Phase I, First-in-Human, Dose-Escalation Study to Evaluate the Safety, Tolerability, and Pharmacokinetics of Vorolanib in Patients with Advanced Solid Tumors

Johanna C Bendell, Manish R Patel, Kathleen N Moore, Cynthia C Chua, Hendrik-Tobias Arkenau, Gary Dukart, Kim Harrow, Chris Liang, Johanna C Bendell, Manish R Patel, Kathleen N Moore, Cynthia C Chua, Hendrik-Tobias Arkenau, Gary Dukart, Kim Harrow, Chris Liang

Abstract

Lessons learned: Pharmacokinetic results underscore that the vorolanib (X-82) study design was successful without the need for further dose escalation beyond 400 mg once daily (q.d.).Therefore, the recommended dose of X-82 as a single agent in patients with advanced cancer is 400 mg q.d.

Background: Vorolanib (X-82) is a novel, oral, multikinase vascular endothelial growth factor (VEGF) receptor/platelet-derived growth factor (PDGF) receptor inhibitor that was developed on the same chemical scaffold as sunitinib, but designed to improve upon the safety profile while maintaining the efficacy of sunitinib. By targeting the VEGF and PDGF receptors, X-82 was expected to disrupt tumor angiogenesis and be active in a broad spectrum of solid tumors. Therefore, we determined the maximum tolerated dose (MTD) and characterized the preliminary pharmacokinetics and clinical tumor response of X-82 as a single agent in patients with advanced solid tumors.

Methods: Adult patients with advanced solid tumors received X-82 as tablets or capsules (once daily [q.d.] or b.i.d.) every 4 weeks. Patients were evaluated for response every 8 weeks, and continued treatment until disease progression or intolerable toxicity.

Results: Fifty-two patients received study treatment in 17 cohorts. X-82 capsule dosing was as follows: cohorts 1-6 (20-400 mg q.d.) and cohorts 7-8 (140-200 mg b.i.d.). Patients in cohorts 9-17 received 50-800 mg q.d. tablet dosing. The median time on treatment was 58 days. X-82 blood pharmacokinetics appeared dose-independent with a t 1/2 of 5.13 hours and 6.48 hours for capsule and tablet formulations, respectively. No apparent accumulation was observed after 21 days of daily dosing.

Conclusion: X-82 had a safety profile consistent with its mechanism of action. It has a short half-life and was well tolerated by most patients. Study enrollment ended prior to the determination of the MTD because of the apparent saturation of absorption at 400-800 mg. The recommended dose of X-82 as a single agent in patients with advanced cancer is 400 mg q.d.

Trial registration: ClinicalTrials.gov NCT01296581.

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

Figures

Figure 1.
Figure 1.
Best response as change from baseline for the sum of target lesions (n = 49). Two patients stopped study treatment during Cycle 1 because of clinical progression and were not reassessed for response. †Hurthle cell carcinoma. ††Pancreatic cancer.
Figure 2.
Figure 2.
Cycle 1 Day 22 arithmetic mean plasma concentration time curves with tablet formulation of X‐82.
Figure 3.
Figure 3.
Time to progression (TTP). Sample size, 49 patients; median progression‐free survival (95% confidence interval [CI]): 2.00 (1.8–3.7); median TTP (95% CI): 2.00 (1.8–3.7).
Figure 4.
Figure 4.
Progression‐free survival. Sample size, 49 patients; median progression‐free survival (95% confidence interval): 2.00 (1.8–3.7).

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Source: PubMed

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