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沃罗替尼,一种用于治疗晚期实体瘤患者的口服VEGFR/PDGFR双靶点酪氨酸激酶抑制剂:一项开放标签的I期剂量递增和剂量扩展试验。

Vorolanib, an oral VEGFR/PDGFR dual tyrosine kinase inhibitor for treatment of patients with advanced solid tumors: An open-label, phase I dose escalation and dose expansion trial.

作者信息

Song Yan, Wang Jinwan, Ren Xiubao, Jin Jie, Mao Li, Liang Chris, Ding Lieming, Yang Lin

机构信息

Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China.

Department of Biotherapy, Tianjin Medical University Cancer Institute and Hospital, Tianjin 300060, China.

出版信息

Chin J Cancer Res. 2021 Feb 28;33(1):103-114. doi: 10.21147/j.issn.1000-9604.2021.01.11.

DOI:10.21147/j.issn.1000-9604.2021.01.11
PMID:33707933
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7941683/
Abstract

OBJECTIVE

This study evaluated the safety and preliminary efficacy of vorolanib, a novel tyrosine kinase inhibitor, for treatment of patients with advanced solid tumors.

METHODS

During dose escalation, patients received increasing doses of oral vorolanib (50-250 mg once daily) in cycles of four weeks for up to one year. During dose expansion, patients received recommended doses (100 and 200 mg) in 4-week cycles. The primary endpoint was to determine the safety and maximum tolerated dose and/or the recommended phase II dose (RP2D). The severity and type of adverse drug reactions (ADRs) were assessed using the Common Terminology Criteria for Adverse Events version 4.0. The second endpoint was preliminary efficacy in terms of objective response and progression-free survival (PFS).

RESULTS

No dose-limiting toxicity occurred during dose escalation (50-250 mg). Five (26.3%) patients in the escalation cohort (n=19) and 12 (48.0%) in the expansion cohort (n=25) experienced grade 3 ADRs. The most common ADRs were hair color changes, fatigue, portal hypertension, hypertriglyceridemia, and proteinuria. During dose expansion, the patients treated with 200 mg and 100 mg (once daily) showed an objective response rate of 22.2% and 5.9%, respectively; the disease control rate was 88.9% and 73.3%, respectively; the median PFS was 9.9 [95% confidence interval (95% CI): 7.4-not reached] months and 3.8 (95% CI: 1.9-not reached) months, respectively.

CONCLUSIONS

Oral vorolanib at a dose of 200 mg (once daily) exhibited an acceptable safety profile and favorable clinical benefit for patients with advanced solid tumors. The RP2D for vorolanib was determined to be 200 mg as a daily regimen.

摘要

目的

本研究评估了新型酪氨酸激酶抑制剂沃罗替尼治疗晚期实体瘤患者的安全性和初步疗效。

方法

在剂量递增阶段,患者接受口服沃罗替尼剂量逐渐增加(50 - 250 mg,每日一次),每四周为一个周期,持续长达一年。在剂量扩展阶段,患者接受推荐剂量(100和200 mg),每4周为一个周期。主要终点是确定安全性和最大耐受剂量及/或推荐的II期剂量(RP2D)。使用不良事件通用术语标准4.0评估药物不良反应(ADR)的严重程度和类型。第二个终点是客观缓解率和无进展生存期(PFS)方面的初步疗效。

结果

在剂量递增阶段(50 - 250 mg)未发生剂量限制性毒性。剂量递增队列(n = 19)中有5名(26.3%)患者和剂量扩展队列(n = 25)中有12名(48.0%)患者发生3级ADR。最常见的ADR是头发颜色改变、疲劳、门静脉高压、高甘油三酯血症和蛋白尿。在剂量扩展阶段,接受200 mg和100 mg(每日一次)治疗的患者客观缓解率分别为22.2%和5.9%;疾病控制率分别为88.9%和73.3%;中位PFS分别为9.9 [95%置信区间(95%CI):7.4 - 未达到]个月和3.8(95%CI:1.9 - 未达到)个月。

结论

每日一次口服200 mg沃罗替尼对晚期实体瘤患者显示出可接受的安全性和良好的临床获益。沃罗替尼的RP2D确定为每日200 mg的方案。

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