Nilotinib in steroid-refractory cGVHD: prospective parallel evaluation of response, according to NIH criteria and exploratory response criteria (GITMO criteria): Bone Marrow Transplantation

A. Olivieri, G. Mancini, J. Olivieri, E. Marinelli Busilacchi, M. Cimminiello, S.P. Pascale, R. Nuccorini, F. Patriarca, P. Corradini, A. Bacigalupo, S. Angelini, A. Poloni, G. Grillo, F. Onida, M. Martino, N. Di Renzo, A. Nagler, N. Mordini, B. Bruno, F. CiceriF. Bonifazi

Research output: Contribution to journalArticlepeer-review

Abstract

We conducted a phase I–II study to evaluate Nilotinib (NIL) safety and pharmacokinetics in 22 SR-cGVHD patients; we also evaluated ORR by using in parallel NIH criteria and an exploratory approach, combining objective improvement (OI) without failure criteria (GITMO criteria). Results: 22 patients were enrolled. After dose escalation up to 600 mg/day, MTD was not reached. Main toxicities were asthenia, headache, nausea, pruritus, cramps, and mild anemia. Mean and median plasma concentrations of NIL (C-NIL) were 817 (SD ± 450) and 773 ng/ml. ORR at 6 months, according to 2005 and 2014 NIH and GITMO criteria were 27.8%, 22.2%, and 55.6% respectively; close correspondence has been observed for ORR, according to 2014 NIH criteria, both assessed in a conventional way and assisted by dedicated software (CROSY). At 48 months OS was 75% while FFS, according to NIH and GITMO criteria, was 30 and 25%. In conclusion the safety profile of NIL and long-term outcome makes NIL an attractive option in SR-cGVHD. Exploratory GITMO criteria could represent an alternative tool for easy response evaluation in patients with prevalent skin and lung involvement, but require validation in a larger population; CROSY software showed excellent reliability in capturing ORR according to the 2014 NIH criteria. © 2020, The Author(s), under exclusive licence to Springer Nature Limited.
Original languageEnglish
Pages (from-to)2077-2086
Number of pages10
JournalBone Marrow Transplant.
Volume55
Issue number11
DOIs
Publication statusPublished - 2020

Keywords

  • cyclosporine
  • mycophenolate mofetil
  • nilotinib
  • prednisone
  • steroid
  • tacrolimus
  • adult
  • aged
  • anemia
  • Article
  • asthenia
  • bronchopneumonia
  • chronic graft versus host disease
  • clinical article
  • clinical effectiveness
  • disease classification
  • drug blood level
  • drug dose comparison
  • drug megadose
  • drug safety
  • exploratory research
  • failure free survival
  • female
  • headache
  • human
  • human cell
  • low drug dose
  • male
  • maximum tolerated dose
  • muscle cramp
  • nausea
  • parallel design
  • pharmacokinetic parameters
  • phase 1 clinical trial
  • phase 2 clinical trial
  • photopheresis
  • pneumococcal meningitis
  • pneumonia
  • priority journal
  • progression free survival
  • prospective study
  • pruritus
  • tonsillitis
  • treatment duration
  • treatment outcome
  • treatment response
  • validation study

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