Targeted Cancer Drugs for Cancer

(CAPTUR Trial)

This trial tests targeted therapies, which are cancer drugs designed to attack specific abnormal gene changes in cancer cells. The aim is to observe how these drugs affect both the patient and their cancer. Multiple drugs, including Axitinib, Bosutinib, Crizotinib, Dasatinib, Erlotinib, Nivolumab plus Ipilimumab, Olaparib, Palbociclib, Sunitinib, Temsirolimus, Trastuzumab plus Pertuzumab, Tucatinib, Vemurafenib plus Cobimetinib, and Vismodegib, are tested across different groups, each focusing on specific gene changes. This trial seeks patients with incurable metastatic solid tumors or certain types of lymphoma who lack standard treatment options known to extend life. Participants should be willing to undergo genetic testing to identify actionable gene changes in their tumors. As a Phase 2 trial, this research focuses on measuring the treatment's effectiveness in an initial, smaller group of people.

The trial does not specify if you need to stop taking your current medications. However, you cannot be on any other anti-cancer therapy, except for certain supportive care medications that may have an anti-cancer effect, which must have been started at least one month before joining the study.

Research shows that the treatments in this trial have different safety profiles. Here are some key points:

Axitinib has been studied in several trials and can cause liver issues in about 39% of patients, with serious liver problems in 20% of cases.

Bosutinib is generally well-tolerated in patients with chronic myeloid leukemia, though almost all patients experience some side effects.

Crizotinib is used for certain lung cancers and is linked to a good survival rate, but its safety in very young patients remains unknown.

Dasatinib can cause serious side effects, including high blood pressure in the lungs and other blood-related issues.

Erlotinib is usually well-tolerated for lung cancer, with mild to moderate side effects like rash and diarrhea.

Nivolumab plus Ipilimumab can cause serious immune-related side effects in a small percentage of patients, some of which can be fatal.

Olaparib, used for ovarian cancer, can cause serious reactions like blood disorders in about 31% of patients.

Palbociclib often leads to low white blood cell counts, which is common but manageable.

Sunitinib has been safely used for kidney cancer, though it's not approved for lung cancer.

Temsirolimus is generally well-tolerated, with manageable side effects.

Trastuzumab plus Pertuzumab can cause serious side effects, but these are expected and manageable with proper care.

Tucatinib has shown serious side effects in about 26% of patients, including diarrhea and nausea.

Vemurafenib plus Cobimetinib can lead to a higher rate of serious side effects, but these are similar to other treatments.

Vismodegib is considered safe for advanced skin cancer, though its safety in children is not known.

Researchers are excited about these treatments because they each target specific genetic mutations or pathways in cancer cells, offering a more personalized approach than many current options. Unlike traditional chemotherapy, which can affect both healthy and cancerous cells, these drugs, such as Nivolumab plus Ipilimumab, focus on boosting the immune system to recognize and attack cancer cells. Other treatments like Olaparib and Palbociclib target specific proteins or enzymes involved in cancer cell growth and repair, which may lead to better outcomes with fewer side effects. This tailored approach allows for more precise interventions, potentially improving effectiveness and reducing harm to healthy cells.

Research shows that each treatment in this trial can target specific genetic changes in certain cancers. For instance, crizotinib, one of the treatments under study, has proven effective for patients with advanced non-small cell lung cancer, particularly those with ALK-positive mutations, showing a high response rate. Studies have shown that dasatinib significantly improves survival rates in patients with chronic myeloid leukemia. The combination of nivolumab and ipilimumab, also part of this trial, has demonstrated long-term survival benefits in cancers like melanoma. Vemurafenib with cobimetinib has helped patients with BRAF mutation-positive melanoma live longer without cancer progression. Lastly, vismodegib has shown good results in treating basal cell carcinoma by targeting the Hedgehog signaling pathway, which is involved in tumor growth. Each of these drugs targets specific genetic changes, offering a more precise treatment approach for cancer patients.³⁶⁷⁸⁹