IDH-mutant glioma: A new IDH1 inhibitor moves forward.

IDH-mutant glioma: A new IDH1 inhibitor moves forward.
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IDH 突变神经胶质瘤:一种新的 IDH1 抑制剂取得进展。

DOI:
10.1093/neuonc/noac275
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发表时间:
2023
期刊:
影响因子:
15.9
通讯作者:
Arrillaga-Romany,Isabel
Arrillaga-Romany,Isabel
中科院分区:
医学1区
文献类型:
--
作者:
Miller,JulieJ;Arrillaga-Romany,Isabel

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大约70%的低级别胶质瘤含有异柠檬酸脱氢酶1 (IDH1)突变,导致肿瘤代谢物d -2-羟基戊二酸(D-2-HG)的积累;这导致表观遗传失调、肿瘤发生和随后的克隆扩增。DS-1001是一种口服脑渗透突变型IDH1选择性抑制剂。这项首次人体研究调查了DS-1001的安全性、药代动力学、药效学和疗效。方法:这是一项多中心、开放标签、剂量递增、DS-1001治疗复发/进展性idh1突变(R132)胶质瘤(N = 47) (NCT03030066)的I期研究。DS-1001口服125-1400 mg,每日2次。剂量递增采用改进的连续重新评估方法。结果未达到最大耐受剂量。数据截止时,8名患者仍在继续治疗。大多数不良事件(ae)为1-2级。20例患者(42.6%)经历了至少1次3级AE。无4级或5级不良事件或严重药物相关不良事件报告。常见的不良反应为皮肤色素沉着、腹泻、瘙痒、脱发、关节痛、恶心、头痛、皮疹和皮肤干燥。强化肿瘤客观有效率为17.1%,非强化肿瘤客观有效率为33.3%。增强和非增强胶质瘤组的中位无进展生存期分别为10.4个月(95%置信区间[CI], 6.1至17.7个月)和未达到(95% CI, 24.1至未达到)。与研究前存档的样本相比,7个接受治疗的脑肿瘤样本的D-2-HG含量显著降低。结论sds -1001耐受性好,脑内分布良好。复发/进行性idh1突变胶质瘤患者对治疗有反应。DS-1001在化疗和radiotherapy-naïve idh1突变的WHO 2级胶质瘤患者中的研究正在进行中(NCT04458272)。
BackgroundApproximately 70% of lower-grade gliomas harbor isocitrate dehydrogenase 1 (IDH1) mutations, resulting in the accumulation of oncometabolite D-2-hydroxyglutarate (D-2-HG); this leads to epigenetic dysregulation, oncogenesis, and subsequent clonal expansion. DS-1001 is an oral brain-penetrant mutant IDH1 selective inhibitor. This first-in-human study investigated the safety, pharmacokinetics, pharmacodynamics, and efficacy of DS-1001.MethodsThis was a multicenter, open-label, dose-escalation, phase I study of DS-1001 for recurrent/progressive IDH1-mutant (R132) glioma (N = 47) (NCT03030066). DS-1001 was administered orally at 125-1400 mg twice daily. Dose-escalation used a modified continual reassessment method.ResultsThe maximum tolerated dose was not reached. Eight patients were continuing treatment at the data cutoff. Most adverse events (AEs) were grade 1-2. Twenty patients (42.6%) experienced at least 1 grade 3 AE. No grade 4 or 5 AEs or serious drug-related AEs were reported. Common AEs (>20%) were skin hyperpigmentation, diarrhea, pruritus, alopecia, arthralgia, nausea, headache, rash, and dry skin. The objective response rates were 17.1% for enhancing tumors and 33.3% for non-enhancing tumors. Median progression-free survival was 10.4 months (95% confidence interval [CI], 6.1 to 17.7 months) and not reached (95% CI, 24.1 to not reached) for the enhancing and non-enhancing glioma cohorts, respectively. Seven on-treatment brain tumor samples showed a significantly lower amount of D-2-HG compared with pre-study archived samples.ConclusionsDS-1001 was well tolerated with a favorable brain distribution. Recurrent/progressive IDH1-mutant glioma patients responded to treatment. A study of DS-1001 in patients with chemotherapy- and radiotherapy-naïve IDH1-mutated WHO grade 2 glioma is ongoing (NCT04458272).
DOI: --
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DOI: --
发表时间: 1982
影响因子: 5.6
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影响因子: --
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