Evidence map›Paper›PMID 30603797›Full record

ArticleCancer chemotherapy and pharmacology2019

Phase 1b trial of nintedanib in combination with bevacizumab in patients with advanced solid tumors.

Ravi Paluri, Ankit Madan, Peng Li, Benjamin Jones, Mansoor Saleh, Mary Jerome, Deborah Miley, Jennifer Keef, Francisco Robert

Abstract readClinical Trial, Phase I
In one paragraph

Article in Cancer chemotherapy and pharmacology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed.

  1. Article
  2. Review
  3. Review
  4. Review
  5. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Ravi PaluriUniversity of Alabama at Birmingham, Comprehensive Cancer Center, Birmingham, USA.
Ankit MadanUniversity of Alabama at Birmingham, Comprehensive Cancer Center, Birmingham, USA.
Peng LiUniversity of Alabama at Birmingham, Comprehensive Cancer Center, Birmingham, USA.
Benjamin JonesUniversity of Alabama at Birmingham, Comprehensive Cancer Center, Birmingham, USA.
Mansoor SalehUniversity of Alabama at Birmingham, Comprehensive Cancer Center, Birmingham, USA.
Mary JeromeUniversity of Alabama at Birmingham, Comprehensive Cancer Center, Birmingham, USA.
Deborah MileyUniversity of Alabama at Birmingham, Comprehensive Cancer Center, Birmingham, USA.
Jennifer KeefUniversity of Alabama at Birmingham, Comprehensive Cancer Center, Birmingham, USA.
Francisco RobertUniversity of Alabama at Birmingham, Comprehensive Cancer Center, Birmingham, USA. pacorobertuab@cs.com.

Funding

XRAY CRYSTALLOGRAPHYP30CA013148 · NCI · UNIVERSITY OF ALABAMA AT BIRMINGHAM · PI Robert S Welner · 1985 to 2026
$165.9M
National Dissemination of I-Corps@NCATS: Accelerating Translation through CommercializationUL1TR003096 · NCATS · UNIVERSITY OF ALABAMA AT BIRMINGHAM · PI GUTIERREZ, ORLANDO M, KIMBERLY, ROBERT P. · 2019 to 2023
$43.6M
UAB Center for Clinical and Translational Science (CCTS)UL1TR001417 · NCATS · UNIVERSITY OF ALABAMA AT BIRMINGHAM · PI KIMBERLY, ROBERT P. · 2015 to 2018
$31.4M
NCATS NIH HHS UL1 TR001417NCATS NIH HHS UL1 TR003096NCI NIH HHS P30 CA013148
6 · The paper itself

Abstract

purposeVascular endothelial growth factor (VEGF) inhibitors have produced demonstrable but limited benefit for various cancers. One mechanism of resistance includes revascularization, secondary to upregulation of alternative pro-angiogenic platelet-derived growth factor receptor and fibroblast growth factor receptor pathways. Nintedanib is an oral, triple kinase inhibitor that blocks these pathways and may improve anti-tumor activity by overcoming resistance to anti-VEGF therapies. The primary objective of this first in-human study was to evaluate the safety and tolerability of nintedanib in combination with bevacizumab.

methodsPatients were treated with escalating doses of nintedanib (150 mg or 200 mg oral twice daily) and bevacizumab (15 mg/kg once intravenously every 3 weeks) until disease progression or unacceptable toxicity using standard 3 + 3 phase 1 design. Plasma levels of angiogenic biomarkers were correlated with clinical outcomes.

resultsEighteen patients with advanced tumors [lung (n = 9), colon (n = 8), and cervical (n = 1)] previously treated with at least two lines of chemotherapy including bevacizumab (n = 9, 50%) were enrolled. The highest dose of nintedanib was 200 mg twice a day with no observed dose-limiting toxicities (DLT). Common adverse events (AE) were fatigue (grade 1-3) and diarrhea (grade 1-2). Durable clinical response was observed in 55% patients pretreated with bevacizumab (1 complete and 4 stable response). Better disease control was correlated with higher than median baseline values for VEFGR2 and E-selectin, and lower levels for SDF-1α.

conclusionNintedanib was well-tolerated with bevacizumab with no DLT. Significant clinical activity was observed, including in bevacizumab-pretreated patients, suggesting nintedanib can overcome bevacizumab resistance.

Indexed as

Administration, OralAdultAgedAngiogenesis InhibitorsAntineoplastic Combined Chemotherapy ProtocolsBevacizumabDose-Response Relationship, DrugDrug Resistance, NeoplasmFemaleFollow-Up StudiesHumansIndolesMaleMiddle AgedNeoplasmsNeoplasm StagingAngiogenesis InhibitorsBevacizumabIndolesnintedanibProtein Kinase InhibitorsVascular Endothelial Growth Factor AVEGFA protein, humanBevacizumabMetastasisNintedanibSolid tumorsVascular endothelial growth factors

Identifiers

PMID30603797
PMCPMC6490179

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.