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卡马替尼(INC280)治疗日本晚期实体瘤患者的 I 期剂量递增研究。

Phase I dose-escalation study of capmatinib (INC280) in Japanese patients with advanced solid tumors.

机构信息

National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan.

National Cancer Center Hospital East, Kashiwa, Japan.

出版信息

Cancer Sci. 2019 Apr;110(4):1340-1351. doi: 10.1111/cas.13956. Epub 2019 Feb 20.

Abstract

Capmatinib is a highly specific, potent and selective MET inhibitor. This was an open-label, multicenter, dose-escalation, phase I study conducted in Japanese patients with advanced solid tumors (not selected based on their MET status). The primary objective was to determine the maximum tolerated dose (MTD) and/or highest studied dose being safe. Secondary objectives included safety, pharmacokinetics and preliminary antitumor activity. Dose escalation was guided by a Bayesian Logistic Regression Model dependent on dose-limiting toxicities (DLT) in cycle 1. Of 44 adult Japanese patients with confirmed advanced solid tumors enrolled, 29 received capmatinib capsules (doses ranging from 100 mg once daily [q.d.] to 600 mg twice daily [b.i.d.]) and 15 received tablets (200 mg b.i.d. and 400 mg b.i.d.). DLT occurred in two patients: grade 2 suicidal ideation (600 mg b.i.d. capsule) and grade 3 depression (400 mg b.i.d. tablet). MTD was not reached. The highest studied dose determined to be safe as tablet was 400 mg b.i.d., whereas it is not yet determined for capsules. Most common adverse events suspected to be drug-related were increased blood creatinine, nausea, decreased appetite, vomiting and diarrhea. Following repeated daily dosing up to day 15 by q.d. or b.i.d. regimen using capsules, median time to reach maximum plasma drug concentration (T ) was 1.0-4.0 hours; absorption was more rapid after dosing using tablets, with median T of 1.0 hour on both days 1 and 15. Eight patients had a best overall response of stable disease. These data support further clinical development of capmatinib.

摘要

卡马替尼是一种高度特异性、强效和选择性的 MET 抑制剂。这是一项在日本晚期实体瘤患者中进行的开放标签、多中心、剂量递增、I 期研究(未根据 MET 状态选择)。主要目的是确定最大耐受剂量(MTD)和/或最高研究剂量的安全性。次要目标包括安全性、药代动力学和初步抗肿瘤活性。剂量递增由依赖于第 1 周期剂量限制毒性(DLT)的贝叶斯逻辑回归模型指导。在已确认的 44 名患有晚期实体瘤的成年日本患者中,29 名患者接受卡马替尼胶囊(剂量范围为 100mg 每日一次 [qd] 至 600mg 每日两次 [bid]),15 名患者接受片剂(200mg bid 和 400mg bid)。两名患者出现 DLT:2 级自杀意念(600mg bid 胶囊)和 3 级抑郁(400mg bid 片剂)。未达到 MTD。确定片剂的最高研究剂量为 400mg bid,而胶囊尚未确定。最常见的疑似药物相关不良事件是血肌酐升高、恶心、食欲下降、呕吐和腹泻。在使用胶囊进行 q.d.或 bid 方案每日重复给药 15 天之后,中位达到最大血浆药物浓度(T )的时间为 1.0-4.0 小时;使用片剂给药后吸收更快,第 1 天和第 15 天的中位 T 均为 1.0 小时。8 名患者的最佳总体反应为疾病稳定。这些数据支持进一步开发卡马替尼。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8c45/6447844/788700105e62/CAS-110-1340-g001.jpg

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