A mixed-methods feasibility trial of protein kinase C iota inhibition with auranofin in asymptomatic ovarian cancer patients

Oncology. 2015;88(4):208-13. doi: 10.1159/000369257. Epub 2014 Dec 6.

Abstract

Purpose: This trial was undertaken (1) to determine the feasibility of enrolling asymptomatic ovarian cancer patients with CA-125 elevation in a trial with the protein kinase C iota (PKCι) inhibitor auranofin and (2) to understand patients' perceptions of CA-125 monitoring.

Methods: Asymptomatic ovarian cancer patients with CA-125 elevation received 3 mg auranofin orally twice per day and were evaluated. The patients participated in interviews about CA-125 monitoring.

Results: Ten patients were enrolled in slightly over 6 months, exceeding our anticipated accrual rate. Four manifested stable CA-125 levels for 1 month or longer. The median progression-free survival was 2.8 months (95% CI: 1.3-3.8); auranofin was well tolerated. One patient had baseline and monthly CA-125 levels of 5,570, 6,085, 3,511, and 2,230 U/ml, respectively, stopped auranofin because of radiographic progression at 3 months, and manifested an increase in CA-125 to 7,168 U/ml approximately 3 months later. Patient interviews revealed (1) the important role of CA-125 in cancer monitoring, (2) ardent advocacy of CA-125 testing, and (3) an evolution toward CA-125 assuming a life of its own.

Conclusions: This study showed the feasibility of enrolling asymptomatic ovarian cancer patients with CA-125 elevation in a trial with auranofin. One patient had a decline in CA-125, suggesting that PKCι inhibition merits further study in ovarian cancer.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Administration, Oral
  • Aged
  • Aged, 80 and over
  • Antirheumatic Agents / therapeutic use*
  • Auranofin / therapeutic use*
  • Biomarkers, Tumor / metabolism
  • CA-125 Antigen / metabolism
  • Drug Administration Schedule
  • Feasibility Studies
  • Female
  • Follow-Up Studies
  • Humans
  • Isoenzymes / antagonists & inhibitors*
  • Middle Aged
  • Neoplasm Staging
  • Ovarian Neoplasms / drug therapy*
  • Ovarian Neoplasms / enzymology
  • Ovarian Neoplasms / pathology
  • Pilot Projects
  • Prognosis
  • Protein Kinase C / antagonists & inhibitors*
  • Survival Rate

Substances

  • Antirheumatic Agents
  • Biomarkers, Tumor
  • CA-125 Antigen
  • Isoenzymes
  • Auranofin
  • Protein Kinase C
  • protein kinase C lambda