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晚期实体瘤患者中 ATR 抑制剂贝佐塞替布(前体 M6620、VX-970)联合吉西他滨±顺铂的 1 期研究。

Phase 1 study of the ATR inhibitor berzosertib (formerly M6620, VX-970) combined with gemcitabine ± cisplatin in patients with advanced solid tumours.

机构信息

Department of Oncology, University of Oxford, Oxford, UK.

Experimental Cancer Medicine Team, The University of Manchester and The Christie NHS Foundation Trust, Manchester, UK.

出版信息

Br J Cancer. 2021 Aug;125(4):510-519. doi: 10.1038/s41416-021-01405-x. Epub 2021 May 26.

Abstract

BACKGROUND

Berzosertib (formerly M6620, VX-970) is a highly potent and selective, first-in-class inhibitor of ataxia telangiectasia and Rad3-related protein kinase (ATR). We assessed multiple ascending doses of berzosertib + gemcitabine ± cisplatin in patients with resistant/refractory advanced solid tumours.

METHODS

We evaluated the safety, tolerability, pharmacokinetics (PK) and preliminary efficacy of intravenous berzosertib + gemcitabine ± cisplatin using a standard 3 + 3 dose-escalation design. The starting doses were berzosertib 18 mg/m, gemcitabine 875 mg/m and cisplatin 60 mg/m.

RESULTS

Fifty-two patients received berzosertib + gemcitabine and eight received berzosertib + gemcitabine + cisplatin. Four patients receiving berzosertib + gemcitabine had a total of seven dose-limiting toxicities (DLTs) and three receiving berzosertib + gemcitabine + cisplatin had a total of three DLTs. Berzosertib 210 mg/m (days 2 and 9) + gemcitabine 1000 mg/m (days 1 and 8) Q3W was established as the recommended Phase 2 dose (RP2D); no RP2D was determined for berzosertib + gemcitabine + cisplatin. Neither gemcitabine nor cisplatin affected berzosertib PK. Most patients in both arms achieved a best response of either partial response or stable disease.

CONCLUSIONS

Berzosertib + gemcitabine was well tolerated in patients with advanced solid tumours and showed preliminary efficacy signs.

CLINICAL TRIAL IDENTIFIER

NCT02157792.

摘要

背景

Berzosertib(前身为 M6620、VX-970)是一种高效且选择性的共济失调毛细血管扩张症和 Rad3 相关蛋白激酶(ATR)的首创抑制剂。我们评估了贝佐塞替布联合吉西他滨±顺铂在耐药/难治性晚期实体瘤患者中的多种递增剂量。

方法

我们采用标准的 3+3 剂量递增设计评估了静脉内贝佐塞替布+吉西他滨±顺铂的安全性、耐受性、药代动力学(PK)和初步疗效。起始剂量为贝佐塞替布 18mg/m2、吉西他滨 875mg/m2 和顺铂 60mg/m2。

结果

52 名患者接受了贝佐塞替布+吉西他滨治疗,8 名患者接受了贝佐塞替布+吉西他滨+顺铂治疗。4 名接受贝佐塞替布+吉西他滨治疗的患者共发生 7 例剂量限制性毒性(DLT),3 名接受贝佐塞替布+吉西他滨+顺铂治疗的患者共发生 3 例 DLT。贝佐塞替布 210mg/m2(第 2 和 9 天)+吉西他滨 1000mg/m2(第 1 和 8 天)Q3W 确立为推荐的 2 期剂量(RP2D);贝佐塞替布+吉西他滨+顺铂未确定 RP2D。吉西他滨和顺铂均不影响贝佐塞替布的 PK。两个治疗组的大多数患者均取得了部分缓解或疾病稳定的最佳缓解。

结论

贝佐塞替布+吉西他滨在晚期实体瘤患者中具有良好的耐受性,并显示出初步疗效迹象。

临床试验标识符

NCT02157792。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d8bd/8368196/0324ec07b4f4/41416_2021_1405_Fig1_HTML.jpg

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