Mross Klaus, Richly Heike, Frost Annette, Scharr Dirk, Nokay Bahar, Graeser Ralph, Lee Chooi, Hilbert James, Goeldner Rainer-George, Fietz Oliver, Scheulen Max E
Department of Medical Oncology, Tumour Biology Center, Breisacherstrasse 117, 79106, Freiburg, Germany.
, Waldhofstrasse 50, 19117, Freiburg, Germany.
Cancer Chemother Pharmacol. 2016 Aug;78(2):405-17. doi: 10.1007/s00280-016-3095-6. Epub 2016 Jun 27.
This phase I study investigated the maximum tolerated dose (MTD), safety, pharmacokinetics, pharmacodynamics, and antitumor activity of the Aurora B kinase inhibitor BI 811283 in patients with advanced solid tumors.
BI 811283 was administered via 24-h infusion on Days 1 and 15 of a 4-week cycle (schedule A) or Day 1 of a 3-week cycle (schedule B) in a modified 3 + 3 dose-escalation design. Pharmacodynamic assessments included immunohistochemistry for phosphorylated histone H3 (pHH3) on skin biopsies to determine Aurora B kinase inhibition and plasma concentrations of caspase-cleaved CK-18 (apoptosis marker).
A total of 121 patients were treated. The MTDs of BI 811283 were 125 mg (schedule A) and 230 mg (schedule B). Dose-limiting toxicities were primarily hematological (febrile neutropenia and grade 4 neutropenia); the most common drug-related adverse effects included neutropenia, fatigue, leukopenia, nausea, alopecia, diarrhea, and decreased appetite. A trend toward a decrease in pHH3 was observed, with increasing BI 811283 doses, indicating target engagement; there was no consistent trend regarding caspase-cleaved CK-18 levels. No objective response was observed although 19 patients in each schedule achieved clinical benefit (stable disease).
BI 811283 demonstrated a generally manageable safety profile and disease stabilization in some patients.
EudraCT No: 2007-000191-17, ClinicalTrials.gov Identifier: NCT00701324.
本I期研究调查了Aurora B激酶抑制剂BI 811283在晚期实体瘤患者中的最大耐受剂量(MTD)、安全性、药代动力学、药效学及抗肿瘤活性。
采用改良的3+3剂量递增设计,BI 811283在4周周期的第1天和第15天通过24小时输注给药(方案A),或在3周周期的第1天给药(方案B)。药效学评估包括对皮肤活检组织进行磷酸化组蛋白H3(pHH3)免疫组化,以确定Aurora B激酶抑制情况,以及检测血浆中半胱天冬酶裂解的细胞角蛋白18(凋亡标志物)浓度。
共治疗121例患者。BI 811283的MTD在方案A中为125 mg,在方案B中为230 mg。剂量限制性毒性主要为血液学毒性(发热性中性粒细胞减少和4级中性粒细胞减少);最常见的药物相关不良反应包括中性粒细胞减少、疲劳、白细胞减少、恶心、脱发、腹泻和食欲减退。随着BI 811283剂量增加,观察到pHH3有下降趋势,表明靶点被作用;半胱天冬酶裂解的细胞角蛋白18水平无一致趋势。尽管每个方案中有19例患者获得临床获益(疾病稳定),但未观察到客观缓解。
BI 811283显示出总体可控的安全性,且在部分患者中可使疾病稳定。
欧洲药品管理局临床试验编号:2007-000191-17,美国国立医学图书馆临床试验标识符:NCT00701324。