title: NABTT 0502: a phase II and pharmacokinetic study of erlotinib and sorafenib for patients with progressive or recurrent glioblastoma multiforme.
abstract: BACKGROUND
  The signal transduction pathways of epidermal growth factor receptor and Ras are both important in the growth of glioblastoma multiforme (GBM). We hypothesized that inhibition of both pathways would improve the survival time of patients with recurrent GBM.
  
  
  METHODS
  Patients with recurrent/progressive GBM with 0-2 prior chemotherapy regimens received erlotinib 150 mg once daily and sorafenib 400 mg twice daily until progression. The primary endpoint was overall survival. Pharmacokinetic sampling was performed during cycle 1.
  
  
  RESULTS
  The median overall survival was 5.7 months. Progression-free survival at 6 months was 14%. Toxicity was manageable. Clearance of erlotinib was markedly enhanced by sorafenib.
  
  
  CONCLUSIONS
  The study did not meet its objective of a 30% increase in overall survival time compared with historical controls. Erlotinib and sorafenib have significant pharmacokinetic interactions that may negatively impact the efficacy of the combination regimen.
authors: Cleveland Clinic, 9500 Euclid Ave, Cleveland, OH 44195, USA. peerebd@ccf.org
authors: David M
authors: DM
authors: Peereboom
authors: Manmeet S
authors: MS
authors: Ahluwalia
authors: Xiaobu
authors: X
authors: Ye
authors: Jeffrey G
authors: JG
authors: Supko
authors: Sarah L
authors: SL
authors: Hilderbrand
authors: Surasak
authors: S
authors: Phuphanich
authors: L Burt
authors: LB
authors: Nabors
authors: Myrna R
authors: MR
authors: Rosenfeld
authors: Tom
authors: T
authors: Mikkelsen
authors: Stuart A
authors: SA
authors: Grossman
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000493:pharmacokinetics* / Q000627:therapeutic use*; D001932:Brain Neoplasms / Q000401:mortality* / Q000473:pathology / Q000628:therapy; D018450:Disease Progression; D000069347:Erlotinib Hydrochloride; D005260:Female; D005500:Follow-Up Studies; D005909:Glioblastoma / Q000401:mortality* / Q000473:pathology / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy*; D009367:Neoplasm Staging; D009536:Niacinamide / Q000008:administration & dosage / Q000031:analogs & derivatives; D010671:Phenylurea Compounds / Q000008:administration & dosage; D011379:Prognosis; D011799:Quinazolines / Q000008:administration & dosage; D000077157:Sorafenib; D015996:Survival Rate; D014018:Tissue Distribution
chemical_list: D010671:Phenylurea Compounds; D011799:Quinazolines; D009536:Niacinamide; D000077157:Sorafenib; D000069347:Erlotinib Hydrochloride