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Basu B, Krebs MG, Sundar R, Wilson RH, Spicer J, Jones R, Brada M, Talbot DC, Steele N, Ingles Garces AH, Brugger W, Harrington EA, Evans J, Hall E, Tovey H, de Oliveira FM, Carreira S, Swales K, Ruddle R, Raynaud FI, Purchase B, Dawes JC, Parmar M, Turner AJ, Tunariu N, Banerjee S, de Bono JS, Banerji U. Vistusertib (dual m-TORC1/2 inhibitor) in combination with paclitaxel in patients with high-grade serous ovarian and squamous non-small-cell lung cancer. Ann Oncol 2018; 29:1918-1925. [PMID: 30016392 PMCID: PMC6158767 DOI: 10.1093/annonc/mdy245] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Background We have previously shown that raised p-S6K levels correlate with resistance to chemotherapy in ovarian cancer. We hypothesised that inhibiting p-S6K signalling with the dual m-TORC1/2 inhibitor in patients receiving weekly paclitaxel could improve outcomes in such patients. Patients and methods In dose escalation, weekly paclitaxel (80 mg/m2) was given 6/7 weeks in combination with two intermittent schedules of vistusertib (dosing starting on the day of paclitaxel): schedule A, vistusertib dosed bd for 3 consecutive days per week (3/7 days) and schedule B, vistusertib dosed bd for 2 consecutive days per week (2/7 days). After establishing a recommended phase II dose (RP2D), expansion cohorts in high-grade serous ovarian cancer (HGSOC) and squamous non-small-cell lung cancer (sqNSCLC) were explored in 25 and 40 patients, respectively. Results The dose-escalation arms comprised 22 patients with advanced solid tumours. The dose-limiting toxicities were fatigue and mucositis in schedule A and rash in schedule B. On the basis of toxicity and pharmacokinetic (PK) and pharmacodynamic (PD) evaluations, the RP2D was established as 80 mg/m2 paclitaxel with 50 mg vistusertib bd 3/7 days for 6/7 weeks. In the HGSOC expansion, RECIST and GCIG CA125 response rates were 13/25 (52%) and 16/25 (64%), respectively, with median progression-free survival (mPFS) of 5.8 months (95% CI: 3.28-18.54). The RP2D was not well tolerated in the SqNSCLC expansion, but toxicities were manageable after the daily vistusertib dose was reduced to 25 mg bd for the following 23 patients. The RECIST response rate in this group was 8/23 (35%), and the mPFS was 5.8 months (95% CI: 2.76-21.25). Discussion In this phase I trial, we report a highly active and well-tolerated combination of vistusertib, administered as an intermittent schedule with weekly paclitaxel, in patients with HGSOC and SqNSCLC. Clinical trial registration ClinicialTrials.gov identifier: CNCT02193633.
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Affiliation(s)
- B Basu
- Department of Oncology, University of Cambridge and Cambridge University Hospitals NHS Foundation Trust, Cambridge
| | - M G Krebs
- Manchester Academic Health Science Centre, The University of Manchester and The Christie NHS Foundation Trust, Manchester
| | - R Sundar
- Drug Development Unit, The Institute of Cancer Research and The Royal Marsden, London, UK; Department of Haematology-Oncology, National University Health System, Singapore
| | - R H Wilson
- Centre for Cancer Research and Cell Biology, Queen's University Belfast and Belfast City Hospital, Belfast
| | - J Spicer
- School of Cancer and Pharmaceutical Sciences, King's College London and Guy's and St Thomas' NHS Foundation Trust, London
| | - R Jones
- Cardiff University and Velindre Cancer Centre, Cardiff
| | - M Brada
- University of Liverpool and Clatterbridge Cancer Centre NHS Foundation Trust, Wirral
| | - D C Talbot
- Department of Oncology, Oxford University Hospitals NHS Foundation Trust, Oxford
| | - N Steele
- University of Glasgow and Beatson West of Scotland Cancer Centre, Glasgow
| | - A H Ingles Garces
- Drug Development Unit, The Institute of Cancer Research and The Royal Marsden, London, UK
| | - W Brugger
- Oncology, IMED Biotech Unit AstraZeneca, Cambridge
| | | | - J Evans
- University of Glasgow and Beatson West of Scotland Cancer Centre, Glasgow
| | - E Hall
- Clinical Trials and Statistics Unit, The Institute of Cancer Research, London
| | - H Tovey
- Clinical Trials and Statistics Unit, The Institute of Cancer Research, London
| | - F M de Oliveira
- Division of Clinical Studies, The Institute of Cancer Research, London
| | - S Carreira
- Division of Clinical Studies, The Institute of Cancer Research, London
| | - K Swales
- Division of Cancer Therapeutics, The Institute of Cancer Research, London
| | - R Ruddle
- Drug Development Unit, The Institute of Cancer Research and The Royal Marsden, London, UK; Division of Cancer Therapeutics, The Institute of Cancer Research, London
| | - F I Raynaud
- Drug Development Unit, The Institute of Cancer Research and The Royal Marsden, London, UK; Division of Cancer Therapeutics, The Institute of Cancer Research, London
| | - B Purchase
- Drug Development Unit, The Institute of Cancer Research and The Royal Marsden, London, UK
| | - J C Dawes
- Drug Development Unit, The Institute of Cancer Research and The Royal Marsden, London, UK
| | - M Parmar
- Drug Development Unit, The Institute of Cancer Research and The Royal Marsden, London, UK
| | - A J Turner
- Drug Development Unit, The Institute of Cancer Research and The Royal Marsden, London, UK
| | - N Tunariu
- Drug Development Unit, The Institute of Cancer Research and The Royal Marsden, London, UK
| | - S Banerjee
- Department of Gynae-Oncology, The Royal Marsden, London, UK
| | - J S de Bono
- Drug Development Unit, The Institute of Cancer Research and The Royal Marsden, London, UK; Division of Clinical Studies, The Institute of Cancer Research, London
| | - U Banerji
- Drug Development Unit, The Institute of Cancer Research and The Royal Marsden, London, UK; Division of Clinical Studies, The Institute of Cancer Research, London; Division of Cancer Therapeutics, The Institute of Cancer Research, London.
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Michalarea V, Lopez J, Lorente D, Carreira S, Hassam H, Parmar M, Turner A, Hall E, Fandos SS, Decordova S, Swales K, Ruddle R, Raynaud F, Tunariu N, Stephens C, Molife L, Banerji U, Plummer R, Bono JD, Yap T. 343 Translational phase I trial combining the AKT inhibitor AZD5363 (AZD) and PARP inhibitor Olaparib (Ola) in advanced cancer patients (pts). Eur J Cancer 2015. [DOI: 10.1016/s0959-8049(16)30206-4] [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: 10/22/2022]
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Yesudian GT, Gilchrist F, Bebb K, Albadri S, Aspinall A, Swales K, Deery C. A multicentre, multicycle audit of the prescribing practices of three paediatric dental departments in the North of England. Br Dent J 2015; 218:681-5. [DOI: 10.1038/sj.bdj.2015.440] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/02/2014] [Indexed: 11/09/2022]
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Basu B, Roda-Perez D, Wong H, Sathiyayogan N, Parmar M, Turner A, Swales K, Stimpson S, Hall E, Hategan M, Garcia-Corbacho J, Yap T, Molife L, Jimenez B, Banerjee S, Kaye S, De Bono J, Banerji U. Phase I Multicentre Tax-Torc Trial of the Dual Mtorc1/2 Inhibitor Azd2014 (A) Plus Weekly Paclitaxel (P) in Patients (Pts) with Solid Tumours (Crukd/12/013). Ann Oncol 2014. [DOI: 10.1093/annonc/mdu331.28] [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: 11/14/2022] Open
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Swales K, Plant N, Ayrton A, Hood S, Gibson G. Relative receptor expression is a determinant in xenobiotic-mediated CYP3A induction in rat and human cells. Xenobiotica 2003; 33:703-16. [PMID: 12893520 DOI: 10.1080/0049825031000121626] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
1. Species differences in xenobiotic-mediated transcriptional activation of CYP3A genes are known to exist. These differences are proposed to be due, in part, to host cell differences. 2. Host cell effects were investigated by trans-species transient transfection of reporter genes containing either the rat CYP3A23 or human CYP3A4 proximal promoters into human HepG2 and rat FaO and H4IIEC3 hepatoma cells. HepG2 and FaO cells supported activation of both CYP3A constructs by xenobiotics in a species-specific manner, whereas H4IIEC3 cells were non-permissive. 3. The mRNA complement of the cell lines was then quantified by semiquantitative RT-PCR for adult CYP3As (CYP3A23, CYP3A4/5), steroid hormone receptors (constitutive androstane receptor, glucocorticoid receptor-alpha, pregnane X receptor) and transcription factors (Hepatic nuclear factor 4alpha, retinoid X receptor). 4. Principal component analysis of absolute receptor levels demonstrated a wide scattering, with no coherent pattern. In contrast, PCA of relative receptor ratios segregated H4IIEC3 cells from all other samples. 5. The observation is confirmed that species differences in response to xenobiotics are a result of host cell environment. In addition, new evidence is provided to support the hypothesis that in addition to individual receptor activation profiles, the relative abundance of steroid hormone receptors that control CYP3A gene expression play an important role in this observed species difference.
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MESH Headings
- Animals
- Aryl Hydrocarbon Hydroxylases/drug effects
- Aryl Hydrocarbon Hydroxylases/genetics
- Aryl Hydrocarbon Hydroxylases/metabolism
- Carcinoma, Hepatocellular/enzymology
- Carcinoma, Hepatocellular/genetics
- Cell Line, Tumor
- Cytochrome P-450 CYP3A
- Dexamethasone/pharmacology
- Dose-Response Relationship, Drug
- Gene Expression Profiling
- Gene Expression Regulation, Enzymologic/drug effects
- Gene Expression Regulation, Enzymologic/genetics
- Humans
- Liver Neoplasms/enzymology
- Liver Neoplasms/genetics
- Oxidoreductases, N-Demethylating/drug effects
- Oxidoreductases, N-Demethylating/genetics
- Oxidoreductases, N-Demethylating/metabolism
- Pregnane X Receptor
- Rats
- Receptors, Cytoplasmic and Nuclear/metabolism
- Receptors, Steroid/metabolism
- Rifampin/pharmacology
- Species Specificity
- Tissue Distribution
- Transcription Factors/genetics
- Transcription Factors/metabolism
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Affiliation(s)
- K Swales
- School of Biomedial and Life Sciences, University of Surrey, Guildford, UK
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