Literature DB >> 19237630

Phase I trial of AEG35156 administered as a 7-day and 3-day continuous intravenous infusion in patients with advanced refractory cancer.

Emma Dean1, Duncan Jodrell, Kate Connolly, Sarah Danson, Jacques Jolivet, Jon Durkin, Stephen Morris, Debra Jowle, Tim Ward, Jeff Cummings, Gemma Dickinson, Leon Aarons, Eric Lacasse, Lesley Robson, Caroline Dive, Malcolm Ranson.   

Abstract

PURPOSE: To establish the maximum-tolerated dose and evaluate tolerability, pharmacokinetics, pharmacodynamic effects, and antitumor activity of AEG35156, a second-generation antisense to X-linked inhibitor of apoptosis (XIAP) protein, in patients with advanced refractory malignant tumors. PATIENTS AND METHODS: This was a first-in-man, open-label, phase I dose-escalation study. AEG35156 was administered by continuous intravenous infusion over 7 days (7DI) or 3 days (3DI) of a 21-day treatment cycle. Dose escalation started at 48 mg/m(2)/d and continued until consistent dose-limiting toxicity (DLT) was observed.
RESULTS: Thirty-eight patients were entered in seven cohorts. Grade 3 to 4 adverse events were uncommon and were predominantly abnormal laboratory values: elevated ALT, thrombocytopenia, and lymphopenia. DLTs comprised elevated hepatic enzymes, hypophosphatemia, and thrombocytopenia. The maximum-tolerated doses were defined as 125 mg/m(2)/d for the 7DI regimen and < or = 213 mg/m(2)/d for the 3DI schedule. AEG35156 area under the plasma concentration curve and peak plasma concentration increased proportionally with dose. Suppression of XIAP mRNA levels was maximal at 72 hours (mean suppression, 21%), and this coincided with a dramatic decrease in circulating tumor cells in a patient with non-Hodgkin's lymphoma. Two further patients had unconfirmed partial responses. Circulating biomarkers of cell death and apoptosis altered in association with drug infusion and toxicity.
CONCLUSION: In this first-in-man study, AEG35156 was well tolerated, with predictable toxicities, pharmacokinetic properties, and clinical evidence of antitumor activity in patients with refractory lymphoma, melanoma, and breast cancer. Phase I/II trials of AEG35156 chemotherapy combinations are ongoing in patients with pancreatic, breast, non-small-cell lung cancer, acute myeloid leukemia, lymphoma, and solid tumors for which docetaxel is indicated.

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Year:  2009        PMID: 19237630     DOI: 10.1200/JCO.2008.19.5677

Source DB:  PubMed          Journal:  J Clin Oncol        ISSN: 0732-183X            Impact factor:   44.544


  26 in total

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Review 4.  Targeting IAP proteins for therapeutic intervention in cancer.

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Review 5.  Fit-for-purpose biomarker method validation for application in clinical trials of anticancer drugs.

Authors:  J Cummings; F Raynaud; L Jones; R Sugar; C Dive
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Authors:  Alura Riley; Lindsay E Jordan; Martin Holcik
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Review 7.  Targeting the apoptosis pathway in hematologic malignancies.

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8.  Phase I/II trial of AEG35156 X-linked inhibitor of apoptosis protein antisense oligonucleotide combined with idarubicin and cytarabine in patients with relapsed or primary refractory acute myeloid leukemia.

Authors:  Aaron D Schimmer; Elihu H Estey; Gautam Borthakur; Bing Z Carter; Gary J Schiller; Martin S Tallman; Jessica K Altman; Judith E Karp; Jeannine Kassis; David W Hedley; Joseph Brandwein; Wei Xu; Duncan H Mak; Eric LaCasse; Christine Jacob; Stephen J Morris; Jacques Jolivet; Michael Andreeff
Journal:  J Clin Oncol       Date:  2009-08-03       Impact factor: 44.544

9.  Safety and pharmacokinetics of the antisense oligonucleotide (ASO) LY2181308 as a single-agent or in combination with idarubicin and cytarabine in patients with refractory or relapsed acute myeloid leukemia (AML).

Authors:  Harry P Erba; Hamid Sayar; Mark Juckett; Michael Lahn; Valerie Andre; Sophie Callies; Shelly Schmidt; Sunil Kadam; John T Brandt; Dirk Van Bockstaele; Michael Andreeff
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10.  A small molecule inhibitor of XIAP induces apoptosis and synergises with vinorelbine and cisplatin in NSCLC.

Authors:  E J Dean; T Ward; C Pinilla; R Houghten; K Welsh; G Makin; M Ranson; C Dive
Journal:  Br J Cancer       Date:  2009-11-10       Impact factor: 7.640

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