Phase III study of matrix metalloproteinase inhibitor prinomastat in non-small-cell lung cancer

Bissett, Donald, O'Byrne, Kenneth J., Von Pawel, J., Gatzemeier, Ulrich, Price, Alan, Nicolson, Marianne, Mercier, Richard, Mazabel, Elva, Penning, Carol, Zhang, Min H., Collier, Mary A., & Shepherd, Frances A. (2005) Phase III study of matrix metalloproteinase inhibitor prinomastat in non-small-cell lung cancer. Journal of Clinical Oncology, 23(4), pp. 842-849.

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Purpose: Matrix metalloproteinases (MMPs) degrade extracellular proteins and facilitate tumor growth, invasion, metastasis, and angiogenesis. This trial was undertaken to determine the effect of prinomastat, an inhibitor of selected MMPs, on the survival of patients with advanced non-small-cell lung cancer (NSCLC), when given in combination with gemcitabine-cisplatin chemotherapy.

Patients and Methods: Chemotherapy-naive patients were randomly assigned to receive prinomastat 15 mg or placebo twice daily orally continuously, in combination with gemcitabine 1,250 mg/m2 days 1 and 8 plus cisplatin 75 mg/m2 day 1, every 21 days for up to six cycles. The planned sample size was 420 patients.

Results: Study results at an interim analysis and lack of efficacy in another phase III trial prompted early closure of this study. There were 362 patients randomized (181 on prinomastat and 181 on placebo). One hundred thirty-four patients had stage IIIB disease with T4 primary tumor, 193 had stage IV disease, and 34 had recurrent disease (one enrolled patient was ineligible with stage IIIA disease). Overall response rates for the two treatment arms were similar (27% for prinomastat v 26% for placebo; P = .81). There was no difference in overall survival or time to progression; for prinomastat versus placebo patients, the median overall survival times were 11.5 versus 10.8 months (P = .82), 1-year survival rates were 43% v 38% (P = .45), and progression-free survival times were 6.1 v 5.5 months (P = .11), respectively. The toxicities of prinomastat were arthralgia, stiffness, and joint swelling. Treatment interruption was required in 38% of prinomastat patients and 12% of placebo patients.

Conclusion: Prinomastat does not improve the outcome of chemotherapy in advanced NSCLC. © 2005 by American Society of Clinical Oncology.

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ID Code: 64813
Item Type: Journal Article
Refereed: Yes
Additional URLs:
Keywords: cisplatin, gemcitabine, placebo, prinomastat, matrix metalloproteinase, organic compound, proteinase inhibitor, adult, aged, anemia, arthralgia, article, cancer growth, cancer recurrence, cancer staging, cancer survival, clinical trial, combination chemotherapy, continuous infusion, controlled clinical trial, controlled study, drug dose reduction, drug effect, drug efficacy, drug intermittent therapy, drug withdrawal, febrile neutropenia, female, human, joint swelling, lung non small cell cancer, major clinical study, male, multiple cycle treatment, musculoskeletal disease, nausea, neuropathy, neutropenia, priority journal, randomized controlled trial, rigidity, side effect, thrombocytopenia, treatment outcome, vomiting, drug antagonism, lung tumor, middle aged, mortality, phase 3 clinical trial, Aged, 80 and over, Carcinoma, Non-Small-Cell Lung, Humans, Lung Neoplasms, Matrix Metalloproteinases, Organic Chemicals, Protease Inhibitors
DOI: 10.1200/JCO.2005.03.170
ISSN: 0732-183X
Divisions: Current > Schools > School of Biomedical Sciences
Current > QUT Faculties and Divisions > Faculty of Health
Current > Institutes > Institute of Health and Biomedical Innovation
Copyright Owner: Copyright 2005 American Society of Clinical Oncology
Deposited On: 26 Nov 2013 04:07
Last Modified: 10 Jan 2014 05:11

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