Wu Yi-Long, Zhang L I, Trandafir Lucia, Dong Tuochuan, Duval Vincent, Hazell Katharine, Xu Binghe
Guangdong Lung Cancer Institute, Guangdong General Hospital and Guangdong Academy of Medical Sciences, Guangzhou, P.R. China.
Sun Yat-Sen University Cancer Center, Guangzhou, P.R. China.
Anticancer Res. 2016 Nov;36(11):6185-6194. doi: 10.21873/anticanres.11212.
BACKGROUND/AIM: The phosphatidylinositol-3-kinase (PI3K) signaling pathway is frequently activated in cancer. Buparlisib (BKM120), an oral pan-PI3K inhibitor, inhibits proliferation of human cancer in preclinical models. Studies of buparlisib in Western and Japanese adults with advanced solid tumors established a recommended dose of 100 mg/day and showed an acceptable safety profile and evidence of efficacy. This phase I dose-escalation/expansion study aimed to establish the maximum tolerated dose (MTD) of single-agent, once daily oral buparlisib in Chinese patients with advanced solid tumors.
Patients (n=32; primary tumor site: lung (n=15), breast (n=10) or head and neck (n=7); ≥2 prior lines of antineoplastic therapy (n=26)) received 80 mg (n=15) or 100 mg (n=17) daily buparlisib.
Five patients experienced dose-limiting toxicities: grade (G)3 depression (n=1), G2 hyperglycemia (n=3) and G3 hyperglycemia (n=1). Most frequent buparlisib-related adverse events were hyperglycemia (n=18; 56%), alanine aminotransferase (ALT) and aspartate aminotransferase (AST) increase (n=9; 28%), as well as anxiety (n=6; 19%); most common buparlisib-related G3/4 adverse events: hyperglycemia (n=3; 9%), ALT and AST increase (n=2; 6%), as well as gamma-glutamyltransferase increase (n=2; 6%). Best response was stable disease (SD) in 10 patients (31%).
The MTD of buparlisib was declared as 100 mg/day. Safety, efficacy and pharmacokinetic data from this study were similar to those previously reported in Western and Japanese populations.
背景/目的:磷脂酰肌醇-3-激酶(PI3K)信号通路在癌症中常被激活。口服泛PI3K抑制剂布帕利昔(BKM120)在临床前模型中可抑制人类癌症的增殖。对布帕利昔在西方和日本晚期实体瘤成人患者中的研究确定了推荐剂量为100mg/天,并显示出可接受的安全性和疗效证据。这项I期剂量递增/扩展研究旨在确定单药、每日一次口服布帕利昔在中国晚期实体瘤患者中的最大耐受剂量(MTD)。
患者(n=32;原发肿瘤部位:肺(n=15)、乳腺(n=10)或头颈部(n=7);≥2线既往抗肿瘤治疗(n=26))接受每日80mg(n=15)或100mg(n=17)的布帕利昔治疗。
5例患者出现剂量限制性毒性:3级抑郁(n=1)、2级高血糖(n=3)和3级高血糖(n=1)。最常见的与布帕利昔相关的不良事件为高血糖(n=18;56%)、丙氨酸转氨酶(ALT)和天冬氨酸转氨酶(AST)升高(n=9;28%)以及焦虑(n=6;19%);最常见的与布帕利昔相关的3/4级不良事件为高血糖(n=3;9%)、ALT和AST升高(n=2;6%)以及γ-谷氨酰转移酶升高(n=2;6%)。最佳疗效为10例患者(31%)病情稳定(SD)。
布帕利昔的MTD确定为100mg/天。本研究的安全性、疗效和药代动力学数据与先前在西方和日本人群中报告的数据相似。