A phase IA dose-escalation study of PHI-101, a new checkpoint kinase 2 inhibitor, for platinum-resistant recurrent ovarian cancer

Soo Jin Park, Suk-Joon Chang, Dong Hoon Suh, Tae Wook Kong, Heekyoung Song, Tae Hun Kim, Jae-Weon Kim, Hee Seung Kim, Sung-Jong Lee, Soo Jin Park, Suk-Joon Chang, Dong Hoon Suh, Tae Wook Kong, Heekyoung Song, Tae Hun Kim, Jae-Weon Kim, Hee Seung Kim, Sung-Jong Lee

Abstract

Background: PHI-101 is an orally available, selective checkpoint kinase 2 (Chk2) inhibitor. PHI-101 has shown anti-tumour activity in ovarian cancer cell lines and impaired DNA repair pathways in preclinical experiments. Furthermore, the in vivo study suggests the synergistic effect of PHI-101 through combination with PARP inhibitors for ovarian cancer treatment. The primary objective of this study is to evaluate the safety and tolerability of PHI-101 in platinum-resistant recurrent ovarian cancer.

Methods: Chk2 inhibitor for Recurrent EpitheliAl periToneal, fallopIan, or oVarian cancEr (CREATIVE) trial is a prospective, multi-centre, phase IA dose-escalation study. Six cohorts of dose levels are planned, and six to 36 patients are expected to be enrolled in this trial. Major inclusion criteria include ≥ 19 years with histologically confirmed epithelial ovarian cancer, fallopian tube carcinoma, or primary peritoneal cancer. Also, patients who showed disease progression during platinum-based chemotherapy or disease progression within 24 weeks from completion of platinum-based chemotherapy will be included, and prior chemotherapy lines of more than five will be excluded. The primary endpoint of this study is to determine the dose-limiting toxicity (DLT) and maximum tolerated dose (MTD) of PHI-101.

Discussion: PHI-101 is the first orally available Chk2 inhibitor, expected to show effectiveness in treating recurrent ovarian cancer. Through this CREATIVE trial, DLT and MTD of this new targeted therapy can be confirmed to find the recommended dose for the phase II clinical trial. This study may contribute to developing a new combination regimen for the treatment of ovarian cancer.

Trial registration: ClinicalTrials.gov Identifier: NCT04678102 .

Keywords: Chk2 inhibitor; PARP inhibitor; Phase IA; Platinum-resistance; ovarian cancer.

© 2021. The Author(s).

Figures

Fig. 1
Fig. 1
Study design schema. (Abbreviations: DLT, dose-limiting toxicity; EOT, end of treatment; PK, pharmacokinetic sampling)
Fig. 2
Fig. 2
Accelerated dose escalation and switching to standard 3+3 dose escalation scheme.

References

    1. Mittempergher L. Genomic Characterization of High-Grade Serous Ovarian Cancer: Dissecting Its Molecular Heterogeneity as a Road Towards Effective Therapeutic Strategies. Current oncology reports. 2016;18(7):44. doi: 10.1007/s11912-016-0526-9.
    1. Tomasova K, Cumova A, Seborova K, Horak J, Koucka K, Vodickova L, et al. DNA Repair and Ovarian Carcinogenesis: Impact on Risk. Prognosis and Therapy Outcome. Cancers. 2020;12(7).
    1. Moore K, Colombo N, Scambia G, Kim BG, Oaknin A, Friedlander M, et al. Maintenance Olaparib in Patients with Newly Diagnosed Advanced Ovarian Cancer. The New England journal of medicine. 2018;379(26):2495–2505. doi: 10.1056/NEJMoa1810858.
    1. González-Martín A, Pothuri B, Vergote I, DePont CR, Graybill W, Mirza MR, et al. Niraparib in Patients with Newly Diagnosed Advanced Ovarian Cancer. The New England journal of medicine. 2019;381(25):2391–2402. doi: 10.1056/NEJMoa1910962.
    1. Smith J, Tho LM, Xu N, Gillespie DA. The ATM-Chk2 and ATR-Chk1 pathways in DNA damage signaling and cancer. Advances in cancer research. 2010;108:73–112. doi: 10.1016/B978-0-12-380888-2.00003-0.
    1. Lee JM, Nair J, Zimmer A, Lipkowitz S, Annunziata CM, Merino MJ, et al. Prexasertib, a cell cycle checkpoint kinase 1 and 2 inhibitor, in BRCA wild-type recurrent high-grade serous ovarian cancer: a first-in-class proof-of-concept phase 2 study. The Lancet Oncology. 2018;19(2):207–215. doi: 10.1016/S1470-2045(18)30009-3.
    1. Rundle S, Bradbury A, Drew Y, Curtin NJ. Targeting the ATR-CHK1 Axis in Cancer Therapy. Cancers. 2017;9(5).
    1. Lampert EJ, An D, McCoy A, Kohn EC, Annunziata CM, Trewhitt K, et al. Prexasertib, a cell cycle checkpoint kinase 1 inhibitor, in BRCA mutant recurrent high-grade serous ovarian cancer (HGSOC): A proof-of-concept single arm phase II study. American Society of Clinical Oncology; 2020.
    1. Williams LH, Choong D, Johnson SA, Campbell IG. Genetic and epigenetic analysis of CHEK2 in sporadic breast, colon, and ovarian cancers. Clinical cancer research : an official journal of the American Association for Cancer Research. 2006;12(23):6967–6972. doi: 10.1158/1078-0432.CCR-06-1770.
    1. June H-J, Han K-TK, Ky-Youb Nam, Jee Jin Im, Jeong Hyeok Yoon, Min Kyung Choi, Bora Lee, Inki Kim. PHI-101, a potent and novel inhibitor of CHK2 in ovarian and breast cancer cells. American Association for Cancer Research. 2021. Abstract #1461.
    1. Richard S, Larry R, Susan GA, Machaele CC, Boris F, Jerry C. Accelerated Titration Designs for Phase I Clinical Trials in Oncology. Journal of the National Cancer Institute. 1997;89(15):1138–1147. doi: 10.1093/jnci/89.15.1138.
    1. Haynes B, Murai J, Lee JM. Restored replication fork stabilisation, a mechanism of PARP inhibitor resistance, can be overcome by cell cycle checkpoint inhibition. Cancer treatment reviews. 2018;71:1–7. doi: 10.1016/j.ctrv.2018.09.003.
    1. Sakai W, Swisher EM, Jacquemont C, Chandramohan KV, Couch FJ, Langdon SP, et al. Functional restoration of BRCA2 protein by secondary BRCA2 mutations in BRCA2-mutated ovarian carcinoma. Cancer research. 2009;69(16):6381–6386. doi: 10.1158/0008-5472.CAN-09-1178.
    1. Omatsu K, Hamanishi J, Katsumata N, Nishio S, Sawada K, Takeuchi S, et al. Nivolumab versus gemcitabine or pegylated liposomal doxorubicin for patients with platinum-resistant (advanced or recurrent) ovarian cancer: Open-label, randomised trial in Japan (NINJA trial). Annals of Oncology. 2020;31:S611: Abstract.
    1. Pujade-Lauraine E, Hilpert F, Weber B, Reuss A, Poveda A, Kristensen G, et al. Bevacizumab combined with chemotherapy for platinum-resistant recurrent ovarian cancer: the AURELIA open-label randomised phase III trial. Obstetrical & Gynecological Survey. 2014;69(7):402–404. doi: 10.1097/01.ogx.0000452705.82050.e4.
    1. Ray-Coquard I, Pautier P, Pignata S, Pérol D, González-Martín A, Berger R, et al. Olaparib plus Bevacizumab as First-Line Maintenance in Ovarian Cancer. The New England journal of medicine. 2019;381(25):2416–2428. doi: 10.1056/NEJMoa1911361.

Source: PubMed

3
Iratkozz fel