Esaki Taito, Seto Takashi, Ariyama Hiroshi, Arita Shuji, Fujimoto Chinatsu, Tsukasa Koichiro, Kometani Takuro, Nosaki Kaname, Hirai Fumihiko, Yagawa Katsuro
Arch Drug Inf. 2011 Jun;4(2):23-31. doi: 10.1111/j.1753-5174.2011.00034.x.
AZD4877 is a potent Eg5 inhibitor that has been shown to have an acceptable tolerability profile in a Phase I study of Western patients with solid tumors. This study was conducted to evaluate the safety, pharmacokinetic (PK) profile, maximum tolerated dose (MTD) and efficacy of AZD4877 in a Japanese population with solid tumors. METHODS: In this Phase I, open-label, dose-escalation study, AZD4877 (10, 15, 20 or 25 mg) was administered as a 1-hour intravenous infusion on days 1, 8 and 15 of repeated 28-day cycles to Japanese patients with advanced solid tumors. Adverse events (AEs) were evaluated according to Common Terminology Criteria for Adverse Events (CTCAE) version 3.0. PK variables were assessed pre- and post dosing. The MTD of AZD4877 was determined by evaluating dose-limiting toxicities (DLTs). Efficacy was evaluated by assessing best response according to Response Evaluation Criteria In Solid Tumors version 1.0. RESULTS: Of the 21 patients enrolled, 18 received at least one dose of AZD4877 (N = 3 in both the 10 and 15 mg cohorts, N = 6 in both the 20 and 25 mg cohorts). The most commonly reported AEs were fatigue and nausea (39% of patients each). One patient in each of the 20 and 25 mg cohorts experienced a DLT (neutropenia and febrile neutropenia). Dose escalation was halted at 25 mg and the MTD was not defined in this population. CTCAE grade ≥3 abnormal laboratory findings/vital signs were reported in 12 patients, with neutropenia (56%) and leukopenia (44%) being the most commonly reported. Exposure to AZD4877 was not fully dose proportional and AZD4877 clearance and elimination half-life appeared independent of dose. The best response to AZD4877 was stable disease in five of 16 evaluable patients. CONCLUSION: AZD4877 up to doses of 25 mg was well tolerated in Japanese patients. There was little evidence of clinical efficacy.
AZD4877是一种强效的Eg5抑制剂,在一项针对西方实体瘤患者的I期研究中已显示出可接受的耐受性。本研究旨在评估AZD4877在日本实体瘤患者中的安全性、药代动力学(PK)特征、最大耐受剂量(MTD)和疗效。方法:在这项I期开放标签剂量递增研究中,AZD4877(10、15、20或25mg)在重复28天周期的第1、8和15天作为1小时静脉输注给予日本晚期实体瘤患者。根据不良事件通用术语标准(CTCAE)第3.0版评估不良事件(AE)。在给药前和给药后评估PK变量。通过评估剂量限制毒性(DLT)确定AZD4877的MTD。根据实体瘤疗效评价标准第1.0版评估最佳反应来评估疗效。结果:在入组的21名患者中,18名接受了至少一剂AZD4877(10mg和15mg队列各3名,20mg和25mg队列各6名)。最常报告的AE是疲劳和恶心(各占患者的39%)。20mg和25mg队列各有一名患者发生DLT(中性粒细胞减少和发热性中性粒细胞减少)。在25mg时停止剂量递增,该人群未确定MTD。12名患者报告了CTCAE≥3级的异常实验室检查结果/生命体征,最常报告的是中性粒细胞减少(56%)和白细胞减少(44%)。AZD4877的暴露量与剂量不完全成比例,且AZD4877的清除率和消除半衰期似乎与剂量无关。16名可评估患者中有5名对AZD4877的最佳反应为疾病稳定。结论:高达25mg剂量的AZD4877在日本患者中耐受性良好。几乎没有临床疗效的证据。