OSI-7836用于晚期难治性实体瘤患者的I期人体首次研究:IND.147,加拿大国家癌症研究所临床试验组新药研究计划的一项研究

A phase I, first in man study of OSI-7836 in patients with advanced refractory solid tumors: IND.147, a study of the Investigational New Drug Program of the National Cancer Institute of Canada Clinical Trials Group.

作者信息

Goss G, Siu L L, Gauthier I, Chen E X, Oza A M, Goel R, Maroun J, Powers J, Walsh W, Maclean M, Drolet D W, Rusk J, Seymour L K

机构信息

The Ottawa Hospital Regional Cancer Centre, 501 Smyth Road, Ottawa, ON, Canada, K1H 8L6.

出版信息

Cancer Chemother Pharmacol. 2006 Nov;58(5):703-10. doi: 10.1007/s00280-006-0201-1. Epub 2006 Mar 10.

Abstract

PURPOSE

To determine the maximum tolerated dose (MTD), recommended phase II dose (RP2D), safety, tolerability, toxicity profile, dose-limiting toxicities (DLTs), anti-tumor activity and pharmacokinetics of OSI-7836 given IV on day 1 and day 8 every 3 weeks in patients with advanced incurable cancer.

METHODS

Twenty-seven previously treated patients with advanced or metastatic solid tumors were enrolled in this phase I study conducted by the National Cancer Institute of Canada Clinical Trial Group (NCIC CTG). OSI-7836 was administered IV on day 1 and day 8 every 3 weeks. The dose was initially escalated from 100 to 600 mg/m2 and finally de-escalated to 200 mg/m2 in seven cohorts of patients. Patients were evaluated every other cycle of treatment for radiological response. Pharmacokinetics were performed on day 1 and day 8 of cycle 1 for all patients.

RESULTS

Twenty-six patients were evaluable for toxicity. All patients experienced reversible Grade 3 lymphopenia beginning at cycle 1. The maximal delivered dose was 600 mg/m2. MTD was reached at 400 mg/m2. DLTs included fever, fatigue, rash, herpes simplex infection, nausea and vomiting. The RP2D was 200 mg/m2. No objective responses were seen in 21 evaluable patients. Pharmacokinetics were dose proportional, with a mean half-life of 46.0 min and a clearance of 34 l/(h.m2).

CONCLUSION

OSI-7836 given at 200 mg/m2 on day 1 and day 8 every 3 weekly is associated with manageable toxicity and is recommended for further study. While no objective responses were seen, the significant treatment related lymphopenia suggests that hematologic malignancies may warrant further investigation.

摘要

目的

确定在晚期无法治愈的癌症患者中,每3周于第1天和第8天静脉注射OSI-7836的最大耐受剂量(MTD)、推荐的II期剂量(RP2D)、安全性、耐受性、毒性特征、剂量限制性毒性(DLT)、抗肿瘤活性和药代动力学。

方法

27例先前接受过治疗的晚期或转移性实体瘤患者参加了由加拿大国家癌症研究所临床试验组(NCIC CTG)开展的这项I期研究。OSI-7836每3周于第1天和第8天静脉给药。剂量最初从100mg/m²逐步递增至600mg/m²,最终在7组患者中降至200mg/m²。每两个治疗周期对患者进行放射学反应评估。对所有患者在第1周期的第1天和第8天进行药代动力学研究。

结果

26例患者可进行毒性评估。所有患者从第1周期开始均出现可逆性3级淋巴细胞减少。最大给药剂量为600mg/m²。在400mg/m²时达到MTD。DLT包括发热、疲劳、皮疹、单纯疱疹感染、恶心和呕吐。RP2D为200mg/m²。21例可评估患者中未观察到客观缓解。药代动力学呈剂量比例关系,平均半衰期为46.0分钟,清除率为34l/(h·m²)。

结论

每3周于第1天和第8天给予200mg/m²的OSI-7836毒性可控,推荐进一步研究。虽然未观察到客观缓解,但显著的治疗相关淋巴细胞减少表明血液系统恶性肿瘤可能值得进一步研究。

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