Table 1 Selected experimental therapies currently in clinical development with putative molecular predictive biomarkers
Class of targeted | Putative predictive | Drug examples and clinical phase |
|---|---|---|
therapy | molecular marker | Â |
pan-PI3K inhibitor | PIK3CA mutation | BKM-120: phase I results published PMID 22162589. |
PIK3CA amplification | Phase II ongoing in triple-negative breast cancer (TNBC) (NCT01629615) and ongoing phase III in HER2− MBC (NCT01610284) | |
PTEN deficiency | ||
PIK3R1 mutation | GDC-0941: phase II trial combined with paclitaxel in MBC (NCT01740336) and a phase II trial combined with fulvestrant (NCT01437566) | |
INPP4B mutation | ||
XL147: two completed phase I trials in breast cancer – combined with Letrozole (NCT01082068) and combined with trastuzumab +/– paclitaxel (NCT01042925) | ||
α-isoform PI3K inhibitor | PIK3CA mutation | BYL719: preliminary data presented at American Association for Cancer Research, 2012 Cancer Res: Abstract CT-01 [13]. Currently in phase IB/II testing in combination with ganitumab in solid tumors (NCT01708161). Combined in phase I trial with letrozole (NCT01791478) and as a single agent in PIK3CA altered tumors (NCT01219699) |
PIK3CA amplification | ||
GDC-0032: a beta isoform-sparing PI3K inhibitor. Results of a first-in-human phase Ia dose escalation study presented at American Association for Cancer Research, 2013 LB-64 | ||
α-isoform specific PI3K inhibitor | PTEN deficiency | GSK2636771: currently in phase I/IIA testing in solid tumors (NCT01458067) |
AKT inhibitor | PIK3CA mutation | MK2206: ongoing phase I study combined with multiple AIs (NCT01344031) |
PIK3CA amplification | ||
PTEN deficiency | GDC-0068: phase Ib study (NCT01562275), phase Ib with docetaxel, paclitaxel, or modified FOLFOX (NCT01362374) | |
AKT1 mutation | ||
AKT1 amplification | AZD5363: phase I combined with paclitaxel in breast cancer (NCT01625286) | |
mTOR inhibitor | PIK3CA mutation | Everolimus: completed phase III study combined with exemestane in hormone receptor-positive MBC [23]. BOLERO-3 is an ongoing phase III trial combining everolimus with vinorelbine and trastuzumab (NCT01007942) |
PIK3CA amplification | ||
PTEN deficiency | ||
AKT1 mutation | ||
AKT1 amplification | ||
INPP4B mutation | ||
FGFR3 mutation | ||
FGFR inhibitor | FGFR1 amplification | BGJ398: preclinical studies demonstrated FGFR1 amplification predicts for response to BGJ398 PMID: 23002168. Ongoing phase I in solid tumors with amplification of FGFR1/2 and FGFR3 mutation (NCT01004224) |
FGFR2 amplification | ||
Dual FGFR and VEGF inhibitor | FGFR1 amplification | Lucitanib (E-3810): phase I results presented at European Society for Clinical Oncology 2012 Annual Meeting [14] |
FGF3/FGF4 amplification | ||
PARP inhibitor | BRCA1 mutation | Olaparib: completed phase II trial in TNBC PMID: 21862407 |
BRCA2 mutation | Veliparib: phase I/II combined with cyclophosphamide (NCT01351909), multiple phase I studies in combination with chemotherapy | |
BRAF inhibitor | BRAF mutation | Vemurafenib: approved in melanoma |
MEK inhibitor | KRAS mutation | Trametinib: completed phase III trial in BRAF mutant melanoma PMID: 22663011 |
BRAF mutation | ||
NRAS mutation | ||
HRAS mutation | ||
CMET inhibitor | CMET amplification | Tivantinib: completed phase II trial and currently in phase III trial MARQUEE in NSCLC |
EGFR inhibitor | EGFR mutation | Gefitinib: approved in NSCLC |
HER2 inhibitor | HER2 mutation/amplification | Trastuzumab and lapatinib: phase III study completed in MBC (EGF104900) PMID: 22689807 |
IGF1R inhibitor | IGF1R amplification | Ganitumab (AMG479): negative phase II study with exemestane or fulvestrant [24] |
MDM2 inhibitor | MDM2 amplification | RG7112: preclinical and proof-of-concept studies performed. Completed phase I in solid tumors (NCT00559533) results pending |
P53 wild-type | ||
CDK inhibitor | CDK4 mutation | PD 0332991: completed phase I study in retinoblastoma-positive tumors PMID: 22090362 and a phase III study in combination with letrozole in ER+HER2- MBC that is yet to open (NCT01740427) |
CDKN2A absent or low expression levels | ||
Cyclin D1 expression | ||
Gamma secretase inhibitor | NOTCH1 amplification | MK-0752: completed phase I study in solid tumors PMID: 22547604 and MBC (NCT00106145) with results pending. |
MAST/NOTCH family rearrangements | ||
BMS-906024: single-agent phase I study (NCT01292655) and phase I combined with chemotherapies (NCT01653470) | ||
WNT inhibitor | CTNNB1 mutation | Small molecules, blocking antibodies, and peptides in preclinical development |