title: A phase II trial of Salirasib in patients with lung adenocarcinomas with KRAS mutations.
abstract: BACKGROUND
  KRAS mutations are present in 30% of lung adenocarcinomas. Salirasib prevents Ras membrane binding thereby blocking the function of all Ras isoforms. This phase II study determined the activity of salirasib in patients with advanced lung adenocarcinomas with KRAS mutations.
  
  
  METHODS
  Two cohorts of patients with stage IIIB/IV lung adenocarcinoma were eligible: patients with tumors with KRAS mutations who were previously treated with chemotherapy and patients receiving initial therapy who had ≥15 pack-year smoking history. Salirasib was given orally from days 1 to 28 of a 35-day cycle. The primary end point was the rate of nonprogression at 10 weeks.
  
  
  RESULTS
  Thirty-three patients were enrolled. Thirty patients had KRAS mutations (23 patients who were previously treated and 7/10 patients who had no prior therapy). Of the previously treated patients, 7 of 23 (30%) had stable disease at 10 weeks, and 4 of 10 (40%) previously untreated patients had stable disease at 10 weeks. No patient had a radiographic partial response (0% observed rate, 95% confidence interval 0-12%). The median overall survival was not reached (>9 months) for previously untreated patients and it was 15 months for patients who received prior chemotherapy. Diarrhea, nausea, and fatigue were the most common toxicities.
  
  
  CONCLUSIONS
  Salirasib at the current dose and schedule has insufficient activity in the treatment of KRAS mutant lung adenocarcinoma to warrant further evaluation. The successful enrollment of 30 patients with tumors with KRAS mutant lung adenocarcinoma over 15 months at a single site demonstrates that drug trials directed at a KRAS-specific genotype in lung cancer are feasible.
authors.affiliation: Thoracic Oncology Service, Division of Solid Tumor Oncology, Department of Medicine, Memorial Sloan-Kettering Cancer Center, Weill Cornell Medical College, New York City, New York, USA. rielyg@mskcc.org
authors.forename: Gregory J
authors.initials: GJ
authors.lastname: Riely
authors.forename: Melissa L
authors.initials: ML
authors.lastname: Johnson
authors.forename: Chanoa
authors.initials: C
authors.lastname: Medina
authors.forename: Naiyer A
authors.initials: NA
authors.lastname: Rizvi
authors.forename: Vincent A
authors.initials: VA
authors.lastname: Miller
authors.forename: Mark G
authors.initials: MG
authors.lastname: Kris
authors.forename: M Catherine
authors.initials: MC
authors.lastname: Pietanza
authors.forename: Christopher G
authors.initials: CG
authors.lastname: Azzoli
authors.forename: Lee M
authors.initials: LM
authors.lastname: Krug
authors.forename: William
authors.initials: W
authors.lastname: Pao
authors.forename: Michelle S
authors.initials: MS
authors.lastname: Ginsberg
mesh_terms: D000230:Adenocarcinoma / Q000188:drug therapy* / Q000235:genetics / Q000473:pathology; D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy* / Q000235:genetics / Q000473:pathology; D004273:DNA, Neoplasm / Q000235:genetics; D005204:Farnesol / Q000031:analogs & derivatives* / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000235:genetics / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009154:Mutation / Q000235:genetics*; D009367:Neoplasm Staging; D016133:Polymerase Chain Reaction; D011518:Proto-Oncogene Proteins / Q000235:genetics*; D016283:Proto-Oncogene Proteins p21(ras); D012459:Salicylates / Q000627:therapeutic use*; D015996:Survival Rate; D016896:Treatment Outcome; D018631:ras Proteins / Q000235:genetics*
chemical_list: D000970:Antineoplastic Agents; D004273:DNA, Neoplasm; C117307:KRAS protein, human; D011518:Proto-Oncogene Proteins; D012459:Salicylates; C093323:farnesylthiosalicylic acid; D005204:Farnesol; D016283:Proto-Oncogene Proteins p21(ras); D018631:ras Proteins