1. Phase I study of MLN8237-investigational Aurora A kinase inhibitor-in relapsed/refractory multiple myeloma, Non-Hodgkin lymphoma and chronic lymphocytic leukemia.
- Author
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Kelly, Kevin, Shea, Thomas, Goy, André, Berdeja, Jesus, Reeder, Craig, McDonagh, Kevin, Zhou, Xiaofei, Danaee, Hadi, Liu, Hua, Ecsedy, Jeffrey, Niu, Huifeng, Benaim, Ely, and Padmanabhan Iyer, Swaminathan
- Subjects
ACADEMIC medical centers ,ANTINEOPLASTIC agents ,CHRONIC lymphocytic leukemia ,CLINICAL trials ,LYMPHOMAS ,MEDICAL cooperation ,MEDICAL protocols ,MULTIPLE myeloma ,RESEARCH ,RESEARCH funding ,SAFETY ,DESCRIPTIVE statistics ,INVESTIGATIONAL drugs ,PHARMACODYNAMICS - Abstract
Purpose Amplification or over-expression of the mitotic Aurora A kinase (AAK) has been reported in several heme-lymphatic malignancies. MLN8237 (alisertib) is a novel inhibitor of AAK that is being developed for the treatment of advanced malignancies. The objectives of this phase I study were to establish the safety, tolerability, and pharmacokinetic profiles of escalating doses of MLN8237 in patients with relapsed or refractory heme-lymphatic malignancies. Methods Sequential cohorts of patients received MLN8237 orally as either a powder-in-capsule (PIC) or enteric-coated tablet (ECT) formulation. Patients received MLN8237 PIC 25-90 mg for 14 or 21 consecutive days plus 14 or 7 days' rest, respectively, or MLN8237 ECT, at a starting dose of 40 mg/day once-daily (QD) for 14 days plus 14 days' rest, all in 28-day cycles. Subsequent cohorts received MLN8237 ECT 30-50 mg twice-daily (BID) for 7 days plus 14 days' rest in 21-day cycles. Results Fifty-eight patients were enrolled (PIC n = 28, ECT n = 30). The most frequent grade ≥3 drug-related toxicities were neutropenia (45 %), thrombocytopenia (28 %), anemia (19 %), and leukopenia (19 %). The maximum tolerated dose on the ECT 7-day schedule was 50 mg BID. The terminal half-life of MLN8237 was approximately 19 h. Six (13 %) patients achieved partial responses and 13 (28 %) stable disease. Conclusion The recommended phase II dose of MLN8237 ECT is 50 mg BID for 7 days in 21-day cycles, which is currently being evaluated as a single agent in phase II/III trials in patients with peripheral T-cell lymphoma. [ABSTRACT FROM AUTHOR]
- Published
- 2014
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