Up to 50% of patients with
uveal melanoma (UM) develop metastatic disease, for which there is no effective systemic treatment. This study aimed to evaluate the safety and efficacy of the orally available
protein kinase C inhibitor,
AEB071, in patients with metastatic UM, and to perform genomic profiling of metastatic
tumor samples, with the aim to propose combination
therapies. Patients with metastatic UM (n = 153) were treated with
AEB071 in a phase I, single-arm study. Patients received total daily doses of
AEB071 ranging from 450 to 1,400 mg. First-cycle dose-limiting toxicities were observed in 13 patients (13%). These were most commonly gastrointestinal system toxicities and were dose related, occurring at doses ≥700 mg/day. Preliminary clinical activity was observed, with 3% of patients achieving a partial response and 50% with stable disease (median duration 15 weeks). High-depth, targeted next-generation
DNA sequencing was performed on 89 metastatic
tumor biopsy samples. Mutations previously identified in UM were observed, including mutations in GNAQ, GNA11, BAP1, SF3B1, PLCB4, and amplification of chromosome arm 8q. GNAQ/GNA11 mutations were observed at a similar frequency (93%) as previously reported, confirming a therapeutic window for inhibition of the downstream effector PKC in metastatic UM.In conclusion, the
protein kinase C inhibitor
AEB071 was well tolerated, and modest clinical activity was observed in metastatic UM. The genomic findings were consistent with previous reports in primary UM. Together, our data allow envisaging combination
therapies of
protein kinase C inhibitors with other compounds in metastatic UM.