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Phase II study of perifosine in previously untreated patients with metastatic melanoma

To assess the response rate and toxicity of the alkylphosphocholine analogue, perifosine, in patients with metastatic or recurrent malignant melanoma. Patients had histologically proven, unidimensionally measurable disease which was incurable by standard therapy. Prior adjuvant immunotherapy was all...

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Published in:Investigational new drugs 2005-12, Vol.23 (6), p.569-575
Main Authors: Ernst, D Scott, Eisenhauer, Elizabeth, Wainman, Nancy, Davis, Mary, Lohmann, Reinhard, Baetz, Tara, Belanger, Karl, Smylie, Michael
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creator Ernst, D Scott
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description To assess the response rate and toxicity of the alkylphosphocholine analogue, perifosine, in patients with metastatic or recurrent malignant melanoma. Patients had histologically proven, unidimensionally measurable disease which was incurable by standard therapy. Prior adjuvant immunotherapy was allowed but patients had not received prior chemotherapy. Perisfosine was given orally as a loading dose of 900 mg on day 1 followed by a maintenance dose of 150 mg po on days 2-21 in a 28 day cycle. The loading dose was 300 mg on day 1 of all subsequent cycles. Tumour response was assessed every 2 cycles. 18 patients were accrued over 7 mos. No objective responses occurred in the 14 evaluable patients. Three patients (21%) achieved stable disease after 2 cycles and 11 had progression. Seventeen patients were evaluable for toxicity. Grade 3 or 4 non-hematologic toxicities included: diarrhea (12%), arthralgia (12%), nausea (6%), headache (6%), and fatigue (6%). No grade 3 or 4 hematological or biochemical toxicity were observed. Seventy-seven percent of patients received >or=90% of planned cycle 1 dose intensity and 58% received >or=90% of planned dose for cycle 2+. Four patients required dose reductions; treatment was delayed in 5 patients; and 5 patients missed doses because of toxicity. Perifosine can be safely administered when given as an initial loading dose followed by daily maintenance therapy over 28 days. Gastrointestinal toxicity is common but generally of low grade. Hematological toxicity is minimal. No objective responses were observed. No further development of single-agent perifosine is recommended in malignant melanoma.
doi_str_mv 10.1007/s10637-005-1157-4
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subjects Adult
Aged
Aged, 80 and over
Arthralgia - chemically induced
Bioavailability
Bone marrow
Cancer therapies
Cell cycle
Chemotherapy
Chondrocalcinosis - chemically induced
Cytotoxicity
Drug dosages
Female
Hematology
Humans
Immunotherapy
Liver Neoplasms - drug therapy
Liver Neoplasms - secondary
Lung Neoplasms - drug therapy
Lung Neoplasms - secondary
Lymphatic Metastasis
Melanoma
Melanoma - drug therapy
Melanoma - secondary
Metastasis
Middle Aged
Phosphorylcholine - adverse effects
Phosphorylcholine - analogs & derivatives
Phosphorylcholine - therapeutic use
Sarcoma
Signal transduction
Skin cancer
Toxicity
Tumors
title Phase II study of perifosine in previously untreated patients with metastatic melanoma
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