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Soumerai JD, Diefenbach CS, Jagadeesh D, Asch A, Kumar A, Tsai ML, Jandl TA, Lossos IS, Kenkre VP, Awan F, Novotny W, Huang J, Miao L, Rajagopalan P, Ghalie RG, Zelenetz AD. Safety and efficacy of zandelisib plus zanubrutinib in previously treated follicular and mantle cell lymphomas. Br J Haematol 2024. [PMID: 38500476 DOI: 10.1111/bjh.19419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Revised: 03/04/2024] [Accepted: 03/12/2024] [Indexed: 03/20/2024]
Abstract
The combination of the phosphatidylinositol 3-kinase delta (PI3Kδ) inhibitor zandelisib with the Bruton's tyrosine kinase (BTK) inhibitor zanubrutinib was hypothesized to be synergistic and prevent resistance to single-agent therapy. This phase 1 study (NCT02914938) included a dose-finding stage in patients with relapsed/refractory (R/R) B-cell malignancies (n = 20) and disease-specific expansion cohorts in follicular lymphoma (FL; n = 31) or mantle cell lymphoma (MCL; n = 19). The recommended phase 2 dose was zandelisib 60 mg on Days 1-7 plus zanubrutinib 80 mg twice daily continuously in 28-day cycle. In the total population, the most common adverse events (AEs; all grades/grade 3-4) were neutropenia (35%/24%), diarrhoea (33%/2%), thrombocytopenia (32%/8%), anaemia (27%/8%), increased creatinine (25%/0%), contusion (21%/0%), fatigue (21%/2%), nausea (21%/2%) and increased aspartate aminotransferase (24%/6%). Three patients discontinued due to AEs. The overall response rate was 87% (complete response [CR] = 33%) for FL and 74% (CR = 47%) for MCL. The median duration of response and progression-free survival (PFS) were not reached in either group. The estimated 1-year PFS was 72.3% (95% confidence interval [CI], 51.9-85.1) for FL and 56.3% (95% CI, 28.9-76.7) for MCL (median follow-up: 16.5 and 10.9 months respectively). Zandelisib plus zanubrutinib was associated with high response rates and no increased toxicity compared to either agent alone.
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Affiliation(s)
- Jacob D Soumerai
- Massachusetts General Hospital Cancer Center, Boston, Massachusetts, USA
| | | | - Deepa Jagadeesh
- Department of Hematology and Medical Oncology, Cleveland Clinic, Cleveland, Ohio, USA
| | - Adam Asch
- Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| | | | | | - Thomas A Jandl
- Stony Brook University Hospital, Stony Brook, New York, USA
| | - Izidore S Lossos
- Sylvester Comprehensive Cancer Center, University of Miami School of Medicine, Miami, Florida, USA
| | | | - Farrukh Awan
- University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | | | - Jane Huang
- BeiGene, LTD, Cambridge, Massachusetts, USA
| | - Lu Miao
- MEI Pharma, Inc., San Diego, California, USA
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Atrafi F, Boix O, Subbiah V, Diamond JR, Chawla SP, Tolcher AW, LoRusso PM, Eder JP, Gutierrez M, Sankhala K, Rajagopalan P, Genvresse I, Langer S, Mathijssen RHJ, Verweij J, Bruns I, Lolkema MP. Correction: A Phase I Study of an MPS1 Inhibitor (BAY 1217389) in Combination with Paclitaxel Using a Novel Randomized Continual Reassessment Method for Dose Escalation. Clin Cancer Res 2022; 28:2969. [PMID: 35775194 DOI: 10.1158/1078-0432.ccr-22-1792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Cao A, Rajagopalan P, Gimotty P, Brody R, Basu D. Targetable Vulnerabilities of Head and Neck Cancer Cell Lines Detected by the DepMap CRISPR Screens. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.01.030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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M M, Rajagopalan P, Xu S, Palani IA, Singh V, Wang X, Wu W. Enhancement of patterned triboelectric output performance by an interfacial polymer layer for energy harvesting application. Nanoscale 2021; 13:20615-20624. [PMID: 34874984 DOI: 10.1039/d1nr07021e] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Efficaciously scavenging waste mechanical energy from the environment is an emerging field in the self-powered and self-governing electronics systems which solves battery limitations. It demonstrates enormous potential in various fields such as wireless devices, vesture, and portable electronic devices. Different surface textured PET triboelectric nanogenerators (TENGs) were developed by the laser pattern method in the previous work, with the line textured TENG device showing improved performance due to a larger surface contact area. Here, a polyethylene oxide (PEO) and polyvinyl alcohol (PVA) coated line patterned PET-based TENG was developed for the conversion of mechanical energy into useful electric energy. The PEO layer boosted the TENG output to 4 times higher than that of the PA6-laser patterned PET TENG device (our previous report) and 2-fold higher than that of a pristine line patterned TENG. It generated an open-circuit voltage, short circuit current, and instantaneous power density of 131 V, 2.32 μA, and 41.6 μW cm-2, respectively. The as-fabricated device was tested for 10 000 cycles for reliability evaluation, which shows no significant performance degradation. In addition, the device was deployed to power 10 LEDs with high intensity. Thus, this device can be used for ambient mechanical energy conversion and to power micro and nano-electronic devices.
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Affiliation(s)
- Manikandan M
- Mechatronics and Instrumentation Lab, Discipline of Mechanical Engineering, Indian Institute of Technology Indore, India.
- School of Industrial Engineering, Purdue University, West Lafayette, USA
- Flex Laboratory, Purdue University, West Lafayette, USA
| | - P Rajagopalan
- Key Laboratory of Micro-nano Electronic Devices and Smart Systems of Zhejiang Province, College of Information Science & Electronic Engineering, Zhejiang University, Hangzhou, China
| | - Shujia Xu
- School of Industrial Engineering, Purdue University, West Lafayette, USA
- Flex Laboratory, Purdue University, West Lafayette, USA
| | - I A Palani
- Mechatronics and Instrumentation Lab, Discipline of Mechanical Engineering, Indian Institute of Technology Indore, India.
| | - Vipul Singh
- Molecular and Nanoelectronics Research Group, Discipline of Electrical Engineering, Indian Institute of Technology Indore, India
| | - Xiaozhi Wang
- Key Laboratory of Micro-nano Electronic Devices and Smart Systems of Zhejiang Province, College of Information Science & Electronic Engineering, Zhejiang University, Hangzhou, China
| | - Wenzhuo Wu
- School of Industrial Engineering, Purdue University, West Lafayette, USA
- Flex Laboratory, Purdue University, West Lafayette, USA
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Atrafi F, Boix O, Subbiah V, Diamond JR, Chawla SP, Tolcher AW, LoRusso PM, Eder JP, Gutierrez M, Sankhala K, Rajagopalan P, Genvresse I, Langer S, Mathijssen RHJ, Verweij J, Bruns I, Lolkema MP. A Phase I Study of an MPS1 Inhibitor (BAY 1217389) in Combination with Paclitaxel Using a Novel Randomized Continual Reassessment Method for Dose Escalation. Clin Cancer Res 2021; 27:6366-6375. [PMID: 34518310 DOI: 10.1158/1078-0432.ccr-20-4185] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 01/05/2021] [Accepted: 09/09/2021] [Indexed: 11/16/2022]
Abstract
PURPOSE Monopolar spindle 1 (MPS1) kinase inhibitor, BAY 1217389 (BAY) synergizes with paclitaxel. This phase I study assessed the combination of BAY with paclitaxel using a novel randomized continuous reassessment method (rCRM) to improve dose determination. PATIENTS AND METHODS Patients with solid tumors were randomized to receive oral BAY (twice daily 2-days-on/5-days-off) with weekly paclitaxel (90 mg/m2) or paclitaxel monotherapy in cycle 1. Dose escalation was guided by CRM modeling. Primary objectives were to assess safety, establish the MTD of BAY, and to evaluate the pharmacokinetic profiles for both compounds. Simulations were performed to determine the contribution of the rCRM for dose determination. RESULTS In total, 75 patients were enrolled. The main dose-limiting toxicities were hematologic toxicities (55.6%). The MTD of BAY was established at 64 mg twice daily with paclitaxel. Inclusion of a control arm enabled the definitive attribution of grade ≥3 neutropenia to higher BAY exposure [AUC0-12 (P< 0.001)]. After determining the MTD, we included 19 patients with breast cancer at this dose for dose expansion. Other common toxicities were nausea (45.3%), fatigue (41.3%), and diarrhea (40.0%). Overall confirmed responses were seen in 31.6% of evaluable patients. Simulations showed that rCRM outperforms traditional designs in determining the true MTD. CONCLUSIONS The combination of BAY with paclitaxel was associated with considerable toxicity without a therapeutic window. However, the use of the rCRM design enabled us to determine the exposure-toxicity relation for BAY. Therefore, we propose that the rCRM could improve dose determination in phase I trials that combine agents with overlapping toxicities.
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Affiliation(s)
| | | | - Vivek Subbiah
- The University of Texas MD Anderson Cancer Center, Houston, Texas
| | | | | | | | | | | | | | | | | | | | | | | | - Jaap Verweij
- Erasmus MC Cancer Institute, Rotterdam, the Netherlands
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Manikandan M, Rajagopalan P, Patra N, Jayachandran S, Muralidharan M, Mani Prabu SS, Palani IA, Singh V. Development of Sn-doped ZnO based ecofriendly piezoelectric nanogenerator for energy harvesting application. Nanotechnology 2020; 31:185401. [PMID: 31935698 DOI: 10.1088/1361-6528/ab6b9e] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
In this work, we have a demonstrated zinc oxide (ZnO) polymer-based ecofriendly piezoelectric nanogenerator (PENG) on a paper substrate for an energy harvesting application. The ZnO thin film is developed on the paper substrate, where different doping concentrations of Sn have been investigated systematically to validate the effect of doping towards enhancing the device performance. The piezoelectric potential of the fabricated device is evaluated by applying three different loads (4 N, 8 N, 22 N), where the source of the corresponding mechanical loads is based on the object of a musical drum stick. The results suggest that the pristine ZnO PENG device can generate a maximum output voltage and current of 2.15 V and 17 nA respectively. Moreover, the ZnO PENG device doped with 2.5% Sn achieved an even higher voltage (4.15 V) and current (36 nA) compared to pristine ZnO devices. In addition, the hydrothermal growth technique used to develop Sn-doped ZnO has the benefits of high scalability and low cost. Hence, the Sn-doped PENG device is a suitable candidate for energy harvesting applications operating in both uniform and non-uniform loading conditions.
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Affiliation(s)
- M Manikandan
- Mechatronics and Instrumentation Lab, Discipline of Mechanical Engineering, Indian Institute of Technology Indore, India
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Hassan R, Blumenschein GR, Moore KN, Santin AD, Kindler HL, Nemunaitis JJ, Seward SM, Thomas A, Kim SK, Rajagopalan P, Walter AO, Laurent D, Childs BH, Sarapa N, Elbi C, Bendell JC. First-in-Human, Multicenter, Phase I Dose-Escalation and Expansion Study of Anti-Mesothelin Antibody-Drug Conjugate Anetumab Ravtansine in Advanced or Metastatic Solid Tumors. J Clin Oncol 2020; 38:1824-1835. [PMID: 32213105 PMCID: PMC7255978 DOI: 10.1200/jco.19.02085] [Citation(s) in RCA: 91] [Impact Index Per Article: 22.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE This phase I study, which to our knowledge is the first-in-human study of this kind, investigates the safety, tolerability, pharmacokinetics, and clinical activity of anetumab ravtansine, an antibody–drug conjugate of anti-mesothelin antibody linked to maytansinoid DM4, in patients with advanced, metastatic, or recurrent solid tumors known to express the tumor-differentiation antigen mesothelin. PATIENTS AND METHODS This phase I, open-label, multicenter, dose-escalation and dose-expansion study of anetumab ravtansine enrolled 148 adult patients with multiple solid tumor types. Ten dose-escalation cohorts of patients with advanced or metastatic solid tumors (0.15-7.5 mg/kg) received anetumab ravtansine once every 3 weeks, and 6 expansion cohorts of patients with advanced, recurrent ovarian cancer or malignant mesothelioma received anetumab ravtansine at the maximum tolerated dose once every 3 weeks, 1.8 mg/kg once per week, and 2.2 mg/kg once per week. RESULTS Forty-five patients were enrolled across the 10 dose-escalation cohorts. The maximum tolerated dose of anetumab ravtansine was 6.5 mg/kg once every 3 weeks or 2.2 mg/kg once per week. Thirty-two patients were enrolled in the 6.5 mg/kg once-every-3-weeks, 35 in the 1.8 mg/kg once-per-week, and 36 in the 2.2 mg/kg once-per-week expansion cohorts. The most common drug-related adverse events were fatigue, nausea, diarrhea, anorexia, vomiting, peripheral sensory neuropathy, and keratitis/keratopathy. There were no drug-related deaths. Anetumab ravtansine pharmacokinetics were dose proportional; the average half-life was 5.5 days. Among 148 patients with mesothelioma or ovarian, pancreatic, non–small-cell lung, and breast cancers, 1 had a complete response, 11 had partial responses, and 66 had stable disease. High levels of tumor mesothelin expression were detected in patients with clinical activity. CONCLUSION Anetumab ravtansine exhibited a manageable safety and favorable pharmacokinetic profile with encouraging preliminary antitumor activity in heavily pretreated patients with mesothelin-expressing solid tumors. The results allowed for the determination of recommended doses, schedules, and patient populations for anetumab ravtansine in phase II studies.
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Affiliation(s)
- Raffit Hassan
- Thoracic and GI Malignancies Branch, Center for Cancer Research, National Cancer Institute, Bethesda, MD
| | - George R Blumenschein
- Department of Thoracic/Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Kathleen N Moore
- Stephenson Oklahoma Cancer Center at University of Oklahoma, Oklahoma City, OK/Sarah Cannon Research Institute, Nashville, TN
| | | | | | - John J Nemunaitis
- Division of Hematology and Medical Oncology, Department of Medicine, University of Toledo College of Medicine and Life Sciences, Toledo, OH
| | - Shelly M Seward
- Wayne State University Karmanos Cancer Institute, Huntington Woods, MI
| | - Anish Thomas
- Thoracic and GI Malignancies Branch, Center for Cancer Research, National Cancer Institute, Bethesda, MD
| | | | | | | | | | | | | | - Cem Elbi
- Bayer HealthCare Pharmaceuticals, Whippany, NJ
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Lorusso P, Chawla S, Bendell J, Shields A, Shapiro G, Rajagopalan P, Cyris C, Bruns I, Mei J, Souza F, Rasco D, Eder J, Tolcher A. First-in-human study of the monopolar spindle 1 (Mps1) kinase inhibitor BAY 1161909 in combination with paclitaxel in subjects with advanced malignancies. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy279.410] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Atrafi F, Boix O, Rajagopalan P, Tolcher AW, LoRusso P, Eder JP, Sankhala KK, Chawla SP, Subbiah V, Diamond JR, Gutierrez M, Mathijssen RH, Mei J, Verweij J, Bruns I, Lolkema MP. A randomized Bayesian phase 1 design combining an MPS-1 inhibitor with paclitaxel: A strategy to improve determination of the incremental toxicity of a novel compound over a known backbone therapy. J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.15_suppl.2537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
| | - Oliver Boix
- These authors contributed equally. Bayer Pharma AG, Wuppertal, Germany
| | | | | | - Patricia LoRusso
- Yale University School of Medicine–Yale Cancer Center, New Haven, CT
| | | | | | | | - Vivek Subbiah
- The University of Texas MD Anderson Cancer Center, Houston, TX
| | | | | | - Ron H.J. Mathijssen
- Department of Medical Oncology, Erasmus MC Cancer Institute, Rotterdam, Netherlands
| | - Jian Mei
- Bayer Pharmaceuticals, Whippany, NJ
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Bulat I, Moore KN, Haceatrean A, Chung JW, Rajagopalan P, Xia C, Laurent D, Childs BH, Santin A. Phase Ib study of anti-mesothelin antibody drug conjugate anetumab ravtansine in combination with pegylated liposomal doxorubicin in platinum-resistant ovarian, fallopian tube, or primary peritoneal cancer. J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.15_suppl.5571] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Iurie Bulat
- ARENSIA Exploratory Medicine Research Unit, Institute of Oncology, Chisinau, The Republic of Moldova
| | | | - Alexei Haceatrean
- ARENSIA Exploratory Medicine’s Research Unit, Institute of Oncology, Chisinau, Moldova, The Republic of
| | | | | | - Chenghua Xia
- Bayer HealthCare Pharmaceuticals, Inc., Whippany, NJ
| | - Dirk Laurent
- Bayer AG, Pharmaceuticals Division, Berlin, Germany
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Rajagopalan P, Singh V, Palani IA. Enhancement of ZnO-based flexible nano generators via a sol-gel technique for sensing and energy harvesting applications. Nanotechnology 2018; 29:105406. [PMID: 29388558 DOI: 10.1088/1361-6528/aaa6bd] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
Zinc oxide (ZnO) is a remarkable inorganic semiconductor with exceptional piezoelectric properties compared to other semiconductors. However, in comparison to lead-based hazardous piezoelectric materials, its properties have undesired limitations. Here we report a 5∼6 fold enhancement in piezoelectric features via chemical doping of copper matched to intrinsic ZnO. A flexible piezoelectric nanogenerator (F-PENG) device was fabricated using an unpretentious solution process of spin coating, with other advantages such as robustness, low-weight, improved adhesion, and low cost. The device was used to demonstrate energy harvesting from a standard weight as low as 4 gm and can work as a self-powered mass sensor in a broad range of 4 to 100 gm. The device exhibited a novel energy harvesting technique from a wind source due to its inherent flexibility. At three different velocities (10∼30 m s-1) and five different angles of attack (0∼180 degrees), the device validated the ability to discern different velocities and directions of flow. The device will be useful for mapping the flow of air apart from harvesting the energy. The simulation was done to verify the underlining mechanism of aerodynamics involved.
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Affiliation(s)
- P Rajagopalan
- Mechatronics and Instrumentation Lab, Discipline of Metallurgy Engineering and Materials Science, Indian Institute of Technology Indore, Indore, India
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12
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Hassan R, Wang D, Wrangle J, Thomas A, Byars A, Asschert L, Atienza R, Rajagopalan P, Walter A, Zhang J, Sarapa N, Kindler H. Abstract A095: Phase Ib study of anetumab ravtansine in combination with pemetrexed and cisplatin in patients with mesothelin-expressing epithelial mesothelioma or nonsquamous non-small cell lung cancer. Mol Cancer Ther 2018. [DOI: 10.1158/1535-7163.targ-17-a095] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Phase I study with the antibody-drug conjugate anetumab ravtansine demonstrated promising safety and efficacy as monotherapy in mesothelin-expressing tumors, and in particular for patients with advanced metastatic malignant pleural mesothelioma. Pemetrexed in combination with cisplatin is standard for first-line treatment of patients with metastatic mesothelioma and NSCLC. We therefore conducted a phase Ib study to determine the safety, tolerability, and maximum tolerated dose (MTD) of anetumab ravtansine in combination with pemetrexed/cisplatin (Pem/Cis) in subjects with mesothelin-expressing predominantly epithelial mesothelioma or nonsquamous NSCLC. Methods: Patients with histologically confirmed, unresectable, locally advanced or metastatic, mesothelin-expressing predominantly epithelial pleural or peritoneal mesothelioma or nonsquamous NSCLC, who previously failed ≤3 prior lines of chemotherapy, were eligible. Patients were prescreened based on obligatory tumor staining for mesothelin as determined by the Ventana MSLN (SP74) immunohistochemistry assay. Anetumab ravtansine was administered by 1-hour IV infusion on day 1 of every 21-day treatment cycle (Q3W). Pem (500 mg/m2) and Cis (75 mg/m2) were administered as IV infusions Q3W. Serial plasma samples were collected and analyzed for anetumab ravtansine and its components, pemetrexed, total and free platinum. Response to therapy was assessed by RECIST 1.1 and modified RECIST criteria for mesothelioma. Results: As of June 12, 2017, 17 patients had been treated and had received ≥2 cycles of treatment, including 7 patients with pleural mesothelioma, 9 with peritoneal mesothelioma, and 1 with NSCLC. Three patients were treated with anetumab ravtansine 5.5 mg/kg in combination with Pem/Cis with no dose-limiting toxicity (DLT). Six patients were then treated with anetumab ravtansine 6.5 mg/kg in combination with Pem/Cis, again without DLTs. This dose in combination was deemed as the MTD. An additional 8 patients were enrolled in an MTD expansion cohort. Anetumab ravtansine-related adverse events were mainly grade (G)1 and G2. G1/G2 eye toxicities were possibly more frequent with the combination than in historical data. There was one G3 corneal microcystic event and one G3 hypertension. There was a 50% overall response rate (all partial responses) from 16 evaluable patients. Of 13 patients treated at the 6.5 mg/kg MTD dose of anetumab ravtansine in combination with Pem/Cis, the overall response rate was 46%. Based on comparisons to historical data and within-subject comparisons in small number of subjects, clinically relevant PK interaction was not observed. Conclusions: Anetumab ravtansine at 6.5 mg/kg dosed Q3W in combination with standard dosing of Pem/Cis had a manageable toxicity profile without evidence of PK interaction and with early signs of clinical efficacy. Anetumab ravtansine at 6.5 mg/kg in combination with Pem 500 mg/m2 and Cis 75 mg/m2, all administered in a Q3W regimen, is thus feasible and the recommended dose for future study.
Citation Format: Raffit Hassan, Ding Wang, John Wrangle, Anish Thomas, Angus Byars, Lianne Asschert, Rolando Atienza, Prabhu Rajagopalan, Annette Walter, Jun Zhang, Nenad Sarapa, Hedy Kindler. Phase Ib study of anetumab ravtansine in combination with pemetrexed and cisplatin in patients with mesothelin-expressing epithelial mesothelioma or nonsquamous non-small cell lung cancer [abstract]. In: Proceedings of the AACR-NCI-EORTC International Conference: Molecular Targets and Cancer Therapeutics; 2017 Oct 26-30; Philadelphia, PA. Philadelphia (PA): AACR; Mol Cancer Ther 2018;17(1 Suppl):Abstract nr A095.
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Affiliation(s)
| | | | - John Wrangle
- 3Medical University of South Carolina, Charleston, SC
| | | | - Angus Byars
- 4Bexon Clinical Consulting, Upper Monclair, NJ
| | | | | | | | | | - Jun Zhang
- 7Bayer Healthcare Pharmaceuticals Inc., Whippany, NJ
| | - Nenad Sarapa
- 7Bayer Healthcare Pharmaceuticals Inc., Whippany, NJ
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Van Laethem JL, Riess H, Jassem J, Haas M, Martens UM, Weekes C, Peeters M, Ross P, Bridgewater J, Melichar B, Cascinu S, Saramak P, Michl P, Van Brummelen D, Zaniboni A, Schmiegel W, Dueland S, Giurescu M, Garosi VL, Roth K, Schulz A, Seidel H, Rajagopalan P, Teufel M, Childs BH. Phase I/II Study of Refametinib (BAY 86-9766) in Combination with Gemcitabine in Advanced Pancreatic cancer. Target Oncol 2017; 12:97-109. [PMID: 27975152 DOI: 10.1007/s11523-016-0469-y] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND Activating KRAS mutations are reported in up to 90% of pancreatic cancers. Refametinib potently inhibits MEK1/2, part of the MAPK signaling pathway. This phase I/II study evaluated the safety and efficacy of refametinib plus gemcitabine in patients with advanced pancreatic cancer. METHODS Phase I comprised dose escalation, followed by phase II expansion. Refametinib and gemcitabine plasma levels were analyzed for pharmacokinetics. KRAS mutational status was determined from circulating tumor DNA. RESULTS Ninety patients overall received treatment. The maximum tolerated dose was refametinib 50 mg twice daily plus standard gemcitabine (1000 mg/m2 weekly). The combination was well tolerated, with no pharmacokinetic interaction. Treatment-emergent toxicities included thrombocytopenia, fatigue, anemia, and edema. The objective response rate was 23% and the disease control rate was 73%. Overall response rate, disease control rate, progression-free survival, and overall survival were higher in patients without detectable KRAS mutations (48% vs. 28%, 81% vs. 69%, 8.8 vs. 5.3 months, and 18.2 vs. 6.6 months, respectively). CONCLUSION Refametinib plus gemcitabine was well tolerated, with a promising objective response rate, and had an acceptable safety profile and no pharmacokinetic interaction. There was a trend towards improved outcomes in patients without detectable KRAS mutations that deserves future investigation.
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Affiliation(s)
- Jean-Luc Van Laethem
- Department of Gastroenterology, Erasme University Hospital, CP 572/10, route de Lennik 808, 1070, Brussels, Belgium.
| | - Hanno Riess
- Medical Department, Division of Hematology, Oncology and Tumor Immunology, Charity Hospital, Virchow-Klinikum Campus, Augustenburger Platz 1, 13353, Berlin, Germany
| | - Jacek Jassem
- Department of Oncology and Radiotherapy, Medical University of Gdansk, M. Skłodowskiej-Curie 3a Street, Gdansk, 80-210, Poland
| | - Michael Haas
- Department of Hematology and Oncology, University of Munich Medical Center, Marchioninistraße 15, 81366, Munich, Germany
| | - Uwe M Martens
- Department of Hematology and Oncology, Cancer Center Heilbronn-Franken, Am Gesundbrunnen 20-26, 74078, Heilbronn, Germany
| | - Colin Weekes
- Division of Medical Oncology, University of Colorado Cancer Center, 1665 Aurora Ct, Aurora, CO, 80045, USA
| | - Marc Peeters
- Department of Oncology, Antwerp University Hospital, Wilrijkstraat 10, 2650, Edegem, Belgium
| | - Paul Ross
- Department of Medical Oncology, Guy's & St Thomas' Hospital, Westminster Bridge Road, London, SE1 7EH, UK
| | - John Bridgewater
- Department of Oncology, UCL Cancer Institute, 72 Huntley Street, London, WC1E 6DD, UK
| | - Bohuslav Melichar
- Department of Oncology, Palacky University Medical School and University Hospital Olomouc, Křížkovského 8, 771 47, Olomouc, Czech Republic
| | - Stefano Cascinu
- Department of Medical Oncology, A.O.U. United Hospitals, Polytechnic University of Marche, Piazza Roma, 22, Ancona, Italy
| | - Piotr Saramak
- Department of Oncological Gastroenterology, Maria Skłodowska-Curie Memorial Cancer Center, ul. W.K. Roentgena 5, 02-781, Warsaw, Poland
| | - Patrick Michl
- Department of Gastroenterology, Endocrinology, Metabolism and Infectiology, University Hospital of Giessen and Marburg, Baldingerstraße, 35043, Marburg, Germany.,Universitätsklinikum Halle - University Hospital Halle (Saale), Ernst-Grube-Straße 40, 06120, Halle (Saale), Germany
| | - David Van Brummelen
- Department of Radiotherapy, UZ Brussels, Avenue du Laerbeek 101, 1090, Brussels, Belgium
| | - Alberto Zaniboni
- Department of Medical Oncology, Poliambulanza Foundation Hospital Institute, Via Bissolati, 57, Brescia, Italy
| | - Wollf Schmiegel
- Department of Gastroenterology and Hepatology, Medical University Hospital Bochum, Alexandrinenstraße 1, Bochum, 44791, Germany
| | - Svein Dueland
- Department of Oncology, Oslo University Radium Hospital, Trondheimsveien 235, Bjerke, 0514, Oslo, Norway
| | | | | | - Katrin Roth
- Bayer Pharma AG, Müllerstraße 178, 13353, Berlin, Germany
| | - Anke Schulz
- Bayer Pharma AG, Müllerstraße 178, 13353, Berlin, Germany
| | - Henrik Seidel
- Bayer Pharma AG, Müllerstraße 178, 13353, Berlin, Germany
| | - Prabhu Rajagopalan
- Bayer HealthCare Pharmaceuticals, Inc., 100 Bayer Blvd, Whippany, NJ, 07981, USA
| | - Michael Teufel
- Bayer HealthCare Pharmaceuticals, Inc., 100 Bayer Blvd, Whippany, NJ, 07981, USA
| | - Barrett H Childs
- Bayer HealthCare Pharmaceuticals, Inc., 100 Bayer Blvd, Whippany, NJ, 07981, USA
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Joerger M, Soo R, Cho B, Navarro A, Sayehli C, Richly H, Tai D, Kim DW, Wolf J, Cassier P, Bender S, Ellinghaus P, Ince S, Rajagopalan P, Ocker M, Schuler M. A novel mRNA-based patient selection strategy identifies fibroblast growth factor receptor (FGFR) inhibitor-sensitive tumors: Results from rogaratinib Phase-1 study. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx367.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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15
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Bahleda R, Grilley-Olson JE, Govindan R, Barlesi F, Greillier L, Perol M, Ray-Coquard I, Strumberg D, Schultheis B, Dy GK, Zalcman G, Weiss GJ, Walter AO, Kornacker M, Rajagopalan P, Henderson D, Nogai H, Ocker M, Soria JC. Phase I dose-escalation studies of roniciclib, a pan-cyclin-dependent kinase inhibitor, in advanced malignancies. Br J Cancer 2017; 116:1505-1512. [PMID: 28463960 PMCID: PMC5518866 DOI: 10.1038/bjc.2017.92] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2016] [Revised: 03/01/2017] [Accepted: 03/05/2017] [Indexed: 02/06/2023] Open
Abstract
Background: To evaluate safety, pharmacokinetics, and maximum tolerated dose of roniciclib in patients with advanced malignancies, with dose expansion to evaluate clinical benefit at the recommended phase II dose (RP2D). Methods: Two phase I dose-escalation studies evaluated two roniciclib dosing schedules: 3 days on/4 days off or 4 weeks on/2 weeks off. The expansion phase included patients with small-cell lung cancer (SCLC), ovarian cancer, or tumour mutations involving the CDK signalling pathway. Results: Ten patients were evaluable in the 4 weeks on/2 weeks off schedule (terminated following limited tolerability) and 47 in the 3 days on/4 days off schedule dose-escalation cohorts. On the 3 days on/4 days off schedule, RP2D was 5 mg twice daily in solid tumours (n=40); undetermined in lymphoid malignancies (n=7). Common roniciclib-related adverse events included nausea (76.6%), fatigue (65.8%), diarrhoea (63.1%), and vomiting (57.7%). Roniciclib demonstrated rapid absorption and dose-proportional increase in exposure. One partial response (1.0%) was observed. In RP2D expansion cohorts, the disease control rate (DCR) was 40.9% for patients with ovarian cancer (n=25), 17.4% for patients with SCLC (n=33), and 33.3% for patients with CDK-related tumour mutations (n=6). Conclusions: Roniciclib demonstrated an acceptable safety profile and moderate DCR in 3 days on/4 days off schedule.
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Affiliation(s)
- Rastislav Bahleda
- Drug Development Department, Gustave Roussy, 114, rue Édouard-Vaillant, Paris 94805, France
| | - Juneko E Grilley-Olson
- Department of Medicine, Lineberger Comprehensive Cancer Center, University of North Carolina, 170 Manning Drive, Chapel Hill, NC 27514, USA
| | - Ramaswamy Govindan
- Department of Medicine, Washington University Medical School, 660 South Euclid Avenue, St Louis, MO 63110, USA
| | - Fabrice Barlesi
- Multidisciplinary Oncology and Therapeutic Innovations Department, Aix Marseille University, Assistance Publique Hôpitaux de Marseille, Centre Essais Précoces en Cancérologie de Marseille CLIP, 80, rue Brochier, Marseille 13005, France
| | - Laurent Greillier
- Multidisciplinary Oncology and Therapeutic Innovations Department, Aix Marseille University, Assistance Publique Hôpitaux de Marseille, Centre Essais Précoces en Cancérologie de Marseille CLIP, 80, rue Brochier, Marseille 13005, France
| | - Maurice Perol
- Department of Medical Oncology, Cancer Research Centre Léon Bérard and Claude Bernard University, 28, Prom. Léa et Napoléon Bullukian, Lyon 69008, France
| | - Isabelle Ray-Coquard
- Department of Medical Oncology, Cancer Research Centre Léon Bérard and Claude Bernard University, 28, Prom. Léa et Napoléon Bullukian, Lyon 69008, France
| | - Dirk Strumberg
- Department of Internal Medicine, Oncology and Haematology, Marienhospital Herne, Ruhr-University Bochum, Bochum Süd, Universitätsstraße 150, Bochum 44801, Germany
| | - Beate Schultheis
- Department of Internal Medicine, Oncology and Haematology, Marienhospital Herne, Ruhr-University Bochum, Bochum Süd, Universitätsstraße 150, Bochum 44801, Germany
| | - Grace K Dy
- Department of Medicine, Roswell Park Cancer Institute, Elm and Carlton Streets, Buffalo, NY 14263, USA
| | - Gérard Zalcman
- Pulmonology and Thoracic Oncology Department, Clinical Research Center, University Hospital, Avenue de la Côte de Nacre, Caen 14033, France
| | - Glen J Weiss
- Virginia G. Piper Cancer Center Clinical Trials at Scottsdale Healthcare/TGen, 10510 North 92nd Street, Suite 200, Scottsdale, AZ 85258, USA.,Cancer Treatment Centers of America, 14200 Celebrate Life Way, Goodyear, AZ 85338, USA
| | | | | | - Prabhu Rajagopalan
- Bayer HealthCare Pharmaceuticals, Inc., 100 Bayer Boulevard, Whippany, NJ 07981, USA
| | | | | | | | - Jean-Charles Soria
- Drug Development Department, Gustave Roussy, 114, rue Édouard-Vaillant, Paris 94805, France
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Joerger M, Soo R, Cho B, Mendivil AN, Sayehli C, Richly H, Tai D, Kim DW, Wolf J, Cassier P, Ellinghaus P, Hildebrandt S, Behre S, Helmbrecht C, Kerpen S, Zielinski D, Ince S, Rajagopalan P, Ocker M, Schuler M. developmental therapeutics Phase I study of the pan-fibroblast growth factor receptor (FGFR) inhibitor BAY 1163877 with expansion cohorts for subjects based on tumor FGFR mRNA expression levels. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw435.10] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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17
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Rajagopalan P, Boudinot FD, Chu CK, Tennant BC, Baldwin BH, Schinazi RF. Pharmacokinetics of (-)-β-D-2,6-Diaminopurine Dioxolane and its Metabolite, Dioxolane Guanosine, in Woodchucks (Marmota Monax). ACTA ACUST UNITED AC 2016. [DOI: 10.1177/095632029600700202] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The woodchuck ( Marmota monax) is a useful animal model for evaluating the in-vivo efficacy of antiviral agents against hepatitis B viral infection (HBV). The pharmacokinetics of a newly synthesized antiviral agent (-)-β-D-2,6-diaminopurine dioxolane (DAPD) in woodchucks is reported. DAPD is a nucleoside analogue, having potent and selective activity against human immunodeficiency virus and HBV in vitro. DAPD is susceptible to deamination in vivo by the ubiquitously present enzyme adenosine deaminase yielding the active metabolite dioxolane guanosine (DXG). The pharmacokinetics of DAPD and DXG were characterized following intravenous (i.v.) and oral (p.o.) administration of 20 mg kg−1 of DAPD to woodchucks. Plasma and urine samples were collected, and nucleoside concentrations were determined by HPLC. Following intravenous administration, the half-life of DAPD averaged 6.7 ± 4.3 h, and that of DXG averaged 17.6 ± 14.5 h. The mean total clearance and steady state volume of distribution of DAPD were 0.33 ± 0.14 L h kg−1 and 1.76 ± 0.65 L kg−1, respectively. The oral bioavailability of DAPD ranged from 3.7-8.2%; however, the apparent availability of DXG following oral administration of DAPD was 10.5-53%.
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Affiliation(s)
- Prabhu Rajagopalan
- Department of Pharmaceutics, University of Georgia, Athens, Georgia 30602, USA
| | - F. D. Boudinot
- Department of Pharmaceutics, University of Georgia, Athens, Georgia 30602, USA
| | - Chung K. Chu
- Department of Medicinal Chemistry, College of Pharmacy, University of Georgia, Athens, Georgia 30602, USA
| | - B. C. Tennant
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, New York 14853, USA
| | - B. H. Baldwin
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, New York 14853, USA
| | - R. F. Schinazi
- Veterans Affairs Medical Center, Decatur, Georgia 30033 and Laboratory of Biochemical Pharmacology, Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia 30322, USA
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18
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Blumenschein GR, Hassan R, Moore KN, Santin A, Kindler HL, Nemunaitis JJ, Seward SM, Rajagopalan P, Walter A, Sarapa N, Bendell JC. Phase I study of anti-mesothelin antibody drug conjugate anetumab ravtansine (AR). J Clin Oncol 2016. [DOI: 10.1200/jco.2016.34.15_suppl.2509] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- George R. Blumenschein
- Department of Thoracic/Head & Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Raffit Hassan
- Thoracic and Gastrointestinal Oncology Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD
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19
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Adjei AA, Richards DA, El-Khoueiry A, Braiteh F, Becerra CHR, Stephenson JJ, Hezel AF, Sherman M, Garbo L, Leffingwell DP, Iverson C, Miner JN, Shen Z, Yeh LT, Gunawan S, Wilson DM, Manhard KJ, Rajagopalan P, Krissel H, Clendeninn NJ. A Phase I Study of the Safety, Pharmacokinetics, and Pharmacodynamics of Combination Therapy with Refametinib plus Sorafenib in Patients with Advanced Cancer. Clin Cancer Res 2015; 22:2368-76. [PMID: 26644411 DOI: 10.1158/1078-0432.ccr-15-1681] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2015] [Accepted: 11/10/2015] [Indexed: 02/04/2023]
Abstract
PURPOSE To assess the safety and tolerability of the small-molecule allosteric MEK inhibitor refametinib combined with sorafenib, in patients with advanced solid malignancies. EXPERIMENTAL DESIGN This phase I dose-escalation study included an expansion phase at the maximum tolerated dose (MTD). Patients received refametinib/sorafenib twice daily for 28 days, from a dose of refametinib 5 mg plus sorafenib 200 mg to a dose of refametinib 50 mg plus sorafenib 400 mg. Plasma levels of refametinib, refametinib metabolite M17, and sorafenib were measured for pharmacokinetic assessments. Tumors were biopsied at the MTD for analysis of MEK pathway mutations and ERK phosphorylation. RESULTS Thirty-two patients were enrolled in the dose-escalation cohort. The MTD was refametinib 50 mg twice daily plus sorafenib 400 mg twice daily. The most common treatment-related toxicities were diarrhea and fatigue. Refametinib was readily absorbed following oral administration (plasma half-life of ∼16 hours at the MTD), and pharmacokinetic parameters displayed near-dose proportionality, with less than 2-fold accumulation after multiple dosing. Another 30 patients were enrolled in the MTD cohort; 19 had hepatocellular carcinoma. The combination was associated with significantly reduced ERK phosphorylation in 5 out of 6 patients biopsied, with the greatest reductions in those with KRAS or BRAF mutations. Disease was stabilized in approximately half of patients, and 1 patient with colorectal cancer achieved a partial response at the MTD lasting approximately 1 year. CONCLUSIONS In this phase I study, refametinib plus sorafenib was well tolerated, with good oral absorption, near-dose proportionality, and target inhibition in a range of tumor types. Clin Cancer Res; 22(10); 2368-76. ©2015 AACR.
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Affiliation(s)
- Alex A Adjei
- Roswell Park Cancer Institute, Buffalo, New York.
| | - Donald A Richards
- The US Oncology Network, The Woodlands, Texas. Texas Oncology-Tyler, Houston, Texas
| | - Anthony El-Khoueiry
- University of Southern California Norris Comprehensive Cancer Center, Los Angeles, California
| | - Fadi Braiteh
- The US Oncology Network, The Woodlands, Texas. Comprehensive Cancer Centers of Nevada, Las Vegas, Nevada
| | - Carlos H R Becerra
- The US Oncology Network, The Woodlands, Texas. Baylor Sammons Cancer Center, Houston, Texas
| | - Joe J Stephenson
- The US Oncology Network, The Woodlands, Texas. Institute of Translational Oncology Research, Houston, Texas
| | - Aram F Hezel
- The US Oncology Network, The Woodlands, Texas. Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, New York
| | - Morris Sherman
- University of Toronto and University Health Network, Toronto, Canada
| | - Lawrence Garbo
- The US Oncology Network, The Woodlands, Texas. New York Oncology Hematology, Albany, New York
| | | | | | - Jeffrey N Miner
- The US Oncology Network, The Woodlands, Texas. Ardea Biosciences, Inc., San Diego, California
| | | | - Li-Tain Yeh
- Ardea Biosciences, Inc., San Diego, California
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20
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Cho B, Dy G, Govindan R, Kim D, Pennell N, Zalcman G, Besse B, Nogai H, Rajagopalan P, Ocker M, Barlesi F. 3100 Phase Ib/II study of the pan-cyclin-dependent kinase (CDK) inhibitor roniciclib (BAY 1000394) in combination with chemotherapy as first-line therapy in subjects with extensive disease small cell lung cancer (ED-SCLC). Eur J Cancer 2015. [DOI: 10.1016/s0959-8049(16)31741-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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21
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Lim HY, Heo J, Choi HJ, Lin CY, Yoon JH, Hsu C, Rau KM, Poon RT, Yeo W, Park JW, Tay MH, Hsieh WS, Kappeler C, Rajagopalan P, Krissel H, Jeffers M, Yen CJ, Tak WY. A Phase II Study of the Efficacy and Safety of the Combination Therapy of the MEK Inhibitor Refametinib (BAY 86-9766) Plus Sorafenib for Asian Patients with Unresectable Hepatocellular Carcinoma. Clin Cancer Res 2014; 20:5976-85. [DOI: 10.1158/1078-0432.ccr-13-3445] [Citation(s) in RCA: 79] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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22
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Bentrup U, Rajagopalan P, Heyl D. Einfluss des Trägermaterials auf die Leistung von Rh/Ni-Katalysatoren bei der Hydrierung von CO 2: Eine Operando-infrarotspektroskopische Studie. CHEM-ING-TECH 2014. [DOI: 10.1002/cite.201450207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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23
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Braskie MN, Boyle CP, Rajagopalan P, Gutman BA, Toga AW, Raji CA, Tracy RP, Kuller LH, Becker JT, Lopez OL, Thompson PM. Physical activity, inflammation, and volume of the aging brain. Neuroscience 2014; 273:199-209. [PMID: 24836855 PMCID: PMC4076831 DOI: 10.1016/j.neuroscience.2014.05.005] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2014] [Revised: 04/23/2014] [Accepted: 05/02/2014] [Indexed: 01/06/2023]
Abstract
Physical activity influences inflammation, and both affect brain structure and Alzheimer's disease (AD) risk. We hypothesized that older adults with greater reported physical activity intensity and lower serum levels of the inflammatory marker tumor necrosis factor α (TNFα) would have larger regional brain volumes on subsequent magnetic resonance imaging (MRI) scans. In 43 cognitively intact older adults (79.3±4.8 years) and 39 patients with AD (81.9±5.1 years at the time of MRI) participating in the Cardiovascular Health Study, we examined year-1 reported physical activity intensity, year-5 blood serum TNFα measures, and year-9 volumetric brain MRI scans. We examined how prior physical activity intensity and TNFα related to subsequent total and regional brain volumes. Physical activity intensity was measured using the modified Minnesota Leisure Time Physical Activities questionnaire at year 1 of the study, when all subjects included here were cognitively intact. Stability of measures was established for exercise intensity over 9 years and TNFα over 3 years in a subset of subjects who had these measurements at multiple time points. When considered together, more intense physical activity intensity and lower serum TNFα were both associated with greater total brain volume on follow-up MRI scans. TNFα, but not physical activity, was associated with regional volumes of the inferior parietal lobule, a region previously associated with inflammation in AD patients. Physical activity and TNFα may independently influence brain structure in older adults.
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Affiliation(s)
- M N Braskie
- Imaging Genetics Center, Institute for Neuroimaging and Informatics, Dept. of Neurology, Keck/USC School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - C P Boyle
- Imaging Genetics Center, Institute for Neuroimaging and Informatics, Dept. of Neurology, Keck/USC School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - P Rajagopalan
- Imaging Genetics Center, Institute for Neuroimaging and Informatics, Dept. of Neurology, Keck/USC School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - B A Gutman
- Imaging Genetics Center, Institute for Neuroimaging and Informatics, Dept. of Neurology, Keck/USC School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - A W Toga
- Imaging Genetics Center, Institute for Neuroimaging and Informatics, Dept. of Neurology, Keck/USC School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - C A Raji
- Department of Radiology, University of California Los Angeles School of Medicine, Los Angeles, CA, USA
| | - R P Tracy
- Departments of Pathology, Biochemistry, and Center for Clinical and Translational Science, University of Vermont, Burlington, VT, USA
| | - L H Kuller
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - J T Becker
- Departments of Neurology, Psychiatry, and Psychology, University of Pittsburgh, Pittsburgh, PA, USA
| | - O L Lopez
- Department of Neurology, University of Pittsburgh, Pittsburgh, PA, USA
| | - P M Thompson
- Imaging Genetics Center, Institute for Neuroimaging and Informatics, Dept. of Neurology, Keck/USC School of Medicine, University of Southern California, Los Angeles, CA, USA; Depts. of Psychiatry, Engineering, Radiology, & Ophthalmology, Keck/USC School of Medicine, University of Southern California, Los Angeles, CA, USA.
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Ramanathan RK, Von Hoff DD, Eskens F, Blumenschein GR, Richards DA, Renshaw FG, Rajagopalan P, Kelly A, Pena CE, Mross KB. A phase 1b trial of PI3K inhibitor copanlisib (BAY 80-6946) combined with the allosteric-MEK inhibitor refametinib (BAY 86-9766) in patients with advanced cancer. J Clin Oncol 2014. [DOI: 10.1200/jco.2014.32.15_suppl.2588] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
| | - Daniel D. Von Hoff
- TGen - Virginia G. Piper Cancer Center at Scottsdale Healthcare, Scottsdale, AZ
| | - Ferry Eskens
- Erasmus University Medical Center, Daniel den Hoed Cancer Center, Rotterdam, Netherlands
| | - George R. Blumenschein
- Department of Thoracic Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
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Rajagopalan P, De wit K, Barrett J, Breen R. P111 Azithromycin prescriptions in a teaching hospital–do we need to monitor for adverse effects? Thorax 2013. [DOI: 10.1136/thoraxjnl-2013-204457.261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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27
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Weekes CD, Von Hoff DD, Adjei AA, Leffingwell DP, Eckhardt SG, Gore L, Lewis KD, Weiss GJ, Ramanathan RK, Dy GK, Ma WW, Sheedy B, Iverson C, Miner JN, Shen Z, Yeh LT, Dubowy RL, Jeffers M, Rajagopalan P, Clendeninn NJ. Multicenter phase I trial of the mitogen-activated protein kinase 1/2 inhibitor BAY 86-9766 in patients with advanced cancer. Clin Cancer Res 2013; 19:1232-43. [PMID: 23434733 DOI: 10.1158/1078-0432.ccr-12-3529] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
PURPOSE To evaluate the safety, pharmacokinetics, and pharmacodynamics of BAY 86-9766, a selective, potent, orally available, small-molecule allosteric inhibitor of mitogen-activated protein kinase 1/2 in patients with advanced solid tumors. EXPERIMENTAL DESIGN BAY 86-9766 was administered orally daily in 28-day courses, with doses escalated to establish the maximum-tolerated dose (MTD). An expanded cohort was evaluated at the MTD. Pharmacokinetic and pharmacodynamic parameters were assessed, with extracellular signal-regulated kinase (ERK) phosphorylation evaluated in paired biopsies from a subset of the expanded MTD cohort. Tumor specimens were evaluated for mutations in select genes. RESULTS Sixty-nine patients were enrolled, including 20 patients at the MTD. The MTD was 100 mg given once-daily or in two divided doses. BAY 86-9766 was well-tolerated. The most common treatment-related toxicities were acneiform rash and gastrointestinal toxicity. BAY 86-9766 was well-absorbed after oral administration (plasma half-life ~12 hours), and displayed dose proportional pharmacokinetics throughout the tested dose range. Continuous daily dosing resulted in moderate accumulation at most dose levels. BAY 86-9766 suppressed ERK phosphorylation in biopsied tissue and tetradecanoylphorbol acetate-stimulated peripheral blood leukocytes. Of 53 evaluable patients, one patient with colorectal cancer achieved a partial response and 11 patients had stable disease for 4 or more courses. An ocular melanoma specimen harbored a GNAQ-activating mutation and exhibited reduced ERK phosphorylation in response to therapy. CONCLUSION This phase I study showed that BAY 86-9766 was well-tolerated, with good oral absorption, dose proportional pharmacokinetics, target inhibition at the MTD, and some evidence of clinical benefit across a range of tumor types.
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Affiliation(s)
- Colin D Weekes
- University of Colorado Cancer Center, Aurora, Colorado 80045, USA
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Lim HY, Yen CJ, Tak WY, Heo J, Choi HJ, Lin CY, Yoon JH, Hsu C, Rau KM, Poon RTP, Yeo W, Park JW, Tay MH, Hsieh WS, Kappeler C, Rajagopalan P, Krissel H. A phase II trial of MEK inhibitor BAY 86-9766 in combination with sorafenib as first-line systemic treatment for patients with unresectable hepatocellular carcinoma (HCC). J Clin Oncol 2012. [DOI: 10.1200/jco.2012.30.15_suppl.4103] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
4103 Background: Sorafenib (S) is the only approved systemic treatment for unresectable HCC. Nevertheless, there remains an unmet medical need for more effective treatment options for this disease. BAY 86-9766 (B) is an oral, allosteric inhibitor of MEK, a key component of the MAP kinase pathway. This study evaluated the efficacy and safety of a combination therapy with B plus S in patients (pts) with HCC. Methods: This is a single arm, open-label, phase 2 study. Eligible were pts with unresectable HCC, Child-Pugh Class A, performance status (PS) 0-1, and no prior systemic anticancer therapy for HCC. Pts started Cycle 1 (21 days) with B 50 mg bid orally plus S 600 mg daily (200 mg AM, 400 mg PM) orally. If there was no hand-foot skin reaction, fatigue, or gastrointestinal toxicity ≥ grade 2, S was escalated to 400 mg bid from Cycle 2 on. Treatment continued until progression or withdrawal criteria were met. Tumor assessment was performed every 6 weeks during treatment. Safety was evaluated every week for the first 6 weeks and every 3 weeks thereafter. Results: Seventy pts from Asia started study treatment. Pts were predominantly male (86%); median age was 56 years; 54% had PS of 0 and 46% PS of 1. The vast majority had liver cirrhosis (83%) and infection with HBV (76%) or HCV (17%). Sixty-five were evaluable for efficacy per protocol. Three pts (5%) had confirmed partial response and 25 pts (38%) had prolonged stable disease (≥10 weeks), with a disease control rate of 43%. Median time-to-progression was 4.1 months. Survival data are not mature, yet. The most frequent drug-related adverse events (AEs) were rash (60%), diarrhea (59%), AST elevation (43%), vomiting (30%), nausea (29%), ALT elevation (26%), and anorexia (26%). There were 4 Grade 5 related AEs (hepatic failure, sepsis/hepatic encephalopathy, tumor lysis syndrome, and unknown cause, respectively). Dose modifications due to AEs were necessary in almost all pts. The median daily dose was 64.2 mg for B and 443.3 mg for S, respectively. Conclusions: B in combination with S showed antitumor activity in pts with HCC. However, frequent dose modifications due to AEs might have limited the treatment effect of this combination.
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Affiliation(s)
- Ho Yeong Lim
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Chia-Jui Yen
- Internal Medicine, National Cheng Kung University Hospital, Tainan, Taiwan
| | - Won-Young Tak
- Kyungpook National University Hospital, Daegu, South Korea
| | - Jeong Heo
- Pusan National University Hospital, Busan, South Korea
| | - Hye Jin Choi
- Yonsei Cancer Center, Yonsei University Health System, Seoul, South Korea
| | | | | | - Chiun Hsu
- National Taiwan University Hospital, Taipei, Taiwan
| | - Kun-Ming Rau
- Chang Gung Memorial Hospital Kaohsiung Branch, Kaohsiung, Taiwan
| | | | - Winnie Yeo
- Prince of Wales Hospital, Shatin, Hong Kong
| | | | | | - Wen Son Hsieh
- Cancer Sciences Institute of Singapore, Singapore, Singapore
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Lotze MT, Appleman LJ, Ramanathan RK, Tolcher AW, Beeram M, Papadopoulos KP, Rasco DW, Weiss GJ, Mountz JM, Toledo FG, Alvarez RJ, Oborski MJ, Rajagopalan P, Jeffers M, Roth D, Dubowy RL, Patnaik A. Phase I study of intravenous PI3K inhibitor BAY 80-6946: Activity in patients (pts) with advanced solid tumors and non-Hodgkin lymphoma treated in MTD expansion cohorts. J Clin Oncol 2012. [DOI: 10.1200/jco.2012.30.15_suppl.3019] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
3019 Background: BAY 80-6946 (BAY) is a potent and highly selective reversible pan-Class I PI3K inhibitor, previously reported to be tolerated as a 1-hr infusion at a dose of 0.8 mg/kg on days 1, 8 and 15 every 28 days (MTD). Additional pts were treated in MTD expansion cohorts to assess safety, PK, biomarkers and clinical benefit in selected tumor types, as well as safety in Type 2 diabetics. Methods: To date, 23 nondiabetic pts with solid tumors and 5 with follicular lymphoma (FL) received BAY at the MTD, until disease progression or unacceptable toxicity. Tumor types were selected for high frequency of PIK3CA mutation, including breast cancer (BC; 16), endometrial (3), gastric (2), GU transitional cell (1) and ovarian clear cell (1). Partial enrichment for PIK3CA mutation was achieved by analysis of plasma DNA. 3 diabetic pts have been enrolled, at starting dose of 0.4 mg/kg. PK was done after the 1st and 3rd doses. FDG-PET/CT scans were done at baseline and 48 hrs after the 1st dose for pharmacodynamic assessment. Results: Safety and tolerability assessments confirmed MTD. There were no 1st cycle DLTs. Almost all nondiabetic pts had acute Grade 2/3 hyperglycemia (HG) following each dose; at least 10 of them received insulin for 1-3 days post dose. Hypertension (HTN) lasting < 24 hrs was common in pts with preexisting HTN, and manageable. 2 FL pts developed interstitial pneumonitis (IP) after cycles 2 and 3, both responsive to steroids. Diabetic pts tolerated 0.4 mg/kg. Tumor SUVmax consistently fell at 48 hrs. 3 of 4 FL pts had partial response (PR) after 2 cycles, with 2 confirmed PR pts on BAY for 10+ and 8+ mos. 2 BC pts showed PR , 1 confirmed. PIK3CA mutation (n=7) does not appear to correlate with response. Average T1/2 was 36 hrs. Observation of high Cmax in very obese pts led to recommended maximum dose of 65 mg. Conclusions: BAY induced PRs in pts with BC and FL. The acute toxicities of HG in most pts and HTN in some are manageable, and IP has been limited to 2 lymphoma pts and is responsive to steroids. The observed clinical activity of BAY, along with its acceptable safety profile, provide a rationale for the ongoing development of BAY in combination with cytotoxic and targeted agents.
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Affiliation(s)
| | | | | | | | | | | | - Drew Warren Rasco
- South Texas Accelerated Research Therapeutics (START) Center for Cancer Care, San Antonio, TX
| | - Glen J. Weiss
- Virginia G. Piper Cancer Center at Scottsdale Healthcare, Scottsdale, AZ
| | | | | | | | | | | | | | - Diane Roth
- Bayer HealthCare Pharmaceuticals, Montville, NJ
| | | | - Amita Patnaik
- South Texas Accelerated Research Therapeutics, LLC, San Antonio, TX
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Bahleda R, Gazzah A, Varga A, Rajagopalan P, Henderson DA, Kornacker M, Soria JC. A first-in-human phase I study of oral pan-CDK inhibitor BAY 1000394 in patients with advanced solid tumors: Dose escalation with an intermittent 3 days on/4 days off schedule. J Clin Oncol 2012. [DOI: 10.1200/jco.2012.30.15_suppl.3012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
3012 Background: BAY 1000394 (BAY) is an oral pan-CDK inhibitor targeting CDKs 1,2,4, 7 and 9 in the low nanomolar range. A phase I dose escalation study was initiated to determine the maximum tolerated dose (MTD), pharmacokinetics (PK), and pharmacodynamics (PD) in patients (pts) with advanced solid tumors. Methods: BAY was administered twice daily in a 3 days on / 4 days off schedule (cycle length 21 days, 3+3 design). PK was evaluated on cycle 1 day 1 and day 10. Response rate was assessed according to RECIST 1.1. PD markers included CK18 fragments in plasma. Results: As of Jan 08 2011, 34 pts were treated at doses of 0.6 (3 pts), 1.2 (4), 2.4 (3), 4.8 (3), 9.6 (3), 19.2 (6) mg per day as oral solution and at doses of 10 (4), 15 (6) and 20 (2) mg per day as tablet. Tumor types included 10 colorectal, 4 mesothelioma and 20 others. Cohort 9 (20 mg tablet) is ongoing. Frequent CTCAEv4 grade 1/2 drug related AEs occurring in more than 25% of patients up to cohort 8 were asthenia, diarrhea, nausea, vomiting and anorexia. DLTs (grade 3, 1 pt each) were hyponatremia, aphtous stomatitis at 19.2 mg solution and arterial thrombosis at 15 mg tablet. Aphthous stomatitis (20%) has not been observed with the tablet formulation. Other grade 3 related AEs were asthenia in 2 and nausea and vomiting in one pt each. Nausea and vomiting on treatment days were observed despite antiemetic treatment (aprepitant +/- setron). PK was dose proportional up to 9.6 mg, T1/2 was 10 hours, and relative bioavailability of tablet formulation was excellent; major metabolite levels were low (<10%). Levels of CK18 fragments did not correlate with dose or tumor response. Stable disease (SD) lasting for 2-4 months was observed in 9 patients, among others in 4 of 4 mesothelioma and 2 of 2 ovarian pts. One additional pt with cholangiocarcinoma has ongoing SD lasting for 5 months. One of the ovarian pts had a significant decline of CA125 lasting for 3 months. Conclusions: The tablet formulation of BAY 1000394 was better tolerated than oral solution. So far, doses up to a 15 mg per day with concomitant antiemetic treatment showed an acceptable tolerability. SD was observed in 10 of 25 heavily pretreated pts across cohorts 3 – 8.
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Van Laethem JL, Heinemann V, Martens UM, Jassem J, Michl P, Peeters M, Weekes CD, Maréchal R, Stieler J, Giurescu M, Rajagopalan P, Garosi VL, Riess H. A phase I/II study of the MEK inhibitor BAY 86-9766 (BAY) in combination with gemcitabine (GEM) in patients with nonresectable, locally advanced or metastatic pancreatic cancer (PC): Phase I dose-escalation results. J Clin Oncol 2012. [DOI: 10.1200/jco.2012.30.15_suppl.4050] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
4050 Background: Targeting the RAS–RAF–MEK–ERK pathway may be useful in the treatment of PC, as 75–90% of PCs have KRAS mutation. BAY is an orally bioavailable, potent, allosteric MEK 1/2 inhibitor that showed single-agent activity, and synergistic activity with GEM, in ectopic, orthotopic, syngenic and patient-derived xenograft PC models. Methods: The phase I part aimed to determine the maximum tolerated dose (MTD) of BAY in combination with GEM, and the pharmacokinetics of BAY and GEM. 3+3 study design was used. After informed consent, eligible patients with advanced PC received GEM 1000 mg/m2 (30-min, once-weekly IV infusion for 7 out of 8 weeks in cycle 1 [C1], and 3 out of 4 weeks in subsequent cycles) and oral BAY 30 mg BID (dose level 1 [DL1]) or 50 mg BID (DL2). No escalation beyond DL2 was planned. MTD was the highest dose at which maximum 1 out of 6 evaluable patients displayed dose-limiting toxicities (DLT) during C1. Results: As of 6 Jan 2012, 17 patients were enrolled and treated (10 at DL1, 7 at DL2). DL1 cohort has completed; DL2 evaluation is ongoing. At DL1, DLTs occurred in 1/6 evaluable patients: a patient with extensive liver metastasis developed chemotherapy-associated steatohepatitis (CASH) and died of hepatic failure. Rare CASH cases have been reported to be associated with GEM alone, but co-involvement of BAY currently cannot be ruled out. To date, 3 patients have completed C1 at DL2 without DLTs. DL2 completion is expected in March 2012. BAY+GEM showed a manageable tolerability profile. The most frequent treatment-related grade 3–4 adverse event (AE) at any DL was neutropenia (n=6). The most frequent clinically relevant BAY-related AE was acneiform rash (n=11), which was mostly grade 1–2 (one case grade 3) and manageable. BAY+GEM showed evidence of clinical efficacy: partial responses were seen in 4/10 patients at DL1 and 1/3 patients at DL2. No pharmacokinetic interaction between BAY and GEM was seen at DL1. Conclusions: In patients with advanced PC, BAY 30 mg BID in combination with GEM had a manageable safety profile, with acneiform rash as the clinically most relevant toxicity attributable to BAY.
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Affiliation(s)
| | - Volker Heinemann
- Department of Oncology and Comprehensive Cancer Center, LMU University of Munich, Munich, Germany
| | | | | | | | | | | | | | | | | | | | | | - Hanno Riess
- Charité-Universitätsmedizin, Berlin, Germany
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Grilley-Olson JE, Weiss GJ, Rajagopalan P, Henderson DA, Kornacker M, Govindan R. A dose-escalation phase I study of oral pan-CDK inhibitor BAY 1000394 in patients with advanced solid tumors: Dose escalation with an intermittent 28 days on/14 days off schedule. J Clin Oncol 2012. [DOI: 10.1200/jco.2012.30.15_suppl.3046] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
3046 Background: BAY 1000394 (BAY) is an oral pan-CDK inhibitor targeting CDKs 1, 2, 4, 7, and 9 in the low nanomolar range. A phase I dose escalation multicenter study was initiated to determine the maximum tolerated dose (MTD), pharmacokinetics (PK), and pharmacodynamics (PD) in patients (pts) with advanced solid tumors. Methods: BAY was administered twice daily as an oral solution on a 28 days on / 14 days off schedule (cycle length 42 days, 3+3 design). PK was evaluated on cycle 1 day 1, 2, and 15. Response rate was assessed according to RECIST 1.1. Results: Ten pts were treated at doses of 0.6 (4 pts) and 1.0 (6 pts) mg per day. Tumor types included 3 non-small cell lung, 2 colorectal, 2 melanoma and 3 others. CTCAEv4 grade 1/2 drug related adverse events (AEs) occurring in more than 3 patients were nausea (5 pts), hot flashes (4), vomiting, diarrhea, dyspepsia, and fatigue (3). The median interval between start of treatment and occurrence of hot flashes was 23 days. Drug-related grade 3 AEs were hyponatremia (2 pts) and edema, lymphopenia, myalgia, fatigue, and hypokalemia in 1 pt each. Hyponatremia in one and hypokalemia in another patient were dose limiting toxicities in cohort 2. Enrollment has been stopped. BAY PK was dose proportional and T1/2 was 13 hours; major metabolite levels were low. One pt with metastatic malignant melanoma pretreated with interferon, talimogene laherparepvec, and ipilimumab (best prior response: progressive disease) achieved stable disease (SD) lasting for 5 months. Three pts had SD lasting for 2.5 - 3 months (thyroid, colorectal, squamous esophageal). Conclusions: BAY administered for 28 days on / 14 days off demonstrated a limited tolerability. This is in contrast to the ongoing 3 days on / 4 days off trial which is currently at a dose level of 20 mg per day. Hot flashes were an infrequent AE in the other dosing schedule but occurred in 4 of the 10 pts presented here. The long interval between start of treatment and occurrence of hot flashes suggests that the 28 days of continuous treatment contributed to the lower tolerability observed in this trial. The 3 days on / 4 days off schedule will be used in the further clinical development of BAY.
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Affiliation(s)
| | - Glen J. Weiss
- Virginia G. Piper Cancer Center at Scottsdale Healthcare, Scottsdale, AZ
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Adjei AA, Richards DA, El-Khoueiry A, Becerra CH, Stephenson JJ, Leffingwell DP, Iverson C, Miner JN, Shen Z, Gunawan S, Wilson D, Manhard KJ, Dubowy RL, Jeffers M, Rajagopalan P, Franklin WA, Haney J, Lenhart P, Clendeninn NJ. Abstract A88: Safety, pharmacokinetic, and pharmacodynamic results of BAY 86–9766, an oral MEK inhibitor, in combination with sorafenib, an oral multikinase inhibitor, in advanced cancer patients. Mol Cancer Ther 2011. [DOI: 10.1158/1535-7163.targ-11-a88] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Preclinical data revealed a synergistic interaction between sorafenib (Nexavar®) and BAY 86-9766 (RDEA119). Sorafenib is an oral, small molecule, multikinase inhibitor that is approved for the treatment of unresectable hepatocellular carcinoma (HCC) and advanced renal cell carcinoma. BAY 86-9766 is an investigational, oral, potent, non-ATP competitive, highly selective inhibitor of MEK1/2. In a Phase 1 single-agent trial of BAY 86-9766 in advanced cancer patients, the maximum tolerated dose (MTD) was 100 mg daily, given as 50 mg twice daily (bid) or 100 mg once daily, with rash being the most common treatment-related adverse event (AE) and significant inhibition of tumor phosphorylated ERK (pERK) observed. This Phase 1 trial was conducted to determine the MTD, safety, pharmacokinetics (PK), pharmacodynamics (PD), and preliminary efficacy of BAY 86-9766 in combination with sorafenib. Data from the dose escalation cohorts and MTD expansion cohort are reported here. An additional cohort of patients with advanced HCC is ongoing in the MTD expansion phase and is not described here.
Materials and Methods: Key eligibility criteria included advanced metastatic or locally recurrent solid tumors, ECOG performance status of 0–1, acceptable organ function, and life expectancy of at least 3 months. Patients initially received BAY 86-9766 alone for up to 3 days to determine PK and then began a 28-day course of combination treatment with BAY 86-9766 and sorafenib. Dose escalation proceeded with increasing doses of BAY 86-9766 from 5 mg to 50 mg bid and either 200 mg or 400 mg bid of sorafenib. At least 3 patients were treated at each of 6 dose escalation levels. Safety was assessed by AEs, clinical laboratory tests, vital signs, ECGs, ECHO/MUGA scans, and physical exams. If benefiting from treatment, patients continued with subsequent 28-day courses and response was assessed every 2 courses. Tumor mutational status and PD effect on pERK in tumor biopsies were evaluated.
Results: Forty-three patients have been enrolled (32 in dose escalation and 11 in MTD expansion). Tumor types included 23 colorectal, 6 melanoma, 4 pancreatic, 3 head & neck, 2 esophageal, 2 ovarian, and 1 each of NSCLC, prostate, and small bowel adenocarcinoma. The MTD was determined to be the full doses of both drugs, 50 mg bid for BAY 86-9766 and 400 mg bid for sorafenib. The most common AEs were diarrhea (81%), rash (63%), fatigue (61%), nausea (49%), and vomiting (37%). Following single and multiple doses, mean Cmax and AUC0–12 of BAY 86-9766 increased nearly proportionally with dose, ranging between 5 mg bid and 50 mg bid. Plasma exposures of sorafenib at 200 mg bid and 400 mg bid were generally within the range reported from other studies. There was 1 confirmed partial response in a patient with colorectal cancer and 24 patients achieved a best overall response of stable disease. Tumor mutational analysis as well as PD data on tumor pERK suppression will be presented.
Conclusions: BAY 86-9766 in combination with sorafenib was well tolerated with diarrhea and rash being the most common AEs. Based on the results of this study, a Phase 2 study with BAY 86-9766 in combination with sorafenib is underway in HCC.
Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the AACR-NCI-EORTC International Conference: Molecular Targets and Cancer Therapeutics; 2011 Nov 12-16; San Francisco, CA. Philadelphia (PA): AACR; Mol Cancer Ther 2011;10(11 Suppl):Abstract nr A88.
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Affiliation(s)
| | | | | | | | - Joe J. Stephenson
- 5Institute of Translational Oncology Research-US Oncology Research, The Woodlands, TX
| | | | | | | | | | | | | | | | | | | | | | | | - Jerry Haney
- 8University of Colorado Cancer Center, Aurora, CO
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Mross K, Frost A, Scheulen ME, Krauss J, Strumberg D, Schultheiss B, Fasol U, Büchert M, Krätzschmer J, Delesen H, Rajagopalan P, Christensen O. Phase I study of telatinib (BAY 57-9352): analysis of safety, pharmacokinetics, tumor efficacy, and biomarkers in patients with colorectal cancer. Vasc Cell 2011; 3:16. [PMID: 21801343 PMCID: PMC3170612 DOI: 10.1186/2045-824x-3-16] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2010] [Accepted: 07/29/2011] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Telatinib (BAY 57-9352) is an orally available, small-molecule inhibitor of vascular endothelial growth factor receptors 2 and 3 (VEGFR-2/-3) and platelet-derived growth factor receptor β tyrosine kinases. METHODS In this multicenter phase I dose-escalation study including a phase II like expansion part, 39 patients with refractory colorectal cancer (CRC) were enrolled into 14 days on / 7 days off in repeating cycles of 28 days (n = 11) or continuous dosing groups (n = 28) to receive ≥ 600 mg telatinib twice-daily (bid). RESULTS Hypertension (28%) and diarrhoea (15%) were the most frequent study drug-related adverse events of CTC grade 3. In this population, no clear relationship between telatinib dose and individual Cmax and AUC was apparent in the 600 mg bid to 1500 mg bid dose range. No partial remission according to RECIST was reached, but 41% of the patients reached some tumour shrinkage during treatment. Tumour blood flow measured by dynamic contrast-enhanced magnetic resonance imaging and sVEGFR-2 plasma levels decreased with increasing telatinib AUC(0-12). CONCLUSION Telatinib treatment was well tolerated. The observed single agent antitumor activity in heavily pretreated CRC patients was limited. Pharmacodynamic results are suggestive for the biological activity of telatinib justifying a further evaluation of telatinib bid in combination with standard chemotherapy regimens in CRC patients.
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Affiliation(s)
- Klaus Mross
- Tumor Biology Center at the Albert-Ludwigs-University Freiburg, Germany.
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Gore L, Lewis K, Von Hoff DD, Weiss GJ, Ramanathan RK, Adjei AA, Dy GK, Ma WW, Clendeninn NJ, Leffingwell DP, Sheedy B, Iverson C, Miner JN, Shen Z, Yeh L, Dubowy RL, Jeffers M, Rajagopalan P, Weekes CD. Safety, pharmacokinetics, and pharmacodynamics results from a phase I trial of BAY 86-9766 (RDEA119), a MEK inhibitor, in patients with advanced cancer. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.3007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Blumenschein GR, Molina JR, Lathia CD, Ong TJ, Roth D, Rajagopalan P, Fossella FV, Kies MS, Marks RS, Adjei AA, Sundaresan PR. Phase I dose-escalation study of sorafenib in combination with bevacizumab (B), paclitaxel (P), and carboplatin (C) for the treatment of advanced nonsquamous non-small cell lung cancer (NSCLC). J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.7565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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37
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Patnaik A, Appleman LJ, Mountz JM, Ramanathan RK, Beeram M, Tolcher AW, Papadopoulos KP, Lotze MT, Petro DP, Laymon C, Paige L, Rajagopalan P, Jeffers M, Roth D, Dubowy RL. A first-in-human phase I study of intravenous PI3K inhibitor BAY 80-6946 in patients with advanced solid tumors: Results of dose-escalation phase. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.3035] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Weekes C, Hoff DV, Adjei A, Yeh L, Leffingwell D, Sheedy B, Iverson C, Rajagopalan P, Dubowy R, Clendeninn N. 368 A multi-center Phase 1, dose-escalation trial to determine the safety and pharmacokinetics/pharmacodynamics of BAY 86-9766 (RDEA119), a MEK inhibitor, in advanced cancer patients. EJC Suppl 2010. [DOI: 10.1016/s1359-6349(10)72075-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Abstract
Cell migration plays a critical role in numerous physiological processes, such as wound healing, response to inflammation, and cancer metastasis. In recent years, accumulating evidence indicates that cell movement is regulated not only by chemical signals but also by mechanical stimuli. In this study, the primary goal is to identify whether a chemical or mechanical stimulus plays the decisive role in directing cell migration. Measuring the motility of cells when they are presented with a combination of chemical and mechanical cues will provide insight into the complex physiological phenomena that guide and direct migration. A novel polyacrylamide hydrogel was designed with an interfacial region where the chemical and mechanical properties varied in opposing directions. One side of the interface was stiff (high Young's modulus) with a low protein concentration, whereas the other side of the interface was compliant (low Young's modulus) with a high protein concentration. The chemical gradient was created by varying the collagen (type I) concentration and the mechanical gradient was introduced by changing the extent of cross-linking in the polymer. The length of the interface with opposing chemical-mechanical profiles was found to be approximately 100 mum. Our results demonstrate that when Balb/c 3T3 fibroblasts were presented with a choice, they either migrated preferentially toward the high-collagen-compliant (low Young's modulus) side of the interfacial region or remained on the high-collagen region, suggesting a more dominant role for chemical stimuli in directing fibroblast locomotion.
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Affiliation(s)
- N A Hale
- Department of Chemical Engineering, Virginia Polytechnic Institute and State University, Blacksburg, Virginia 24061, USA
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Eskens FALM, Steeghs N, Verweij J, Bloem JL, Christensen O, van Doorn L, Ouwerkerk J, de Jonge MJA, Nortier JWR, Kraetzschmar J, Rajagopalan P, Gelderblom H. Phase I dose escalation study of telatinib, a tyrosine kinase inhibitor of vascular endothelial growth factor receptor 2 and 3, platelet-derived growth factor receptor beta, and c-Kit, in patients with advanced or metastatic solid tumors. J Clin Oncol 2009; 27:4169-76. [PMID: 19636022 DOI: 10.1200/jco.2008.18.8193] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE Telatinib (BAY 57-9352) is an orally available tyrosine kinase inhibitor of vascular endothelial growth factor receptor (VEGFR) -2, VEGFR-3, platelet-derived growth factor receptor-beta, and c-Kit. This phase I dose escalation study was conducted to evaluate the safety and tolerability of telatinib, with additional pharmacokinetic, pharmacodynamic, and efficacy assessments. PATIENTS AND METHODS Patients with solid tumors refractory to standard therapies or with no standard therapy available were enrolled. Doses of continuously administered telatinib were escalated from 20 mg once daily to 1,500 mg twice daily. RESULTS Fifty-three patients were enrolled. Most frequently observed drug-related adverse events were nausea (26.4%; grade >or= 3, 0%) and hypertension (20.8%; grade 3, 11.3%; grade 4, 0%). Two dose-limiting toxicities were observed: one poorly controlled hypertension (600 mg twice daily), and one grade 2 weight loss, anorexia, and fatigue (1,500 mg twice daily). A formal maximum-tolerated dose was not reached. Telatinib was rapidly absorbed, with median time to peak concentration (t(max)) lower than 3 hours after dose. A nearly dose-proportional increase in exposure was observed with substantial variability. Telatinib half-life averaged 5.5 hours. Biomarker analyses showed dose-dependent increase in VEGF levels and decrease in plasma soluble VEGFR-2 levels, with a plateau at 900 mg twice daily. A decrease in tumor blood flow (K(trans) and IAUC(60)) was observed with dynamic contrast-enhanced magnetic resonance imaging. Best tumor response was stable disease, observed in 50.9% of patients. CONCLUSION Telatinib was safe and well tolerated up to 1,500 mg twice daily. Based on pharmacodynamic and pharmacokinetic end points, telatinib 900 mg twice daily is the recommended dose for subsequent phase II studies.
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Affiliation(s)
- Ferry A L M Eskens
- Department of Medical Oncology, Erasmus University Medical Center, PO Box 2040, Rotterdam, 3000 CA, the Netherlands.
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Swierczewska M, Hajicharalambous C, Janorkar A, Megeed Z, Yarmush M, Rajagopalan P. Cellular response to nanoscale elastin-like polypeptide polyelectrolyte multilayers. Acta Biomater 2008; 4:827-37. [PMID: 18178532 DOI: 10.1016/j.actbio.2007.11.004] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2007] [Revised: 10/31/2007] [Accepted: 11/02/2007] [Indexed: 10/22/2022]
Abstract
Ionic elastin-like polypeptide (ELP) conjugates are a new class of biocompatible, self-assembling biomaterials. ELPs composed of the repeat unit (GVGVP)(n) are derived from the primary sequence of mammalian elastin and produced in Escherichia coli. These biopolymers exhibit an inverse transition temperature that renders them extremely useful for applications in cell-sheet engineering. Cationic and anionic conjugates were synthesized by the chemical coupling of ELP to polyethyleneimine (PEI) and polyacrylic acid (PAA). The self-assembly of ELP-PEI and ELP-PAA using the layer-by-layer deposition of alternately charged polyelectrolytes is a simple, versatile technique to generate bioactive and biomimetic surfaces with the ability to modulate cell-substratum interactions. Our studies are focused on cellular response to self-assembled multilayers of ionic (GVGVP)(40) incorporated within the polymeric sequence H(2)N-MVSACRGPG-(GVGVP)(40)-WP-COOH. Angle-dependent XPS studies indicated a difference in the chemical composition at the surface ( approximately 10A below the surface) and subsurface regions. These studies provided additional insight into the growth of the nanoscale multilayer assembly as well as the chemical environment that the cells can sense. Overall, cellular response was enhanced on glass substrata coated with ELP conjugates compared with uncoated surfaces. We report significant differences in cell proliferation, focal adhesions and cytoskeletal organization as a function of the number of bilayers in each assembly. These multilayer assemblies have the potential to be successfully utilized in the rational design of coatings on biomaterials to elicit a desired cellular response.
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Steeghs N, Gelderblom H, Roodt JO', Christensen O, Rajagopalan P, Hovens M, Putter H, Rabelink TJ, de Koning E. Hypertension and Rarefaction during Treatment with Telatinib, a Small Molecule Angiogenesis Inhibitor. Clin Cancer Res 2008; 14:3470-6. [DOI: 10.1158/1078-0432.ccr-07-5050] [Citation(s) in RCA: 158] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Davey RT, Pertel PE, Benson A, Cassell DJ, Gazzard BG, Holodniy M, Lalezari JP, Levy Y, Mitsuyasu RT, Palella FJ, Pollard RB, Rajagopalan P, Saag MS, Salata RA, Sha BE, Choudhri S. Safety, tolerability, pharmacokinetics, and efficacy of an interleukin-2 agonist among HIV-infected patients receiving highly active antiretroviral therapy. J Interferon Cytokine Res 2008; 28:89-100. [PMID: 18279104 DOI: 10.1089/jir.2007.0064] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
We sought to determine the safety, maximum tolerated dose, optimal dose, and preliminary dose efficacy of intermittent subcutaneously (s.c.) administered BAY 50-4798 among patients with HIV infection receiving highly active antiretroviral therapy (HAART) compared with patients receiving HAART alone. A phase I/II randomized, double-blind, dose-escalation study was conducted of the safety, tolerability, pharmacokinetics, and efficacy of s.c. BAY 50-4798 administered to HIV-infected patients already receiving stable HAART. There were no unexpected safety findings in a population of HIV-infected patients receiving HAART plus SC BAY 50-4798 as adjunctive therapy. BAY 50-4798 exhibited nearly dose-proportional pharmacokinetics, and accumulation was minimal during multiple-dose treatment. Limited efficacy data indicated that treatment with BAY 50-4798 caused at least a transient increase in CD4(+) T cell counts in some recipients, particularly at the early time points. In general, this effect appeared to increase with increasing dose. Bay 50-4798 was generally well tolerated across the dose range tested, but a lack of potent, sustained immunologic activity suggests that further optimization of dose and schedule will be necessary.
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Affiliation(s)
- Richard T Davey
- National Institutes of Health, National Institute of Allergy and Infectious Disease, Bethesda, MD 20892, USA.
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Strumberg D, Christensen O, Strecker R, Scheulen M, Frost A, Rajagopalan P, Voliotis D, Zuehlsdorf M, Wensing G, Mross K. 41 POSTER Clinical and biomarker responses in a phase I study of BAY 57 9352 – a VEGFR-2 inhibitor – administered as continuous dosing in patients with advanced solid tumors. EJC Suppl 2006. [DOI: 10.1016/s1359-6349(06)70047-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Gelderblom H, Verweij J, Steeghs N, de Koning E, van Erkel A, van Doorn L, Zuehlsdorf M, Rajagopalan P, Christensen O, Eskens F. 72 POSTER Phase I, safety, pharmacokinetic and biomarker study of telatinib (BAY 57-9352), an oral VEGFR-2 inhibitor, in a continuous schedule in patients with advanced solid tumors. EJC Suppl 2006. [DOI: 10.1016/s1359-6349(06)70078-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Strumberg D, Mross K, Scheulen M, Frost A, Hedbom S, Rajagopalan P, Voliotis D, Wensing G, Christensen O. Phase I study of BAY 57–9352, a VEGFR-2 inhibitor, in cycles of 14 days on/7 days off in patients with advanced solid tumors. J Clin Oncol 2006. [DOI: 10.1200/jco.2006.24.18_suppl.3089] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
3089 Background: BAY 57–9352 (BAY) inhibits the VEGFR-2 and VEGFR-3 tyrosine kinases, in addition to PDGFR-β and c-kit. BAY showed anti-tumor activity in colon, breast, pancreatic, and NSCLC preclinical models. Methods: This study investigated the safety, pharmacokinetics (PK), and pharmacodynamics (PD) of oral BAY in 14 days on/7 days off treatment cycles until discontinuation due to toxicity or progression. PK was assessed on days 1 and 14 of cycle 1. Dynamic contrast-enhanced MRI (DCE-MRI) was performed at baseline and in cycles 1–3. Plasma biomarkers (VEGF, sVEGFR-2) were assessed at each cycle. Results: 77 patients (pts) were enrolled at doses from 20 mg once daily to 1500 mg twice daily (bid). Common tumor types were CRC (31%) and RCC (16%). Frequent drug-related adverse events (≥5% pts) were hypertension (all grades, 11 pts [14%]; grade 3, 10 [13%]), hoarseness (10 [13%], only grade 1/2), anorexia (7 [9%], only grade 1/2), myalgia (6 [8%], only grade 1/2), fatigue (5 [6%], only grade 1/2), and diarrhea (all grades, 4 [5%]; grade 3, 1 [1%]). Hypertension in cycle 1 caused a dose reduction/interruption in 3 pts. One pt had diarrhea in cycle 7 requiring a dose reduction. One pt discontinued due to fatigue in cycle 8. BAY AUC increased dose-proportionally up to 900 mg bid. As measured by DCE-MRI, pts with CRC showed the greatest decrease in iAUC60 of Gd-DTPA, a parameter related to tumor blood flow and permeability. One pt with RCC achieved a partial response (PR); another had significant tumor shrinkage not reaching formal criteria (RECIST) for PR. PD responses (VEGF and sVEGFR-2 levels) increased in a dose-dependent manner up to 900 mg bid. Conclusions: The MTD was not reached for BAY up to 1500 mg bid in a 14 days on/7 days off schedule. BAY had a favorable safety profile. Tumor efficacy was shown in individual patients. The PD effect of BAY was demonstrated by DCE-MRI and plasma biomarkers. The recommended dose for Phase II evaluations is 900 mg bid. [Table: see text]
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Affiliation(s)
- D. Strumberg
- University Freiburg, Freiburg, Germany; West German Cancer Center, Essen, Germany; Tumor Biology Center, Freiburg, Germany; Bayer Pharmaceuticals, West Haven, CT; Bayer HealthCare AG, Wuppertal, Germany; University of Bochum, Herne, Germany
| | - K. Mross
- University Freiburg, Freiburg, Germany; West German Cancer Center, Essen, Germany; Tumor Biology Center, Freiburg, Germany; Bayer Pharmaceuticals, West Haven, CT; Bayer HealthCare AG, Wuppertal, Germany; University of Bochum, Herne, Germany
| | - M. Scheulen
- University Freiburg, Freiburg, Germany; West German Cancer Center, Essen, Germany; Tumor Biology Center, Freiburg, Germany; Bayer Pharmaceuticals, West Haven, CT; Bayer HealthCare AG, Wuppertal, Germany; University of Bochum, Herne, Germany
| | - A. Frost
- University Freiburg, Freiburg, Germany; West German Cancer Center, Essen, Germany; Tumor Biology Center, Freiburg, Germany; Bayer Pharmaceuticals, West Haven, CT; Bayer HealthCare AG, Wuppertal, Germany; University of Bochum, Herne, Germany
| | - S. Hedbom
- University Freiburg, Freiburg, Germany; West German Cancer Center, Essen, Germany; Tumor Biology Center, Freiburg, Germany; Bayer Pharmaceuticals, West Haven, CT; Bayer HealthCare AG, Wuppertal, Germany; University of Bochum, Herne, Germany
| | - P. Rajagopalan
- University Freiburg, Freiburg, Germany; West German Cancer Center, Essen, Germany; Tumor Biology Center, Freiburg, Germany; Bayer Pharmaceuticals, West Haven, CT; Bayer HealthCare AG, Wuppertal, Germany; University of Bochum, Herne, Germany
| | - D. Voliotis
- University Freiburg, Freiburg, Germany; West German Cancer Center, Essen, Germany; Tumor Biology Center, Freiburg, Germany; Bayer Pharmaceuticals, West Haven, CT; Bayer HealthCare AG, Wuppertal, Germany; University of Bochum, Herne, Germany
| | - G. Wensing
- University Freiburg, Freiburg, Germany; West German Cancer Center, Essen, Germany; Tumor Biology Center, Freiburg, Germany; Bayer Pharmaceuticals, West Haven, CT; Bayer HealthCare AG, Wuppertal, Germany; University of Bochum, Herne, Germany
| | - O. Christensen
- University Freiburg, Freiburg, Germany; West German Cancer Center, Essen, Germany; Tumor Biology Center, Freiburg, Germany; Bayer Pharmaceuticals, West Haven, CT; Bayer HealthCare AG, Wuppertal, Germany; University of Bochum, Herne, Germany
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Gelderblom H, Verweij J, Steeghs N, Van Erkel A, Van Doorn L, Ouwerkerk J, Rajagopalan P, Matthys A, Voliotis D, Eskens F. Phase I, safety, pharmacokinetic and biomarker study of BAY 57–9352, an oral VEGFR-2 inhibitor, in a continuous schedule in patients with advanced solid tumors. J Clin Oncol 2006. [DOI: 10.1200/jco.2006.24.18_suppl.3040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
3040 Background: BAY 57–9352 is a potent competitive inhibitor of the VEGFR-2 (IC50: 6 nM), VEGFR-3 (IC50: 4 nM), PDGFR-β and c-KIT tyrosine kinases. BAY 57–9352 showed tumor efficacy in colon, breast, pancreatic and NSCLC models. Methods: Patients with advanced solid tumors received oral BAY 57–9352 on a continuous basis, in escalating doses. One cycle was defined as 21 days of treatment. Extensive PK and PD (dynamic contrast-enhanced MRI [DCE-MRI]) evaluations were performed. Plasma biomarkers (e.g. VEGF)were also evaluated. Results: Forty patients (median 54 yrs) were enrolled at seven dose levels from 20 mg solution once daily to1500 mg twice daily (bid; 150 mg tablets) for a total of 169 cycles (range 1–17). The most frequent drug-related adverse events were nausea, hypertension, headache, vomiting, hoarseness, rash, dry skin and anorexia. One patient treated at 600 mg bid had a dose-limiting toxicity defined by an increase from grade 2 to 3 hypertension, despite the addition of an ACE-inhibitor and Ca-antagonist on day 8 of cycle 2. Another patient at that same dose level and also on day 8 cycle 2, had grade 3 AST/ALT increase, however this was not assessed as dose-limiting. Both patients continued treatment after dose reductions. Treatment was well tolerated, even at the highest dose levels. One patient with a hemangio-endothelioma (600 mg bid) had a clinical response and one desmoid tumor patient (900 mg bid) had a 53% reduction in tumor volume. BAY 57–9352 AUC increased dose proportionally up to 900 mg bid. The target AUC, based on animal models (5 mg × h/L) was reached in all patients at 900 mg bid. Dose levels exceeding 900 mg bid had similar plasma VEGF biomarker levels. Conclusions: BAY 57–9352 was well tolerated in doses up to 1500 mg bid. Based on safety, PK, PD and biomarker assessments, the recommended dose level is 900 mg bid. A 300 mg tablet is being tested for patient convenience. Combination chemotherapy studies have been started. [Table: see text]
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Affiliation(s)
- H. Gelderblom
- Leiden University Medical Center, Leiden, The Netherlands; Erasmus Medical Center, Rotterdam, The Netherlands; Bayer Pharmaceuticals, West Haven, CT; Bayer SA, Brussels, Belgium; Bayer HealthCare AG, Wuppertal, Germany
| | - J. Verweij
- Leiden University Medical Center, Leiden, The Netherlands; Erasmus Medical Center, Rotterdam, The Netherlands; Bayer Pharmaceuticals, West Haven, CT; Bayer SA, Brussels, Belgium; Bayer HealthCare AG, Wuppertal, Germany
| | - N. Steeghs
- Leiden University Medical Center, Leiden, The Netherlands; Erasmus Medical Center, Rotterdam, The Netherlands; Bayer Pharmaceuticals, West Haven, CT; Bayer SA, Brussels, Belgium; Bayer HealthCare AG, Wuppertal, Germany
| | - A. Van Erkel
- Leiden University Medical Center, Leiden, The Netherlands; Erasmus Medical Center, Rotterdam, The Netherlands; Bayer Pharmaceuticals, West Haven, CT; Bayer SA, Brussels, Belgium; Bayer HealthCare AG, Wuppertal, Germany
| | - L. Van Doorn
- Leiden University Medical Center, Leiden, The Netherlands; Erasmus Medical Center, Rotterdam, The Netherlands; Bayer Pharmaceuticals, West Haven, CT; Bayer SA, Brussels, Belgium; Bayer HealthCare AG, Wuppertal, Germany
| | - J. Ouwerkerk
- Leiden University Medical Center, Leiden, The Netherlands; Erasmus Medical Center, Rotterdam, The Netherlands; Bayer Pharmaceuticals, West Haven, CT; Bayer SA, Brussels, Belgium; Bayer HealthCare AG, Wuppertal, Germany
| | - P. Rajagopalan
- Leiden University Medical Center, Leiden, The Netherlands; Erasmus Medical Center, Rotterdam, The Netherlands; Bayer Pharmaceuticals, West Haven, CT; Bayer SA, Brussels, Belgium; Bayer HealthCare AG, Wuppertal, Germany
| | - A. Matthys
- Leiden University Medical Center, Leiden, The Netherlands; Erasmus Medical Center, Rotterdam, The Netherlands; Bayer Pharmaceuticals, West Haven, CT; Bayer SA, Brussels, Belgium; Bayer HealthCare AG, Wuppertal, Germany
| | - D. Voliotis
- Leiden University Medical Center, Leiden, The Netherlands; Erasmus Medical Center, Rotterdam, The Netherlands; Bayer Pharmaceuticals, West Haven, CT; Bayer SA, Brussels, Belgium; Bayer HealthCare AG, Wuppertal, Germany
| | - F. Eskens
- Leiden University Medical Center, Leiden, The Netherlands; Erasmus Medical Center, Rotterdam, The Netherlands; Bayer Pharmaceuticals, West Haven, CT; Bayer SA, Brussels, Belgium; Bayer HealthCare AG, Wuppertal, Germany
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Zuehlsdorf M, Christensen O, Strumberg D, Mross K, Eskens F, Gelderblom H, Verweij J, Rajagopalan P, Voliotis D, Wensing G. VEGF, sVEGFR-2, bFGF, and IL-8 as biomarkers of the pharmacological activity of BAY 57–9352, an oral VEGFR-2 receptor tyrosine kinase inhibitor, in patients with solid tumors. J Clin Oncol 2006. [DOI: 10.1200/jco.2006.24.18_suppl.3035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
3035 Background: BAY 57–9352 (BAY) is a potent anti-angiogenic drug that inhibits VEGFR-2, as well as VEGFR-1, VEGFR-3, PDGFR-β, and c-Kit tyrosine kinases. Molecular biomarkers of angiogenesis (VEGF165, soluble VEGFR-2 [sVEGFR-2], basic FGF [bFGF], and interleukin-8 [IL-8]) were used to assess the pharmacodynamic effects of BAY. Methods: Patients with advanced solid tumors from two Phase I studies received oral BAY on either an intermittent 21 day cycle (14 days on drug, 7 days off drug) or continuous schedule (21 day cycle). Doses were escalated from 20 mg once daily (od) to 1500 mg twice daily (bid). Molecular biomarkers were measured at baseline, pre-dose, and 8 hours post-dose on Days 1 and 14 of each cycle. Pharmacokinetic parameters of BAY were also assessed. Results: Plasma samples from 130 patients were analyzed for angiogenic biomarkers. Increased VEGF165 and decreased sVEGFR-2 clearly correlated with the dose of BAY, respectively. All clinical responders (as shown by tumor shrinkage) were located within the upper 10% of the total response distribution for these markers. Subgroup analysis in the three more prevalent tumors showed that patients with colorectal, renal cell, and hepatocellular carcinoma all showed biomarker responses exceeding the mean overall responses. Biomarker levels reached a plateau at daily doses of approximately 900 mg bid or 1800 mg, suggesting a saturated pharmacodynamic effect. There were no consistent changes in bFGF and IL-8. Conclusions: Both VEGF and sVEGFR-2 demonstrated a dose-dependent change with BAY 57–9352. VEGF and sVEGFR-2 may be appropriate biomarkers of the therapeutic effects of BAY, and may be useful as potential predictors of early response. [Table: see text]
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Affiliation(s)
- M. Zuehlsdorf
- Bayer HealthCare AG, Wuppertal, Germany; University of Bochum, Herne, Germany; Tumor Biology Center, Freiburg, Germany; Erasmus Medical Center, Rotterdam, The Netherlands; Leiden University Medical Center, Leiden, The Netherlands; Bayer Pharmaceuticals, West Haven, CT
| | - O. Christensen
- Bayer HealthCare AG, Wuppertal, Germany; University of Bochum, Herne, Germany; Tumor Biology Center, Freiburg, Germany; Erasmus Medical Center, Rotterdam, The Netherlands; Leiden University Medical Center, Leiden, The Netherlands; Bayer Pharmaceuticals, West Haven, CT
| | - D. Strumberg
- Bayer HealthCare AG, Wuppertal, Germany; University of Bochum, Herne, Germany; Tumor Biology Center, Freiburg, Germany; Erasmus Medical Center, Rotterdam, The Netherlands; Leiden University Medical Center, Leiden, The Netherlands; Bayer Pharmaceuticals, West Haven, CT
| | - K. Mross
- Bayer HealthCare AG, Wuppertal, Germany; University of Bochum, Herne, Germany; Tumor Biology Center, Freiburg, Germany; Erasmus Medical Center, Rotterdam, The Netherlands; Leiden University Medical Center, Leiden, The Netherlands; Bayer Pharmaceuticals, West Haven, CT
| | - F. Eskens
- Bayer HealthCare AG, Wuppertal, Germany; University of Bochum, Herne, Germany; Tumor Biology Center, Freiburg, Germany; Erasmus Medical Center, Rotterdam, The Netherlands; Leiden University Medical Center, Leiden, The Netherlands; Bayer Pharmaceuticals, West Haven, CT
| | - H. Gelderblom
- Bayer HealthCare AG, Wuppertal, Germany; University of Bochum, Herne, Germany; Tumor Biology Center, Freiburg, Germany; Erasmus Medical Center, Rotterdam, The Netherlands; Leiden University Medical Center, Leiden, The Netherlands; Bayer Pharmaceuticals, West Haven, CT
| | - J. Verweij
- Bayer HealthCare AG, Wuppertal, Germany; University of Bochum, Herne, Germany; Tumor Biology Center, Freiburg, Germany; Erasmus Medical Center, Rotterdam, The Netherlands; Leiden University Medical Center, Leiden, The Netherlands; Bayer Pharmaceuticals, West Haven, CT
| | - P. Rajagopalan
- Bayer HealthCare AG, Wuppertal, Germany; University of Bochum, Herne, Germany; Tumor Biology Center, Freiburg, Germany; Erasmus Medical Center, Rotterdam, The Netherlands; Leiden University Medical Center, Leiden, The Netherlands; Bayer Pharmaceuticals, West Haven, CT
| | - D. Voliotis
- Bayer HealthCare AG, Wuppertal, Germany; University of Bochum, Herne, Germany; Tumor Biology Center, Freiburg, Germany; Erasmus Medical Center, Rotterdam, The Netherlands; Leiden University Medical Center, Leiden, The Netherlands; Bayer Pharmaceuticals, West Haven, CT
| | - G. Wensing
- Bayer HealthCare AG, Wuppertal, Germany; University of Bochum, Herne, Germany; Tumor Biology Center, Freiburg, Germany; Erasmus Medical Center, Rotterdam, The Netherlands; Leiden University Medical Center, Leiden, The Netherlands; Bayer Pharmaceuticals, West Haven, CT
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Pescovitz MD, Guasch A, Gaston R, Rajagopalan P, Tomlanovich S, Weinstein S, Bumgardner GL, Melton L, Ducray PS, Banken L, Hall J, Boutouyrie BX. Equivalent pharmacokinetics of mycophenolate mofetil in African-American and Caucasian male and female stable renal allograft recipients. Am J Transplant 2003; 3:1581-6. [PMID: 14629290 DOI: 10.1046/j.1600-6135.2003.00243.x] [Citation(s) in RCA: 59] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
African-American (AA) renal transplant recipients require higher doses of mycophenolate mofetil (MMF) than Caucasians. A hypothesized pharmacokinetic (PK) difference was tested in stable renal transplant recipients. Whole blood was collected before, and 20, 40 and 75 min, and 2, 3, 4, 6, 8 and 12 h after the MMF dose. Mycophenolic acid (MPA) and its glucuronide metabolite (MPAG) were analyzed using HPLC. Analysis of variance was performed for the primary end-points of dose-adjusted PK parameters AUC0-12 and Cmax of MPA using log-transformed values. Differences between races and genders were estimated: 90% confidence intervals (CI) were calculated. Back-transformation gave estimates of the race and gender ratio and their CI. Equivalence of the groups was determined if the 90% confidence limits were included in the interval (0.80, 1.25). The calculated PK parameters were comparable among the four subgroups (Caucasian, AA, Male, Female). The 90% CIs for the ratio of dose-adjusted AUC0-12 of MPA between races were between 89.7 and 112.9%. There were no race, gender or race-by-gender effects (p-values = 0.196) nor differences between diabetics and nondiabetics. This study demonstrates that dosing requirement for MMF in AA and Caucasians is unlikely to be related to different exposures to MPA.
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