Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Hospital, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan.
Department of Medical Oncology and Hematology, Oita University Faculty of Medicine, Oita, Japan.
Cancer Chemother Pharmacol. 2019 Feb;83(2):289-299. doi: 10.1007/s00280-018-3725-2. Epub 2018 Nov 16.
BEZ235 is a dual kinase inhibitor of phosphatidylinositol 3-kinase (PI3K) and mammalian target of rapamycin, which are key components of the PI3K pathway. This was an open-label, multicenter, dose-escalation, phase I study of single-agent BEZ235 in Japanese oncology patients to determine the maximum tolerated dose (MTD) of BEZ235 based on dose-limiting toxicities (DLTs).
Dose escalation was guided by a standard 3 + 3 method and was based on DLTs observed in Cycle 1 and other safety, pharmacokinetic, and pharmacodynamic information. A total of 35 adult Japanese patients with advanced solid tumors received BEZ235 according to once daily (qd; n = 27) or twice daily (bid; n = 8) dosing schedules.
Two DLTs, namely, allergic reaction and thrombocytopenia, were observed at 1200 and 1400 mg qd, respectively, while liver dysfunction was reported as a DLT at 400 mg bid. The most common adverse events suspected to be related to BEZ235 in both dosing schedules were diarrhea, nausea, decreased appetite, stomatitis, and thrombocytopenia.
Although the MTD was not established, the maximum clinically tolerable dose was determined to be 1200 mg because two out of six patients required dose reduction in Cycle 2. The recommended dose was determined to be 1000 mg qd, which was comparable with the results of the first-in-human BEZ235 study in Western patients with advanced solid tumors (NCT00620594). Additionally, the tolerability of BEZ235 400 mg bid in Japanese oncology patients was confirmed in this study. CLINICALTRIALS.
NCT01195376.
BEZ235 是一种磷酸肌醇 3-激酶(PI3K)和雷帕霉素哺乳动物靶蛋白的双重激酶抑制剂,这两种物质都是 PI3K 通路的关键组成部分。这是一项在日本肿瘤患者中进行的 BEZ235 单药治疗的开放性、多中心、剂量递增、I 期研究,旨在根据剂量限制性毒性(DLT)确定 BEZ235 的最大耐受剂量(MTD)。
剂量递增由标准的 3+3 方法指导,并基于第 1 周期观察到的 DLT 以及其他安全性、药代动力学和药效学信息。总共 35 名患有晚期实体瘤的日本成年患者接受了 BEZ235 治疗,每日一次(qd;n=27)或每日两次(bid;n=8)给药方案。
qd 组在 1200 和 1400mg 时观察到 2 例 DLT,即过敏反应和血小板减少症,bid 组在 400mg 时报告肝功能障碍为 DLT。两种给药方案中最常见的疑似与 BEZ235 相关的不良事件是腹泻、恶心、食欲下降、口腔炎和血小板减少症。
尽管未确定 MTD,但由于 2 名患者在第 2 周期需要减少剂量,因此确定最大耐受剂量为 1200mg。推荐剂量确定为 1000mg qd,这与在西方晚期实体瘤患者中进行的 BEZ235 首次人体研究(NCT00620594)结果相当。此外,本研究还证实了 BEZ235 400mg bid 在日本肿瘤患者中的耐受性。临床试验。
gov 标识符:NCT01195376。