Vanderbilt University Medical Center, Nashville, TN, USA.
Department of Medical Oncology, Vall d'Hebron University Hospital, Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain.
Breast Cancer Res Treat. 2019 Nov;178(1):121-133. doi: 10.1007/s10549-019-05360-3. Epub 2019 Jul 31.
This open-label, phase Ib, dose-escalation, and dose-expansion study (NCT01862081) evaluated taselisib with a taxane in locally advanced or metastatic breast cancer (BC) and/or non-small cell lung cancer (NSCLC).
Patients received taselisib (2-6 mg tablet or 3-6 mg capsule) plus docetaxel or paclitaxel. Primary endpoints were safety, dose-limiting toxicities, maximum tolerated dose, and identification of a recommended phase II dose. Secondary endpoints included pharmacokinetics and antitumor activity assessment.
Eighty patients (BC: 72; NSCLC: 7; BC/NSCLC: 1) were enrolled (docetaxel-receiving arms: 21; paclitaxel-receiving arms: 59). Grade ≥ 3 adverse events (AEs), serious AEs, and AEs leading to death were reported in 90.5%, 42.9%, and 14.3% of patients, respectively (docetaxel-receiving arms), and 78.9%, 40.4%, and 3.5% of patients, respectively (paclitaxel-receiving arms). Eight patients experienced dose-limiting toxicities. The maximum tolerated dose was exceeded with 3 mg taselisib (capsule) for 21 consecutive days plus 75 mg/m docetaxel and not exceeded with 6 mg taselisib (tablet) for 5 days on/2 days off plus 80 mg/m paclitaxel. Objective response rates and clinical benefit rates were 35.0% and 45.0%, respectively (docetaxel-receiving arms), and 20.4% and 27.8%, respectively (paclitaxel-receiving arms). Exposure for paclitaxel or docetaxel plus taselisib was consistent with the single agents.
Taselisib in combination with a taxane has a challenging safety profile. Despite evidence of antitumor activity, the benefit-risk profile was deemed not advantageous. Further development is not planned.
这项开放标签、Ib 期、剂量递增和剂量扩展研究(NCT01862081)评估了 taselisib 联合紫杉烷类药物在局部晚期或转移性乳腺癌(BC)和/或非小细胞肺癌(NSCLC)中的应用。
患者接受 taselisib(2-6mg 片剂或 3-6mg 胶囊)加多西他赛或紫杉醇。主要终点为安全性、剂量限制性毒性、最大耐受剂量和确定 II 期推荐剂量。次要终点包括药代动力学和抗肿瘤活性评估。
共纳入 80 例患者(BC:72 例;NSCLC:7 例;BC/NSCLC:1 例)(多西他赛组:21 例;紫杉醇组:59 例)。90.5%、42.9%和 14.3%的患者分别发生了≥3 级不良事件(AE)、严重 AE 和导致死亡的 AE(多西他赛组),78.9%、40.4%和 3.5%的患者分别发生了这些 AE(紫杉醇组)。8 例患者发生剂量限制性毒性。3mg 剂量的 taselisib(胶囊)连续 21 天加 75mg/m2 多西他赛和 6mg 剂量的 taselisib(片剂)连续 5 天/2 天加 80mg/m2 紫杉醇的最大耐受剂量均被超过。多西他赛组客观缓解率和临床获益率分别为 35.0%和 45.0%,紫杉醇组分别为 20.4%和 27.8%。紫杉醇或多西他赛加 taselisib 的暴露量与单药治疗一致。
taselisib 联合紫杉烷类药物的安全性具有挑战性。尽管有抗肿瘤活性的证据,但获益风险比不占优势,因此不计划进一步开发。