An Open-Label, Multicenter, Phase I, Dose Escalation Study with Phase II Expansion Cohort to Determine the Safety, Pharmacokinetics, and Preliminary Antitumor Activity of Intravenous TKM-080301 in Subjects with Advanced Hepatocellular Carcinoma

Imane El Dika, Ho Yeong Lim, Wei Peng Yong, Chia-Chi Lin, Jung-Hwan Yoon, Manuel Modiano, Bradley Freilich, Hye Jin Choi, Tsu-Yi Chao, Robin K Kelley, Joanne Brown, Jennifer Knox, Baek-Yeol Ryoo, Thomas Yau, Ghassan K Abou-Alfa, Imane El Dika, Ho Yeong Lim, Wei Peng Yong, Chia-Chi Lin, Jung-Hwan Yoon, Manuel Modiano, Bradley Freilich, Hye Jin Choi, Tsu-Yi Chao, Robin K Kelley, Joanne Brown, Jennifer Knox, Baek-Yeol Ryoo, Thomas Yau, Ghassan K Abou-Alfa

Abstract

Lessons learned: TKM-080301 showed a favorable toxicity profile at the studied dose.TKM-080301 targeting PLK1 through small interfering RNA mechanism did not demonstrate improved overall survival in patients with advanced hepatocellular carcinoma compared with historical control. Preliminary antitumor activity as shown in this early-phase study does not support further evaluation as a single agent.

Background: Polo-like kinase 1 (PLK1) is overexpressed in hepatocellular carcinoma (HCC). Knockdown of PLK1 expression by PLK1 small interfering RNA (siRNA) in an HCC cell line showed reduced expression in RNA-induced silencing complex and a reduction in cell proliferation.

Methods: A 3 + 3 dose escalation plus expansion cohort at the maximum tolerated dose (MTD) was implemented. Patients with HCC, Eastern Cooperative Oncology Group (ECOG) performance status ≤2, and Child-Pugh score A received TKM-080301 as an intravenous infusion once every week for 3 consecutive weeks, repeated every 28 days.

Results: The study enrolled 43 patients. The starting dose of TKM-080301 was 0.3 mg/kg, and MTD was declared at 0.75 mg/kg. Following the development of grade 4 thrombocytopenia in two subjects on the expansion cohort, the MTD was redefined at 0.6 mg/kg. Four patients did not have any evaluable postbaseline scan. Of the other 39 subjects who had received at least 0.3 mg/kg, 18 subjects (46.2%) had stable disease (SD) by independent RECIST 1.1 criteria. By Choi criteria, eight subjects (23.1%) had a partial response (PR). For 37 assessable subjects, with 2 subjects censored, median progression-free survival (PFS) was 2.04 months. Median survival for the whole study population was 7.5 months.

Conclusion: TKM-080301 was generally well tolerated. In this early-phase study, antitumor effect for TKM 080301 was limited. Further evaluation as a single agent in large randomized trials is not warranted.

Trial registration: ClinicalTrials.gov NCT02191878.

© AlphaMed Press; the data published online to support this summary are the property of the authors.

Figures

Figure 1.
Figure 1.
Waterfall plot on percentage change from baseline in target tumor diameter. Best response (RECIST) was assessed by central imaging (intent‐to‐treat population).

References

    1. Strebhardt K, Ullrich A. Targeting polo‐like kinase 1 for cancer therapy. Nat Rev Cancer 2006;6:321–330.
    1. Barr FA, Silljé HH, Nigg EA. Polo‐like kinases and the orchestration of cell division. Nat Rev Mol Cell Bio 2004;5:429–440.
    1. Steegmaier M, Hoffmann M, Baum A et al. BI 2536, a potent and selective inhibitor of polo‐like kinase 1, inhibits tumor growth in vivo. Curr Biol 2007;17:316–322.
    1. Spankuch B, Kurunci‐Csacsko E, Kaufmann M et al. Rational combinations of siRNAs targeting Plk1 with breast cancer drugs. Oncogene 2007;26:5793–5807.
    1. Ronot M, Bouattour M, Wassermann J et al. Alternative Response Criteria (Choi, European Association for the Study of the Liver, and modified Response Evaluation Criteria in Solid Tumors [RECIST]) versus RECIST 1.1 in patients with advanced hepatocellular carcinoma treated with sorafenib. The Oncologist 2014;19:394–402.
    1. Cheng AL, Kang YK, Chen Z et al. Efficacy and safety of sorafenib in patients in the Asia‐Pacific region with advanced hepatocellular carcinoma: a phase III randomised, double‐blind, placebo‐controlled trial. Lancet Oncol 2009;10:25–34.
    1. Mok WC, Wasser S, Tan T et al. Polo‐like kinase 1, a new therapeutic target in hepatocellular carcinoma. World J Gastroenterol 2012;18:3527–3536.
    1. Wang XQ, Zhu YQ, Lui KS et al. Aberrant Polo‐like kinase 1‐Cdc25A pathway in metastatic hepatocellular carcinoma. Clin Cancer Res 2008;14:6813–6820.
    1. Semple SC, Judge AD, Robbins M et al. Preclinical characterization of TKM‐080301, a lipid nanoparticle formulation of a small interfering RNA directed against polo‐like kinase 1. Cancer Res 2011;71(suppl 8):2829A.
    1. Dorsett Y, Tuschl T. siRNAs: Applications in functional genomics and potential as therapeutics. Nat Rev Drug Discov 2004;3:318–329.
    1. Seymour LW. Passive tumor targeting of soluble macromolecules and drug conjugates. Crit Rev Ther Drug Carrier Syst 1992;9:135–187.
    1. Yuan F, Dellian M, Fukumura D et al. Vascular permeability in a human tumor xenograft: Molecular size dependence and cutoff size. Cancer Res 1995;55:3752–3756.
    1. Judge AD, Robbins M, Tavakoli I et al. Confirming the RNAi‐mediated mechanism of action of siRNA‐based cancer therapeutics in mice. J Clin Invest 2009;119:661–673.

Source: PubMed

3
Abonnieren