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A Bioluminescent and Fluorescent Orthotopic Syngeneic Murine Model of Androgen-dependent and Castration-resistant Prostate Cancer
Published on: March 6, 2018
Phase II Study of Dovitinib in Patients with Castration-Resistant Prostate Cancer (KCSG-GU11-05)
Yoon Ji Choi1, Hye Sook Kim1, Se Hoon Park2
1Division of Oncology/Hematology, Department of Internal Medicine, Korea University Anam Hospital, Seoul, Korea.
Purpose:
Fibroblast growth factor (FGF) signals are important in carcinogenesis and progression of prostate cancer. Dovitinib is an oral, pan-class inhibitor of vascular endothelial growth factor receptor (VEGFR), platelet-derived growth factor receptor, and fibroblast growth factor receptor (FGFR). We evaluated the efficacy and toxicity of dovitinib in men with metastatic castration resistant prostate cancer (mCRPC).
Materials And Methods:
This study was a single-arm, phase II, open-label, multicenter trial of dovitinib 500 mg/day (5-days-on/2-days-off schedule). The primary endpointwas 16-week progression-free survival (PFS). Secondary endpoints were overall survival (OS), toxicity and prostate-specific antigen (PSA) response rate. Biomarker analyses for VEGFR2, FGF23, and FGFR2 using multiplex enzyme-linked immunosorbent assay was performed.
Results:
Forty-four men were accrued from 11 hospitals. Eighty percent were post-docetaxel. Median PSA was 100 ng/dL, median age was 69, 82% had bone metastases, and 23% had liver metastases. Median cycles of dovitinibwas 2 (range, 0 to 33). Median PFSwas 3.67 months (95% confidence interval [CI], 1.36 to 5.98) and median OS was 13.70 months (95% CI, 0 to 27.41). Chemotherapy-naïve patients had longer PFS (17.90 months; 95% CI, 9.23 to 28.57) compared with docetaxel-treated patients (2.07 months; 95% CI, 1.73 to 2.41; p=0.001) and the patients with high serum VEGFR2 level over median level (7,800 pg/mL) showed longer PFS compared with others (6.03 months [95% CI, 4.26 to 7.80] vs. 1.97 months [95% CI, 1.79 to 2.15], p=0.023). Grade 3 related adverse events were seen in 40.9% of patients. Grade 1-2 nausea, diarrhea, fatigue, anorexia, and all grade thrombocytopenia are common.
Conclusion:
Dovitinib showed modest antitumor activity with manageable toxicities in men with mCRPC. Especially, patients who were chemo-naïve benefitted from dovitinib.
Insights
Dovitinib demonstrated modest efficacy in men with metastatic castration-resistant prostate cancer (mCRPC). Chemotherapy-naïve patients and those with high VEGFR2 levels showed improved progression-free survival (PFS).
Area of Science:
- Oncology
- Pharmacology
Background:
- Fibroblast growth factor (FGF) signaling pathways are implicated in prostate cancer development and progression.
- Dovitinib is an oral inhibitor targeting VEGFR, PDGFR, and FGFR, relevant to cancer signaling.
Purpose of the Study:
- To evaluate the efficacy and toxicity of dovitinib in patients with metastatic castration-resistant prostate cancer (mCRPC).
Main Methods:
- A single-arm, phase II, open-label, multicenter trial involving 44 men with mCRPC.
- Primary endpoint: 16-week progression-free survival (PFS). Secondary endpoints: overall survival (OS), toxicity, and prostate-specific antigen (PSA) response.
- Biomarker analyses included VEGFR2, FGF23, and FGFR2 levels.
Main Results:
- Median PFS was 3.67 months and median OS was 13.70 months.
- Chemotherapy-naïve patients experienced significantly longer PFS (17.90 months) compared to docetaxel-treated patients (2.07 months; p=0.001).
- Patients with high serum VEGFR2 levels (>median) had longer PFS (6.03 months) than others (1.97 months; p=0.023).
- Common toxicities included nausea, diarrhea, fatigue, anorexia, and thrombocytopenia. Grade 3 adverse events occurred in 40.9% of patients.
Conclusions:
- Dovitinib exhibits modest antitumor activity and manageable toxicity in men with mCRPC.
- Chemotherapy-naïve patients represent a subgroup that may particularly benefit from dovitinib treatment.
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