G. Schwartz’s research while affiliated with University of Texas Health Science Center at Tyler and other places

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Publications (27)


Table 1 Patient characteristics (n ¼ 42)
Table 2 Erlotinib dose escalation
Table 3 Antitumour activity as a function of target rash
Mean erlotinib plasma concentration–time profiles at highest dose attained.
Erlotinib dosing-to-rash: A phase II intrapatient dose escalation and pharmacologic study of erlotinib in previously treated advanced non-small cell lung cancer
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August 2011

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145 Reads

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39 Citations

British Journal of Cancer

AC Mita

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K Papadopoulos

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To evaluate the anticancer activity of erlotinib in patients with previously treated, advanced non-small cell lung cancer (NSCLC) whose dose is increased to that associated with a maximal level of tolerable skin toxicity (i.e., target rash (TR)); to characterise the pharmacokinetics (PK) and pharmacodynamics (PD) of higher doses of erlotinib. Patients initially received erlotinib 150 mg per day. The dose was successively increased in each patient to that associated with a TR. Anticancer activity was evaluated. Plasma, skin, and hair were sampled for PK and PD studies. Erlotinib dose escalation to 200-475 mg per day was feasible in 38 (90%) of 42 patients. Twenty-four (57%) patients developed a TR, but 19 (79%) did so at 150 mg per day. Five (12%) patients, all of whom developed a TR, had a partial response. Median progression-free survival (PFS) was 2.3 months (95% CI: 1.61, 4.14); median PFS was 3.5 months and 1.9 months, respectively, for patients who did and did not experience a TR (hazard ratio, 0.51; P=0.051). Neither rash severity nor response correlated with erlotinib exposure. Intrapatient dose escalation of erlotinib does not appreciably increase the propensity to experience a maximal level of tolerable skin toxicity, or appear to increase the anticancer activity of erlotinib in NSCLC.

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A phase I, pharmacokinetic (PK) and pharmacodynamic (PD) study of the combination of an oral antimicrotubular agent, DJ-927 (D), and capecitabine (C) in patients (Pts) with advanced cancers

June 2006

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5 Reads

Journal of Clinical Oncology

2016 Background: DJ-927, an oral microtubule stabilizer, has impressive cytotoxic activity in taxane-resistant tumors and an acceptable toxicity profile. C and Taxane combinations are active in solid tumors such as breast cancer. Non-overlapping mechanism of action and toxicity profiles and the convenience of an orally administered therapy have prompted a phase I evaluation of the combination. D was given orally once on day 1 and C for 14-days (D1–14), every three weeks. Methods: Eligible pts had evaluable cancer, minimal prior therapy and PS 0 - 2 ECOG. D was started at 18 mg/m ² on day 1 along with 1,250 mg/m ² of C orally B.I.D for 14 days, of a 21-day cycle. Incremental doses of both drugs were explored until the maximum tolerated dose (MTD) was reached. PK samples were collected during cycles 1 and 2, for assays of C and for D when given concurrently with C during cycle 1 and D given alone during cycle 2. Results: Twenty-seven pts [18 Male/ 9 Female; median age (range)- 58 yrs (33–70); PS 0 (n=8) ; PS 1 (n=19)] received 81 cycles [median (range)- 3 (1–8)] in 5 cohorts, with D and C 18/ 1250 mg/m ² (n = 3), 27/ 1250 mg/m ² (n = 7), 27/ 1900 mg/m ² (n = 7), 35/ 1900 mg/m ² (n = 3),and 27/ 2500 mg/m ² (n = 7). Dose-limiting toxicity (DLT) was grade 4 neutropenia in 2 of 3 pts at 35/ 1900 mg/m ² dose. Other common drug-related toxicities were leukopenia, nausea & vomiting (12 pts each, 44.4%), neutropenia, diarrhea and hand-foot syndrome (11 pts each, 40.7%), and fatigue (7 pts, 25.9%). A pt with hepatocellular carcinoma had an unconfirmed partial response at cycle 2 and 10 pts experienced disease stabilization lasting ≥ 12 weeks. The median elimination half-life (t½) of D was 182 hrs for cycle 1 (with C) and 204 hrs for cycle 2 (without C). Median t max values for D with and without C occurred at 2 hours. Median clearance values (CL/F) for D in plasma were similar with and without C at 18.4 L/h/m ² and 19.8 L/h/m ² , respectively. Conclusions: The combination of D and C is feasible and safe at the MTD of 27 mg/m ² and 2500 mg/m ² , respectively. Co-administering C with D did not alter the PK of either drug. Preliminary evidence of antitumor activity suggests that further studies of this combination are warranted. [Table: see text]


Figure 2. Western blot determination of Bcl-2 expresssion pretreatment and day 6 and 8 after treatment with oblimersen. Day 10 sample is not evaluable as the actin is not detectable. Bcl-2 protein level as detected by western blot decreased after treatment with oblimersen compared with baseline. 
Table 2 . Dose escalation scheme
Table 3 . Hematologic toxicities of oblimersen and irinotecan
A phase I, pharmacokinetic and biologic correlative study of oblimersen sodium (GenasenseTM, G3139) and irinotecan in patients with metastatic colorectal cancer

March 2006

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62 Reads

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55 Citations

Annals of Oncology

To assess the feasibility and antitumor activity of oblimersen sodium, an antisense oligonucleotide directed to the Bcl-2 mRNA, combined with irinotecan in patients with advanced colorectal carcinoma, characterize the pharmacokinetic behavior of both oblimersen sodium and irinotecan, and examine Bcl-2 protein inhibition in peripheral blood mononuclear cells (PBMC). Patients were treated with escalating doses of oblimersen sodium administered by continuous intravenous infusion (CIVI) days 1-8, and irinotecan administered intravenously on day 6 once every 3 weeks. Twenty patients received a total of 84 courses at doses ranging from 3 to 7 mg/kg/day for oblimersen sodium and from 280 to 350 mg/m2 for irinotecan. Febrile neutropenia and diarrhea limited escalation of oblimersen sodium and irinotecan to 5 mg/kg/day and 350 mg/m2, respectively. Other toxicities included nausea, vomiting, fever and fatigue. Steady-state plasma concentrations were achieved within 48 h of beginning oblimersen sodium treatment and the agent was undetectable 24 h after the discontinuation of the infusion. Reduction in levels of Bcl-2 protein in PBMC was documented following treatment with oblimersen sodium. One patient experienced a partial response and 10 additional patients had stable disease lasting 2.5-10 months. The combination is well tolerated at the recommended phase II oblimersen sodium dose of 7 mg/kg/day CIVI days 1-8 with irinotecan 280 mg/m2 intravenously on day 6 every 3 weeks.









Citations (21)


... No responses were seen in seven patients with advanced CRC enrolled in a Phase I trial of lapatinib in combination with capecitabine. 52 Phase I studies conducted in patients with advanced solid malignancies revealed no dose-limiting toxicities when lapatinib was combined with FOLFOX4, but dose-limiting toxicities of diarrhea and myelosuppression were seen when lapatinib was combined with FOLFIRI. ...

Reference:

EGFR-Targeted Therapies in Colorectal Cancer
Phase I clinical, biology & pharmacokinetic study of the combination of GW 572016 and capecitabine in patients with advanced solid tumors
  • Citing Article
  • July 2004

Journal of Clinical Oncology

... 11,12 Data in the neoadjuvant setting suggest that lapatinib may inhibit the self-renewal of HER2-overexpressing breast cancer stem cells, rendering them more sensitive to cytotoxic chemotherapy. 13 Based on positive efficacy and safety data from singleagent phase I and II clinical studies, [14][15][16][17] a randomized, double-blind, comparative trial of lapatinib plus capecitabine versus capecitabine alone was initiated in patients with HER2-positive, trastuzumab-resistant MBC. 18 As this trial (EGF100151) formed the basis for global regulatory approvals of lapatinib, it is pertinent to consider key inclusion and exclusion criteria. ...

Phase I clinical, biology & pharmacokinetic study of the combination of GW 572016 and capecitabine in patients with advanced solid tumors
  • Citing Article
  • July 2004

Journal of Clinical Oncology

... There are several alternatives to PEG-conjugated anticancer agents. Paclitaxel poliglumex (PPX, Xyotax, Cell Therapeutics, Seattle, WA), a macromolecular drug conjugate that links paclitaxel with a biodegradable polymer, poly-L-glutamic acid, has completed phase I studies [99]. PPX is a water-soluble formulation that also eliminates the need for polyethoxylated castor oil in the formulation. ...

Phase I evaluation of paclitaxel poliglumex (PPX) administered weekly for patients with advanced cancer
  • Citing Article
  • June 2005

Journal of Clinical Oncology

... The combination was well tolerated. Intriguingly, responses were seen in patients with taxane and trastuzumab refractory breast cancer, indicating that EGFR inhibition may overcome resistance to trastuzumab therapy (41). ...

Phase I and pharmacokinetics (PK) of combined erbB1 and erbB2 blockade with OSI-774 (erlotinib; E) and trastuzumab (T) in combination with weekly paclitaxel (P) in patients (pts) with advanced solid tumors
  • Citing Article
  • June 2005

Journal of Clinical Oncology

... Tasidotin (ILX-651), an orally active synthetic microtubule-targeted derivative of the marine depsipeptide dolastatin-15, is currently undergoing clinical evaluation for cancer treatment. Phase-I trials with ILX651, in patients with advanced solid tumors, indicated that the compound is well tolerated and no cardiotoxicities were observed, as observed with the compound LU-103793 (Mita et al., 2006). Tasidotin has completed three rounds of clinical tests II in patients with hormone refractory prostate cancer and advanced or metastatic non-small-lung carcinoma (Tan, 2010). ...

A pilot, pharmacokinetic (PK), and pharmacodynamic (PD) study to determine the feasibility of intrapatient dose escalation to tolerable rash and the activity of maximal doses of erlotinib (E) in previously treated patients with advanced non-small cell lung cancer (NSCLC)
  • Citing Article
  • June 2005

Journal of Clinical Oncology

... Dovepress Dovepress therapy, and in a Phase I study in combination with an anti-HER-2/neu-targeted agent trastuzumab. 89 In 2003, Johnston et al published the results of a single-agent tipifarnib study that compared two cohorts of advanced BC patients treated with either continuous dosing (CD, n = 41) of tipifarnib 400 or 300 mg BID or intermittent dosing (ID, n = 35) of 300 mg BID for 21 days every 4 weeks. 57 In the CD cohort, 10% had a partial response and 15% had stable disease at or beyond 24 weeks, whereas in the ID cohort, 14% had a partial response and 9% had stable disease. ...

A phase I, pharmacokinetic, and biologic correlative study of R115777 and trastuzumab (herceptin) in patients with advanced cancer
  • Citing Article
  • January 2001

... Several phase I studies evaluated different infusion schedules of trabectedin in solid tumors, yielding objective antitumor response in heavily pretreated patients affected by bone sarcoma, melanoma, mesothelioma, and breast and ovarian cancer [24][25][26][27]. The recommended phase II doses were 1.5 mg/m 2 as a 24-h continuous infusion every 3 weeks and 0.58 mg/m 2 as a 3-h infusion weekly for 3 out of 4 weeks [24,26]. ...

Phase I and pharmacokinetic study of the marine-derived DNA minor groove binder ET-743 on a weekly x3 every-4-week schedule in patients with advanced solid malignancies.
  • Citing Article
  • November 2001

Clinical Cancer Research

... Panitumumab gained FDAapproval in 2006 for the treatment of patients with EGFR expressing metastatic colorectal carcinoma with disease progression while on or following fluoropyrimidine-, oxaliplatin-, or irinotecan-containing chemotherapy regimens [22]. Panitumumab has been well tolerated in clinical trials and as a result, close observation of patients has not been required nor has pre-medication with antihistamines [23]. The intact antibody has been shown to be successfully radiolabeled with 111 In in high yields and has demonstrated excellent tumor targeting with low normal tissue uptake [24,25]. ...

ABX-EGF, a fully human anti-epidermal growth factor receptor (EGFr) monoclonal antibody: phase II clinical trial in renal cell cancer (RCC)
  • Citing Conference Paper
  • November 2002

European Journal of Cancer

... Recently, the results of the BR.21 Phase III study showed a significant 42.5% improvement in median survival compared to placebo in patients with advanced NSCLC [16] and the US Food and Drug Administration (FDA) has approved erlotinib for this indication in November 2004. Moreover, phase I clinical trials of erlotinib plus paclitaxel-carboplatin [17], or gemcitabine-cisplatin [18], or docetaxel [19] have been undertaken. Concomitant pharmacokinetic studies [18,19] revealed that no interactions occurred between the tested cytostatics and erlotinib, thus facilitating combination treatments with full doses of cytostatics. ...

Phase I, pharmacokinetic (PK) and biologic study of OSI-774, a selective epidermal growth factor receptor (EGFR) tyrosine kinase (TK) inhibitor in combination with paclitaxel and carboplatin in patients with advanced solid malignancies
  • Citing Conference Paper
  • November 2002

European Journal of Cancer

... Several drugs targeting metalloproteinases (MMPs) have been developed to control CSC invasion and metastasis (Roma-Rodrigues et al. 2019). For instance, incyclinide, also known as CMT-3 or COL-3, is an MMP inhibitor that went through several clinical trial investigations for advanced carcinomas (NCT00004147, NCT00003721, NCT00001683, and NCT00020683) (Fingleton 2003;Gu et al. 2005;Chu et al. 2007). Other MMP inhibitors include JNJ0966, with a high selectivity toward MMP-9 (Scannevin et al. 2017), and the antibody Fab 3,369 that targets MMP-14 (Ling et al. 2017). ...

140 A two-stage phase II study of the matrix metalloproteinase inhibitor (MMPI) Col3 in patients with advanced soft tissue sarcoma (ASTS) — report of stage I data
  • Citing Article
  • September 2004

European Journal of Cancer Supplements