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Clinical Trial
. 2015 Feb 1;21(3):544-52.
doi: 10.1158/1078-0432.CCR-14-1756. Epub 2014 Nov 25.

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  1 , Hyeong Ju Kwon  2 , Inkyung Jung  3 , Mi Ran Yun  4 , Myung-Ju Ahn  5 , Byung Woog Kang  6 , Jong-Mu Sun  5 , Sung Bae Kim  7 , Dok-Hyun Yoon  7 , Keon Uk Park  8 , Se-Hoon Lee  9 , Yoon Woo Koh  10 , Se Hun Kim  10 , Eun Chang Choi  10 , Dong Hoe Koo  11 , Jin Hee Sohn  12 , Bomi Kim  13 , Nak-Jung Kwon  14 , Hwan Jung Yun  15 , Min Goo Lee  16 , Ji Hyun Lee  17 , Tae-Min Kim  18 , Hye Ryun Kim  19 , Joo Hang Kim  19 , Soonmyung Paik  20 , Byoung Chul Cho  21
Affiliations
Clinical Trial

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 et al. Clin Cancer Res. .

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, p16(INK4A) 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 progression-free 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.

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