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Phase I and pharmacodynamic study of the oral MEK inhibitor CI-1040 in patients with advanced malignancies.
- Source :
-
Journal of clinical oncology : official journal of the American Society of Clinical Oncology [J Clin Oncol] 2005 Aug 10; Vol. 23 (23), pp. 5281-93. Date of Electronic Publication: 2005 Jul 11. - Publication Year :
- 2005
-
Abstract
- Purpose: This phase I study was undertaken to define the toxicity, pharmacokinetics, pharmacodynamics, maximum tolerated dose (MTD), and clinical activity of CI-1040, a small-molecule inhibitor of the dual-specificity kinases MEK(mitogen-activated protein kinase kinase) -1 and MEK2 , in patients with advanced malignancy.<br />Patients and Methods: CI-1040 was tested in multiple daily dosing frequencies administered for 21 days repeated every 28 days leading ultimately to continuous administration, and effect of food on absorption was tested. Single dose and steady-state pharmacokinetics were assessed during cycle 1 and phosphorylated extracellular receptor kinase (pERK) levels were assessed in WBCs and also in tumor tissue from selected patients.<br />Results: Seventy-seven patients received CI-1040 at dose levels ranging from 100 mg QD to 800 mg tid. Grade 3 asthenia was dose limiting at the highest dose level tested, 800 mg tid administered with food. Ninety-eight percent of all drug-related adverse events were grade 1 or 2 in severity; most common toxicities included diarrhea, asthenia, rash, nausea, and vomiting. Plasma concentrations of CI-1040 and its active metabolite, PD 0184264, increased in a less than dose proportional manner from 100 to 800 mg QD. Administration with a high-fat meal resulted in an increase in drug exposure. The MTD and recommended phase II dose was 800 mg BID administered with food. Sixty-six patients were assessable for response. One partial response was achieved in a patient with pancreatic cancer and 19 patients (28%) achieved stable disease lasting a median of 5.5 months (range, 4 to 17 months). Inhibition of tumor pERK (median, 73%; range, 46% to 100%) was demonstrated in 10 patients.<br />Conclusion: CI-1040 was well tolerated at 800 mg BID administered with food. Both target suppression and antitumor activity were demonstrated in this phase I study.
- Subjects :
- Administration, Oral
Adult
Aged
Aged, 80 and over
Benzamides adverse effects
Benzamides pharmacokinetics
Calcium-Calmodulin-Dependent Protein Kinases metabolism
Enzyme Inhibitors adverse effects
Enzyme Inhibitors pharmacokinetics
Female
Humans
Male
Maximum Tolerated Dose
Middle Aged
Neoplasms blood
Treatment Outcome
Benzamides therapeutic use
Enzyme Inhibitors therapeutic use
MAP Kinase Kinase 1 antagonists & inhibitors
MAP Kinase Kinase 2 antagonists & inhibitors
Neoplasm Metastasis drug therapy
Neoplasms drug therapy
Subjects
Details
- Language :
- English
- ISSN :
- 0732-183X
- Volume :
- 23
- Issue :
- 23
- Database :
- MEDLINE
- Journal :
- Journal of clinical oncology : official journal of the American Society of Clinical Oncology
- Publication Type :
- Academic Journal
- Accession number :
- 16009947
- Full Text :
- https://doi.org/10.1200/JCO.2005.14.415