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Breast Cancer Res Treat. 2017 Sep;165(2):375-382. doi: 10.1007/s10549-017-4310-9. Epub 2017 Jun 16.

A Phase I/II study of suberoylanilide hydroxamic acid (SAHA) in combination with trastuzumab (Herceptin) in patients with advanced metastatic and/or local chest wall recurrent HER2-amplified breast cancer: a trial of the ECOG-ACRIN Cancer Research Group (E1104).

Author information

1
Fox Chase Cancer Center, Philadelphia, PA, USA. lori.goldstein@fccc.edu.
2
Dana Farber Cancer Institute - ECOG-ACRIN Biostatistics Center, Boston, MA, USA.
3
Fox Chase Cancer Center, Philadelphia, PA, USA.
4
Merck Pharmaceuticals, North Wales, PA, USA.
5
West Chester Medical Center, Valhalla, NY, USA.
6
University Hospitals Case Medical Center, Cleveland, OH, USA.
7
MD Anderson Cancer Center, Houston, TX, USA.
8
Georgia Regents University NCORP, Augusta, Georgia.
9
University of Alabama, Birmingham, AL, England, UK.
10
Beth Israel Medical Center, New York, USA.
11
St. Vincent's Comp. Cancer Center, New York, USA.
12
Stanford University, Stanford, CA, USA.
13
Indiana University Cancer Center, Indianapolis, IN, USA.

Abstract

PURPOSE:

Suberoylanilide hydroxamic acid (SAHA; vorinostat), a small molecule inhibitor of histone deacetylase, attenuates signaling pathways known to confer trastuzumab resistance. A combination of SAHA and trastuzumab may be a promising strategy to improve the efficacy of trastuzumab against breast cancer. In this Phase I/II study, we evaluated the toxicity and response rate after treatment with SAHA and trastuzumab in patients with HER2-overexpressing metastatic breast cancer with trastuzumab-resistant progressive disease.

METHODS:

In Phase I, the SAHA dose was modified in cohorts of 3-6 patients to find the dose level at which 0 or 1 patients experienced a dose-limiting toxicity (DLT) during the first cycle of therapy. In the Phase II study, response to the recommended dose identified in Phase I was based on the response evaluation criteria in solid tumors. Overall survival and time to progression were also evaluated.

RESULTS:

The recommended dose was determined to be 200 mg twice a day on days 1-14 and IV trastuzumab 6 mg/kg on day 1 of a 21-day cycle (n = 6). The Phase II study (n = 10) was terminated when the pre-planned efficacy evaluation found that none of the patients in the primary analysis set responded to combination SAHA and trastuzumab treatment.

CONCLUSIONS:

In patients with HER2-positive metastatic breast cancer who had relapsed or progressed during trastuzumab therapy, we observed no DLTs with SAHA 200 mg twice daily combined with trastuzumab; however, there was insufficient statistical evidence that adding SAHA reversed trastuzumab resistance in these patients.

KEYWORDS:

Anticancer therapy; Histone deacetylase; Resistance; Toxicity; Tumor

PMID:
28623430
PMCID:
PMC5682621
DOI:
10.1007/s10549-017-4310-9
[Indexed for MEDLINE]
Free PMC Article

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