Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Republic of Korea.
The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Target Oncol. 2019 Oct;14(5):591-601. doi: 10.1007/s11523-019-00670-4.
Fibroblast growth factor receptor (FGFR) 2 is overexpressed in several tumor types, including triple-negative breast cancer and gastric cancer, both of which have a high unmet medical need. Aprutumab ixadotin (BAY 1187982) is the first antibody-drug conjugate (ADC) to target FGFR2 and the first to use a novel auristatin-based payload.
This first-in-human trial was conducted to determine the safety, tolerability, and maximum tolerated dose (MTD) of aprutumab ixadotin in patients with advanced solid tumors from cancer indications known to be FGFR2-positive.
In this open-label, multicenter, phase I dose-escalation trial (NCT02368951), patients with advanced solid tumors received escalating doses of aprutumab ixadotin (starting at 0.1 mg/kg body weight), administered intravenously on day 1 of every 21-day cycle. Primary endpoints included safety, tolerability, and the MTD of aprutumab ixadotin; secondary endpoints were pharmacokinetic evaluation and tumor response to aprutumab ixadotin.
Twenty patients received aprutumab ixadotin across five cohorts, at doses of 0.1-1.3 mg/kg. The most common grade ≥ 3 drug-related adverse events were anemia, aspartate aminotransferase increase, proteinuria, and thrombocytopenia. Dose-limiting toxicities were thrombocytopenia, proteinuria, and corneal epithelial microcysts, and were only seen in the two highest dosing cohorts. The MTD was determined to be 0.2 mg/kg due to lack of quantitative data following discontinuations at 0.4 and 0.8 mg/kg doses. One patient had stable disease; no responses were reported.
Aprutumab ixadotin was poorly tolerated, with an MTD found to be below the therapeutic threshold estimated preclinically; therefore, the trial was terminated early. CLINICALTRIALS.
NCT02368951.
成纤维细胞生长因子受体(FGFR)2 在多种肿瘤类型中过表达,包括三阴性乳腺癌和胃癌,这两种癌症均存在高度未满足的医疗需求。Aprutumab ixadotin(BAY 1187982)是首个靶向 FGFR2 的抗体药物偶联物(ADC),也是首个使用新型auristatin 类有效载荷的 ADC。
本首次人体试验旨在确定 aprutumab ixadotin 在 FGFR2 阳性已知癌症适应证的晚期实体瘤患者中的安全性、耐受性和最大耐受剂量(MTD)。
在这项开放标签、多中心、I 期剂量递增试验(NCT02368951)中,接受过治疗的晚期实体瘤患者接受 aprutumab ixadotin 的递增剂量(起始剂量为 0.1mg/kg 体重),每 21 天周期的第 1 天静脉输注。主要终点包括 aprutumab ixadotin 的安全性、耐受性和 MTD;次要终点为 aprutumab ixadotin 的药代动力学评估和肿瘤反应。
20 名患者在五个队列中接受 aprutumab ixadotin 治疗,剂量为 0.1-1.3mg/kg。最常见的≥3 级药物相关不良事件为贫血、天冬氨酸转氨酶升高、蛋白尿和血小板减少症。剂量限制性毒性为血小板减少症、蛋白尿和角膜上皮微囊,仅见于两个最高剂量组。由于在 0.4mg/kg 和 0.8mg/kg 剂量下停药后缺乏定量数据,因此确定 MTD 为 0.2mg/kg。1 名患者疾病稳定,无缓解报告。
Aprutumab ixadotin 耐受性差,MTD 低于临床前估计的治疗阈值;因此,试验提前终止。临床试验。
gov 标识符:NCT02368951。