A phase I study of two dosing schedules of volasertib (BI 6727), an intravenous polo-like kinase inhibitor, in patients with advanced solid malignancies.

A phase I study of two dosing schedules of volasertib (BI 6727), an intravenous polo-like kinase inhibitor, in patients with advanced solid malignancies.
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DOI:
10.1038/bjc.2014.195
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发表时间:
2014-05-13
影响因子:
8.8
通讯作者:
Yang, J. C-H
Yang, J. C-H
中科院分区:
医学1区
文献类型:
--
作者:
Lin, C-C;Su, W-C;Yen, C-J;Hsu, C-H;Su, W-P;Yeh, K-H;Lu, Y-S;Cheng, A-L;Huang, D. C-L;Fritsch, H.;Voss, F.;Taube, T.;Yang, J. C-H

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Polo 样激酶 1 (Plk1) 在有丝分裂中发挥重要作用。 Volasertib (BI 6727) 是一种有效的选择性细胞周期激酶抑制剂,通过靶向 Plk 诱导有丝分裂停滞和细胞凋亡;这项 I 期研究旨在确定亚洲晚期实体瘤患者的最大耐受剂量 (MTD)。患者同时纳入两个为期 3 周的 volasertib 方案:第 1 天(方案 A)或第 1 天和第 8 天(方案 B)输注 2 小时。剂量递增遵循3+3设计。 MTD 是根据第一个疗程中的剂量限制毒性 (DLT) 确定的。在 59 名接受治疗的患者中,最常见的首个疗程 DLT 是可逆性血小板减少症、中性粒细胞减少症和发热性中性粒细胞减少症;方案 A 的 MTD 为 300 mg,方案 B 的 MTD 为 150 mg。 Volasertib 表现出多指数药代动力学 (PK)、约 135 h 的长终末半衰期、大分布体积 (> 3000 l) 和中等清除率。在两名接受过治疗的患者(输尿管癌;黑色素瘤)中观察到部分缓解。 Volasertib 通常具有良好的耐受性,不良事件特征与其抗有丝分裂作用模式一致,并且 PK 特征良好。这些数据支持 volasertib 的进一步开发以及亚洲和白人患者的统一剂量。
Polo-like kinase 1 (Plk1) has an important role in mitosis. Volasertib (BI 6727), a potent and selective cell cycle kinase inhibitor, induces mitotic arrest and apoptosis by targeting Plk; this phase I study sought to determine its maximum tolerated dose (MTD) in Asian patients with advanced solid tumours. Patients were enrolled simultaneously into two 3-week schedules of volasertib: a 2-h infusion on day 1 (schedule A) or days 1 and 8 (schedule B). Dose escalation followed a 3+3 design. The MTD was determined based on dose-limiting toxicities (DLT) in the first treatment course. Among 59 treated patients, the most common first course DLTs were reversible thrombocytopenia, neutropenia and febrile neutropenia; MTDs were 300 mg for schedule A and 150 mg for schedule B. Volasertib exhibited multi-exponential pharmacokinetics (PK), a long terminal half-life of ∼135 h, a large volume of distribution (>3000 l), and a moderate clearance. Partial responses were observed in two pre-treated patients (ureteral cancer; melanoma). Volasertib was generally well tolerated, with an adverse event profile consistent with its antimitotic mode of action and a favourable PK profile. These data support further development of volasertib and a harmonised dosing for Asian and Caucasian patients.
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