Richardson Gary Edward, Al-Rajabi Raed, Uprety Dipesh, Hamid Anis, Williamson Stephen K, Baranda Joaquina, Mamdani Hirva, Lee Ya-Li, Li Li, Wang Xingli, Dong Xunwei
Cabrini Health, Malvern, VIC 3144, Australia.
University of Kansas Cancer Center, Kansas City, KS 64114, USA.
Cancers (Basel). 2023 Apr 29;15(9):2553. doi: 10.3390/cancers15092553.
FN-1501, a potent inhibitor of receptor FMS-like tyrosine kinase 3 () and , , , , and tyrosine kinase proteins, has demonstrated significant in vivo activity in various solid tumor and leukemia human xenograft models. Anomalies in have an established role as a therapeutic target where the gene has been shown to play a critical role in the growth, differentiation, and survival of various cell types in hematopoietic cancer and have shown promise in various solid tumors. An open-label, Phase I/II study (NCT03690154) was designed to evaluate the safety and PK profile of FN-1501 as monotherapy in patients (pts) with advanced solid tumors and relapsed, refractory (R/R) AML.
Pts received FN-1501 IV three times a week for 2 weeks, followed by 1 week off treatment in continuous 21-day cycles. Dose escalation followed a standard 3 + 3 design. Primary objectives include the determination of the maximum tolerated dose (MTD), safety, and recommended Phase 2 dose (RP2D). Secondary objectives include pharmacokinetics (PK) and preliminary anti-tumor activity. Exploratory objectives include the relationship between pharmacogenetic mutations (e.g., , , , , etc.), safety, and efficacy; as well as an evaluation of the pharmacodynamic effects of treatment with FN-1501. Dose expansion at RP2D further explored the safety and efficacy of FN-1501 in this treatment setting.
A total of 48 adult pts with advanced solid tumors (N = 47) and AML (N = 1) were enrolled at doses ranging from 2.5 to 226 mg IV three times a week for two weeks in 21-day cycles (2 weeks on and 1 week off treatment). The median age was 65 years (range 30-92); 57% were female and 43% were male. The median number of prior lines of treatment was 5 (range 1-12). Forty patients evaluable for dose-limiting toxicity (DLT) assessment had a median exposure of 9.5 cycles (range 1-18 cycles). Treatment-related adverse events (TRAEs) were reported for 64% of the pts. The most common treatment-emergent adverse events (TEAEs), defined as those occurring in ≥20% of pts, primarily consisted of reversible Grade 1-2 fatigue (34%), nausea (32%), and diarrhea (26%). The most common Grade ≥3 events occurring in ≥5% of pts consisted of diarrhea and hyponatremia. Dose escalation was discontinued due to DLTs of Grade 3 thrombocytopenia (N = 1) and Grade 3 infusion-related reaction (N = 1) occurring in 2 pts. The maximum tolerated dose (MTD) was determined to be 170 mg.
FN-1501 demonstrated reasonable safety, tolerability, and preliminary activity against solid tumors in doses up to 170 mg. Dose escalation was terminated based on 2 DLTs occurring at the 226 mg dose level.
FN - 1501是一种有效的受体FMS样酪氨酸激酶3(FLT3)以及其他多种酪氨酸激酶蛋白的抑制剂,已在多种实体瘤和白血病人异种移植模型中显示出显著的体内活性。FLT3异常作为一种治疗靶点已得到确认,该基因在造血系统癌症中多种细胞类型的生长、分化和存活中起关键作用,并且在多种实体瘤中也显示出前景。一项开放标签的I/II期研究(NCT03690154)旨在评估FN - 1501作为单药治疗晚期实体瘤患者和复发、难治性(R/R)急性髓系白血病(AML)患者的安全性和药代动力学(PK)特征。
患者接受FN - 1501静脉注射,每周3次,共2周,随后停药1周,以21天为一个连续周期。剂量递增遵循标准的3 + 3设计。主要目标包括确定最大耐受剂量(MTD)、安全性和推荐的2期剂量(RP2D)。次要目标包括药代动力学(PK)和初步抗肿瘤活性。探索性目标包括药物基因突变(例如,FLT3、NRAS、KRAS、BRAF等)、安全性和疗效之间的关系;以及评估FN - 1501治疗的药效学效应。在RP2D剂量下的剂量扩展进一步探索了FN - 1501在此治疗环境中的安全性和疗效。
共有48例成年患者,其中晚期实体瘤患者47例,AML患者1例,接受剂量范围为2.5至226 mg静脉注射,每周3次,共2周,以21天为周期(2周治疗,1周停药)。中位年龄为65岁(范围30 - 92岁);57%为女性,43%为男性。既往治疗线数的中位数为5(范围1 - 12)。40例可评估剂量限制性毒性(DLT)的患者中位暴露周期为9.5个周期(范围1 - 18个周期)。64%的患者报告了与治疗相关的不良事件(TRAEs)。最常见的治疗期间出现的不良事件(TEAEs),定义为在≥20%的患者中出现的事件,主要包括可逆的1 - 2级疲劳(34%)、恶心(32%)和腹泻(26%)。在≥5%的患者中出现的最常见的≥3级事件包括腹泻和低钠血症。由于2例患者出现3级血小板减少(N = 1)和3级输液相关反应(N = 1)的DLT,剂量递增停止。确定最大耐受剂量(MTD)为170 mg。
FN - 1501在高达170 mg的剂量下显示出合理的安全性、耐受性和对实体瘤的初步活性。基于在226 mg剂量水平出现的2例DLT,剂量递增终止。