Department of Medical Oncology, Fudan University Shanghai Cancer Center Shanghai, Shanghai, People's Republic of China.
Department of Urology, Nanjing Drum Tower Hospital, Clinical College of Nanjing Medical University, Nanjing, People's Republic of China.
Oncologist. 2023 Dec 11;28(12):e1259-e1267. doi: 10.1093/oncolo/oyad163.
Senaparib, a novel poly(ADP-ribose) polymerase 1/2 inhibitor, demonstrated antitumor activity in preclinical studies. This phase I, first-in-human, dose-escalation/-expansion study explored the pharmacokinetics, safety and tolerability, and preliminary antitumor activity of senaparib in Chinese patients with advanced solid tumors.
Adults with advanced solid tumors who had failed ³1 line of prior systemic treatment were enrolled. Senaparib (once daily [QD]) dose was escalated from 2 mg until the maximum tolerated dose (MTD)/recommended phase II dose (RP2D) using a modified 3 + 3 design. Dose expansion included: dose groups with ≥1 objective response and one dose higher, as well as those at the MTD/RP2D. Primary objectives were to evaluate the safety and tolerability, and determine the MTD and/or RP2D of senaparib.
Fifty-seven patients were enrolled across 10 dose groups (2-120 mg QD, and 50 mg twice daily). No dose-limiting toxicities were observed. The most common senaparib-related adverse events were anemia (80.9%), white blood cell count decreased (43.9%), platelet count decreased (28.1%), and asthenia (26.3%). Senaparib exposure increased dose proportionately at 2-80 mg; absorption saturated at 80-120 mg. Senaparib accumulation was minimal after repeated QD administration (accumulation ratio=1.1-1.5). The objective response rate was 22.7% (n=10/44) overall (all partial responses) and 26.9% (n=7/26) for patients harboring BRCA1/BRCA2 mutations. Disease control rates were 63.6% and 73.1%, respectively.
Senaparib was well tolerated and demonstrated promising antitumor activity in Chinese patients with advanced solid tumors. The RP2D for this clinical study in China was identified as 100 mg QD.
CLINICALTRIALS.GOV IDENTIFIER: NCT03508011.
Senaparib 是一种新型的聚(ADP-核糖)聚合酶 1/2 抑制剂,在临床前研究中显示出抗肿瘤活性。这项在中国晚期实体瘤患者中进行的首次人体、剂量递增/扩展的 I 期研究,旨在探索 Senaparib 的药代动力学、安全性和耐受性,以及初步的抗肿瘤活性。
入组标准为患有晚期实体瘤且既往接受过 ≥1 线系统治疗失败的成年人。采用改良的 3+3 设计,从 2mg 开始递增 Senaparib(QD)剂量,直到最大耐受剂量(MTD)/推荐的 II 期剂量(RP2D)。剂量扩展包括:至少有 1 个客观缓解和 1 个更高剂量的缓解的剂量组,以及 MTD/RP2D 的剂量组。主要目的是评估 Senaparib 的安全性和耐受性,并确定其 MTD 和/或 RP2D。
共有 57 名患者入组了 10 个剂量组(QD,2-120mg,每天一次,以及 50mg,每天两次)。未观察到剂量限制性毒性。最常见的 Senaparib 相关不良事件为贫血(80.9%)、白细胞计数下降(43.9%)、血小板计数下降(28.1%)和乏力(26.3%)。Senaparib 暴露量呈剂量比例增加,在 2-80mg 之间;在 80-120mg 时吸收饱和。重复 QD 给药后 Senaparib 蓄积最小(蓄积比为 1.1-1.5)。总体客观缓解率为 22.7%(44 例中有 10 例)(均为部分缓解),携带 BRCA1/BRCA2 突变的患者为 26.9%(26 例中有 7 例)。疾病控制率分别为 63.6%和 73.1%。
Senaparib 在晚期实体瘤中国患者中具有良好的耐受性和有前景的抗肿瘤活性。本研究在中国的 RP2D 确定为 100mgQD。
临床试验.gov 标识符:NCT03508011。