixabepilone was administered at a dose of 20 mg/m(2) on days 1, 8, and 15 during each 28-day cycle. The primary endpoint was response rate (RR); secondary endpoints were time to progression (TTP) and toxicity. Twenty-four patients were enrolled and 23 were evaluable for response. Initial serum lactate dehydrogenase (LDH) levels were elevated in 6/11 (55%) of the previously treated and in 5/13 (38%) of the previously untreated patients. No complete or partial responses were seen in either cohort. One patient in the previously treated group developed neutropenia and fatal septic shock. Seventeen patients (8 in the previously untreated group and 9 in the previously treated group) progressed after 2 cycles, whereas six patients (3 in each group) had stable disease after 2-6 cycles. Median TTP was 1.74 months in the previously untreated group (95% CI = 1.51 months, upper limit not estimated) and 1.54 months in the previously treated group (95% CI = 1.15 months, 2.72 months). Grade 3 and/or 4 toxicities occurred in 5/11 (45%) of previously untreated and in 5/13 (38%) of previously treated patients and included neutropenia, peripheral neuropathy, fatigue, diarrhea, and dyspnea.<h4>Conclusions/significance</h4>Ixabepilone has no meaningful activity in either chemotherapy-naïve (previously untreated) or previously treated patients with metastatic melanoma. Further investigation with ixabepilone as single agent in the treatment of melanoma is not warranted.<h4>Trial registration</h4>Clinical Trials.gov NCT00036764.
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spelling doaj-art-bcaa7301c3184c05ad9a4660ad8a3bc02025-08-20T03:19:50ZengPublic Library of Science (PLoS)PLoS ONE1932-62032010-01-0151e871410.1371/journal.pone.0008714A phase II trial of the epothilone B analog ixabepilone (BMS-247550) in patients with metastatic melanoma.Patrick A OttAnne HamiltonAmanda JonesNaomi HaasTsiporah ShoreSandra LiddellPaul J ChristosL Austin DoyleMichael MillwardFranco M MuggiaAnna C Pavlick<h4>Background</h4>Ixabepilone (BMS-247550), an epothilone B analog, is a microtubule stabilizing agent which has shown activity in several different tumor types and preclinical models in melanoma. In an open label, one-arm, multi-center phase II trial the efficacy and toxicity of this epothilone was investigated in two different cohorts: chemotherapy-naïve (previously untreated) and previously treated patients with metastatic melanoma.<h4>Methodology/principal findings</h4>Eligible patients had histologically-confirmed stage IV melanoma, with an ECOG performance status of 0 to 2. Ixabepilone was administered at a dose of 20 mg/m(2) on days 1, 8, and 15 during each 28-day cycle. The primary endpoint was response rate (RR); secondary endpoints were time to progression (TTP) and toxicity. Twenty-four patients were enrolled and 23 were evaluable for response. Initial serum lactate dehydrogenase (LDH) levels were elevated in 6/11 (55%) of the previously treated and in 5/13 (38%) of the previously untreated patients. No complete or partial responses were seen in either cohort. One patient in the previously treated group developed neutropenia and fatal septic shock. Seventeen patients (8 in the previously untreated group and 9 in the previously treated group) progressed after 2 cycles, whereas six patients (3 in each group) had stable disease after 2-6 cycles. Median TTP was 1.74 months in the previously untreated group (95% CI = 1.51 months, upper limit not estimated) and 1.54 months in the previously treated group (95% CI = 1.15 months, 2.72 months). Grade 3 and/or 4 toxicities occurred in 5/11 (45%) of previously untreated and in 5/13 (38%) of previously treated patients and included neutropenia, peripheral neuropathy, fatigue, diarrhea, and dyspnea.<h4>Conclusions/significance</h4>Ixabepilone has no meaningful activity in either chemotherapy-naïve (previously untreated) or previously treated patients with metastatic melanoma. Further investigation with ixabepilone as single agent in the treatment of melanoma is not warranted.<h4>Trial registration</h4>Clinical Trials.gov NCT00036764.https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0008714&type=printable
spellingShingle Patrick A Ott
Anne Hamilton
Amanda Jones
Naomi Haas
Tsiporah Shore
Sandra Liddell
Paul J Christos
L Austin Doyle
Michael Millward
Franco M Muggia
Anna C Pavlick
A phase II trial of the epothilone B analog ixabepilone (BMS-247550) in patients with metastatic melanoma.
PLoS ONE
title A phase II trial of the epothilone B analog ixabepilone (BMS-247550) in patients with metastatic melanoma.
title_full A phase II trial of the epothilone B analog ixabepilone (BMS-247550) in patients with metastatic melanoma.
title_fullStr A phase II trial of the epothilone B analog ixabepilone (BMS-247550) in patients with metastatic melanoma.
title_full_unstemmed A phase II trial of the epothilone B analog ixabepilone (BMS-247550) in patients with metastatic melanoma.
title_short A phase II trial of the epothilone B analog ixabepilone (BMS-247550) in patients with metastatic melanoma.
title_sort phase ii trial of the epothilone b analog ixabepilone bms 247550 in patients with metastatic melanoma
url https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0008714&type=printable
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