Evaluation of KRAS Mutations, Angiogenic Biomarkers, and DCE-MRI in Patients with Advanced Non–Small-Cell Lung Cancer Receiving Sorafenib
Open Access
- 1 March 2011
- journal article
- research article
- Published by American Association for Cancer Research (AACR) in Clinical Cancer Research
- Vol. 17 (5), 1190-1199
- https://doi.org/10.1158/1078-0432.ccr-10-2331
Abstract
Purpose: Sorafenib, a multikinase inhibitor targeting Raf and VEGFR, has shown activity in unselected patients with non–small-cell lung cancer (NSCLC). At present there are no validated biomarkers indicative of sorafenib activity. Experimental Design: Patients received sorafenib 400 mg BID daily to determine activity and tolerability and to measure its biological effects. KRAS mutation status (N = 34), angiogenesis markers (VEGF, bFGF, FLT-1, PLGF-1) and imaging with DCE-MRI (dynamic contrast enhanced MRI) to determine early changes in tumor vascular characteristics were evaluated. Three parameters Ktrans, Kep, and Ve were measured by DCE-MRI at baseline and day 14 of cycle 1. Cytokine analysis was done on days 0, 14, 28, and 54. Results: Thirty-seven patients with previously treated stage IV NSCLC were enrolled in this single-center phase II trial. In 34 evaluable patients, 2 had partial responses and 20 had stable disease for 3 to 17 months, a disease control rate of 65%. The median progression-free survival (PFS) was 3.4 months, and median overall survival (OS) was 11.6 months. Toxicity was consistent with the known side effects of sorafenib. KRAS (32%) and EGFR mutations (22%) showed no correlation with response, PFS, or OS. Kep, was significant in predicting an improvement in OS (P = 0.035) and PFS (P = 0.029). Cytokine analysis demonstrated an improved OS for bFGF day 0 (6 pg/mL; P = 0.042), whereas a PFS benefit was seen with bFGF at day 28 (6; P = 0.028). Conclusions: KRAS and EGFR mutational status showed no correlation with response, PFS, or OS. Radiologic and cytokine changes may act as biomarkers indicative of early angiogenesis inhibition. Clin Cancer Res; 17(5); 1190–9. ©2011 AACR.Keywords
Other Versions
This publication has 39 references indexed in Scilit:
- Plasma Cytokine and Angiogenic Factor Profiling Identifies Markers Associated with Tumor Shrinkage in Early-Stage Non–Small Cell Lung Cancer Patients Treated with PazopanibCancer Research, 2010
- Clinical Features and Outcome of Patients With Non–Small-Cell Lung Cancer Who Harbor EML4-ALKJournal of Clinical Oncology, 2009
- Gefitinib or Carboplatin–Paclitaxel in Pulmonary AdenocarcinomaThe New England Journal of Medicine, 2009
- Multiple circulating proangiogenic factors induced by sunitinib malate are tumor-independent and correlate with antitumor efficacyProceedings of the National Academy of Sciences of the United States of America, 2007
- Circulating protein biomarkers of pharmacodynamic activity of sunitinib in patients with metastatic renal cell carcinoma: modulation of VEGF and VEGF-related proteinsJournal of Translational Medicine, 2007
- Discovery and development of sorafenib: a multikinase inhibitor for treating cancerNature Reviews Drug Discovery, 2006
- Erlotinib in Previously Treated Non–Small-Cell Lung CancerThe New England Journal of Medicine, 2005
- Soluble markers for the assessment of biological activity with PTK787/ZK 222584 (PTK/ZK), a vascular endothelial growth factor receptor (VEGFR) tyrosine kinase inhibitor in patients with advanced colorectal cancer from two phase I trialsAnnals of Oncology, 2005
- Careful Decoy Receptor Titering is Required to Inhibit Tumor Angiogenesis While Avoiding Adversely Altering VEGF BioavailabilityMolecular Therapy, 2005
- Role of the Vascular Endothelial Growth Factor Pathway in Tumor Growth and AngiogenesisJournal of Clinical Oncology, 2005