Dana-Farber Cancer Institute, Department of Medical Oncology, Boston, Massachusetts, USA.
PTC Therapeutics, Inc., South Plainfield, New Jersey, USA.
Clin Pharmacol Drug Dev. 2021 Aug;10(8):940-949. doi: 10.1002/cpdd.904. Epub 2021 Jan 13.
PTC596 is a novel, orally bioavailable, small-molecule tubulin-binding agent that reduces B-cell-specific Moloney murine leukemia virus insertion site 1 activity and is being developed for the treatment of solid tumors. A phase 1, open-label, multiple-ascending-dose study was conducted to evaluate the pharmacokinetics and safety of the drug in subjects with advanced solid tumors. PTC596 was administered orally biweekly based on body weight. Dose escalation followed a modified 3 + 3 scheme using doses of 0.65, 1.3, 2.6, 5.2, 7.0, and 10.4 mg/kg. Following oral administration, PTC596 was rapidly absorbed, and between 0.65 and 7.0 mg/kg reached a maximum plasma concentration 2 to 4 hours after dosing. Area under the plasma concentration-time curve increased proportionally with body weight-adjusted doses. Maximum plasma concentration increased with dose, although the increase was less than dose proportional at dose levels >2.6 mg/kg. No accumulation occurred after multiple administrations up to 7.0 mg/kg. PTC596 had a terminal half-life ranging 12 to 15 hours at all doses except for the highest dose of 10.4 mg/kg, where the half-life was approximately 20 hours. Overall, PTC596 was well tolerated. The most frequently reported PTC596-related treatment-emergent adverse events were mild to moderate gastrointestinal symptoms, including diarrhea (54.8%), nausea (45.2%), vomiting (35.5%), and fatigue (35.5%). Only 1 patient treated with 10.4 mg/kg experienced dose-limiting toxicity of neutropenia and thrombocytopenia, both of which were reversible. Stable disease as best overall response was observed among 7 patients, with 2 patients receiving the study drug up to 16 weeks. These results support the further development of PTC596 for the treatment of solid tumors.
PTC596 是一种新型、口服生物利用度的小分子微管结合剂,可降低 B 细胞特异性 Moloney 鼠白血病病毒插入位点 1 的活性,目前正在开发用于治疗实体瘤。进行了一项 I 期、开放标签、多剂量递增研究,以评估药物在晚期实体瘤患者中的药代动力学和安全性。根据体重,PTC596 每两周口服一次。剂量递增采用改良的 3 + 3 方案,剂量为 0.65、1.3、2.6、5.2、7.0 和 10.4 mg/kg。口服后,PTC596 迅速吸收,在 0.65 至 7.0 mg/kg 剂量范围内,在给药后 2 至 4 小时达到最大血浆浓度。血浆浓度-时间曲线下面积与体重调整剂量成比例增加。最大血浆浓度随剂量增加而增加,但在 >2.6 mg/kg 剂量水平时,增加幅度小于剂量比例。在高达 7.0 mg/kg 的剂量下,多次给药后无蓄积。除了最高剂量 10.4 mg/kg 外,PTC596 的终末半衰期在所有剂量下均为 12 至 15 小时,在该剂量下,半衰期约为 20 小时。总体而言,PTC596 具有良好的耐受性。报告最频繁的与 PTC596 相关的治疗后出现的不良事件是轻度至中度胃肠道症状,包括腹泻(54.8%)、恶心(45.2%)、呕吐(35.5%)和疲劳(35.5%)。只有 1 名接受 10.4 mg/kg 剂量的患者出现剂量限制性毒性的中性粒细胞减少症和血小板减少症,两者均为可逆性。7 名患者中观察到最佳总体反应为疾病稳定,其中 2 名患者接受研究药物治疗长达 16 周。这些结果支持进一步开发 PTC596 用于治疗实体瘤。