TY - JOUR
T1 - A phase 1 open-label, sequential dose-escalation study investigating the safety, tolerability, and pharmacokinetics of intravenous TLC388 administered to patients with advanced solid tumors
AU - Ghamande, Sharad
AU - Lin, Chia Chi
AU - Cho, Daniel C.
AU - Shapiro, Geoffrey I.
AU - Kwak, Eunice L.
AU - Silverman, Michael H.
AU - Tseng, Yunlong
AU - Kuo, Min Wen
AU - Mach, Wendy B.
AU - Hsu, Shu Chi
AU - Coleman, Teresa
AU - Yang, James Chih Hsin
AU - Cheng, Ann Lii
AU - Ghalib, Mohammad H.
AU - Chuadhary, Imran
AU - Goel, Sanjay
PY - 2014/6
Y1 - 2014/6
N2 - Purpose: The first-in-human phase 1 trial examined the dose-limiting toxicities (DLT), maximum tolerated dose (MTD), pharmacokinetic profile, and antitumor activity of TLC388, a novel camptothecin with a unique lactone ring modification, in patients with advanced solid tumors. Experimental design: TLC388 was administered intravenously to patients with metastatic chemotherapy refractory solid tumors on days 1, 8, and 15 of a 28-day cycle. Patients underwent tumor assessments every other cycle. Pharmacokinetic samples were drawn on days 1, 8, and 15 of cycles 1 and 2. Results: Fifty-four patients were enrolled at doses ranging from 1.5 to 60.0 mg/m2 over 12 cohorts. Treatment was generally well-tolerated and no cumulative toxicity observed. Two of six patients treated at 60.0 mg/m2 developed DLTs of grade 3 neutropenia causing dose delay and grade 3 febrile neutropenia. The next lower dose, 50.0 mg/m2, was declared as MTD. Treatment-related grade 3-4 hematologic toxicities included neutropenia (19 %), leukopenia (15 %), anemia (9 %), and thrombocytopenia (7 %). Grade 3-4 nonhematologic toxicities included diarrhea (2 %) and hyponatremia (4 %). Pharmacokinetics of both diastereomers (S,R and S,S) of TLC388, a mixture of two diastereomers, was dose independent; mean (SD) values for the volume of distribution at steady-state and clearance were 857 (1122) L/m2 for S,R and 996 (1333) L/m2 for S,S, and 2174 (2526) L/h-m2 for S,R and 2670 (2988) L/h-m2 for S,S, respectively. The half-life values averaged 0.67 (1.15) hours for S,R and 0.64 (1.11) hours for S,S. The best overall response was stable disease in 21 (39 %) patients. Prolonged (≥ 6 months) stable disease was noted in eight patients. Conclusions: TLC388 at 50 mg/m2 on the current treatment schedule is generally safe and well tolerated.
AB - Purpose: The first-in-human phase 1 trial examined the dose-limiting toxicities (DLT), maximum tolerated dose (MTD), pharmacokinetic profile, and antitumor activity of TLC388, a novel camptothecin with a unique lactone ring modification, in patients with advanced solid tumors. Experimental design: TLC388 was administered intravenously to patients with metastatic chemotherapy refractory solid tumors on days 1, 8, and 15 of a 28-day cycle. Patients underwent tumor assessments every other cycle. Pharmacokinetic samples were drawn on days 1, 8, and 15 of cycles 1 and 2. Results: Fifty-four patients were enrolled at doses ranging from 1.5 to 60.0 mg/m2 over 12 cohorts. Treatment was generally well-tolerated and no cumulative toxicity observed. Two of six patients treated at 60.0 mg/m2 developed DLTs of grade 3 neutropenia causing dose delay and grade 3 febrile neutropenia. The next lower dose, 50.0 mg/m2, was declared as MTD. Treatment-related grade 3-4 hematologic toxicities included neutropenia (19 %), leukopenia (15 %), anemia (9 %), and thrombocytopenia (7 %). Grade 3-4 nonhematologic toxicities included diarrhea (2 %) and hyponatremia (4 %). Pharmacokinetics of both diastereomers (S,R and S,S) of TLC388, a mixture of two diastereomers, was dose independent; mean (SD) values for the volume of distribution at steady-state and clearance were 857 (1122) L/m2 for S,R and 996 (1333) L/m2 for S,S, and 2174 (2526) L/h-m2 for S,R and 2670 (2988) L/h-m2 for S,S, respectively. The half-life values averaged 0.67 (1.15) hours for S,R and 0.64 (1.11) hours for S,S. The best overall response was stable disease in 21 (39 %) patients. Prolonged (≥ 6 months) stable disease was noted in eight patients. Conclusions: TLC388 at 50 mg/m2 on the current treatment schedule is generally safe and well tolerated.
KW - Camptothecin
KW - Hypoxia-inducible factor
KW - Phase 1 trial
KW - Topoisomerase
KW - Topotecan
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U2 - 10.1007/s10637-013-0044-7
DO - 10.1007/s10637-013-0044-7
M3 - Article
C2 - 24271274
AN - SCOPUS:84904639018
SN - 0167-6997
VL - 32
SP - 445
EP - 451
JO - Investigational New Drugs
JF - Investigational New Drugs
IS - 3
ER -