Metastatic Breast Cancer Clinical Trial
Official title:
LY2157299 Monohydrate (LY2157299) and Radiotherapy in Metastatic Breast Cancer
Patients with metastatic breast cancer receiving at least one single agent chemotherapy and
demonstrating stable disease or disease progression at two consecutive clinical/radiological
assessments (at an interval of at least 2 weeks).
Transforming growth factor-beta (TGFΒ) blockade will enhance response of irradiated tumors
and improve the function of Dendritic and T cells. Patients will receive 300 mg/day of study
drug administered via oral drug tablet every day for 14 days on and 14 days off (=28 day
cycle). Radiation to a metastatic site will be delivered at a dose of 7.5 Gy, given
consecutively on days 1-3-5.
Transforming growth factor-beta (TGFβ) is a pleiotropic cytokine which belongs to a
superfamily of ligands, including bone morphogenetic proteins and activins [1-5]. Under
normal conditions, members of the TGFβ family maintain homeostasis in many organ systems. In
normal and non-cancerous cells, TGFβ limits the growth of epithelial, endothelial, neuronal,
and hematopoietic cell lineages through anti-proliferative and apoptotic responses. In
addition, TGFβ exerts potent effects that influence immune function, cell proliferation/
functional differentiation, cell adhesion, extracellular matrix production, cell motility,
angiogenesis, and cytokine production. TGFβ has been implicated as an important factor in the
growth, progression, and metastatic potential of advanced cancers. Although TGFβ has been
shown to suppress the growth of epithelial cells in the early stages of tumor development
(premalignant conditions), the effect on advanced cancers is more complex [1, 5-6]. Increased
production of TGFβ has been found in many neoplasms such as breast, prostate, gastric, renal,
and epidermal carcinomas, and elevated plasma TGFβ levels in patients have been correlated
with advanced disease, metastases, and lower survival rates [7-13]. In these later stage
cancers, TGFβ induced growth suppression is lost, and instead, TGFβ promotes tumor growth and
metastasis.
Eli Lilly has developed and produced a Transforming Growth Factor-beta (TGF-β) receptor
type-1 kinase inhibitor. LY2157299 monohydrate (LY2157299) is a small molecule that inhibits
the TGF-β receptor type 1 kinase activity. LY2157299 was developed to investigate its
activity in patients with glioblastoma where TGF-β has been demonstrated to play a specific
role in tumor progression. In addition, LY2157299 was investigated in other patient
populations, either as a stand-alone therapy or in combination with standard anti-tumor
treatment regimens for indications including hepatocellular carcinoma and pancreatic cancer.
Future investigations include indications with likely TGF-β associated pathway activation,
such as melanoma, breast and prostate cancer as well as hematologic malignancies.
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