Wen Wee Ma1, Mojun Zhu2, Elaine T Lam3, Jennifer R Diamond3, Grace K Dy4, George A Fisher5, Laura Williams Goff6, Steven Alberts2, Lynne A Bui7, Akhil Sanghal7, Mudgal Kothekar7, Ajay Khopade7, Geetanjali Chimote7, Robert Faulkner8, S Gail Eckhardt9, Alex A Adjei2, Antonio Jimeno10. 1. Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA. ma.wen@mayo.edu. 2. Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA. 3. Division of Medical Oncology, Department of Medicine, Developmental Therapeutics Program, University of Colorado School of Medicine, MS 8117, 12801 E 17th Avenue, Room 8101, Aurora, CO, 80045, USA. 4. Roswell Park Cancer Institute, 665 Elm Street, Buffalo, NY, 14263, USA. 5. Stanford University School of Medicine, 875 Blake Wilbur Drive, Stanford, CA, 94305, USA. 6. Division of Hematology and Oncology, Vanderbilt-Ingram Cancer Center, 2220 Pierce Avenue, 777 Preston Research Building, Nashville, TN, 37232-6307, USA. 7. Sun Pharma Advanced Research Co. Ltd., 17/B Mahal Industrial Estate, Mahakali Caves Road, Andheri (E), Mumbai, 400093, India. 8. Sun Pharmaceutical Industries, Inc., 2 Independence Way, Princeton, NJ, 08540, USA. 9. Department of Oncology, Dell Medical School, The University of Texas at Austin, 1601 Trinity Street, Building B, Austin, TX, 78712, USA. 10. Division of Medical Oncology, Department of Medicine, Developmental Therapeutics Program, University of Colorado School of Medicine, MS 8117, 12801 E 17th Avenue, Room 8101, Aurora, CO, 80045, USA. Antonio.jimeno@cuanschutz.edu.
Abstract
PURPOSE: Paclitaxel injection concentrate for nano-dispersion (PICN) is a Cremophor-free, nanotechnology-driven paclitaxel formulation. This phase I study examined the safety, tolerability, pharmacokinetics and maximum tolerated dose (MTD) of PICN alone and in combination with carboplatin. Its early efficacy in unresectable biliary tract cancers (BTCs) was also evaluated. METHODS: This multi-center study comprised two parts. Part A contained a dose-escalation cohort following "3 + 3" design using PICN monotherapy in advanced solid tumors (Part A1); Part A2 dose-expansion cohort was then conducted in advanced BTCs due to observed efficacy in Part A1. Part B1 and B2 evaluated escalating dose of PICN with carboplatin in advanced solid tumors. PICN was administered as a 30 min-infusion every 3 weeks without pre-medications for hypersensitivity reactions. RESULTS: Thirty-six patients received PICN monotherapy in Part A and 21 received PICN plus carboplatin in Part B. The MTD of PICN was determined to be 295 mg/m2 both as a monotherapy and in combination with carboplatin at AUC 5. Dose-proportional exposure in paclitaxel Cmax and AUC was observed overdose range from 175 to 325 mg/m2 for PICN monotherapy and its combination with carboplatin. Carboplatin did not alter PICN exposure. Clinically significant toxicities mainly include neutropenia and peripheral neuropathy. PICN monotherapy yielded a response rate of 20% in unresectable BTCs. CONCLUSION: This study demonstrated the safety and stable pharmacokinetics of PICN as a monotherapy and in combination with carboplatin. Single-agent PICN showed promising antitumor activity in advanced BTCs, warranting further studies to investigate its role in gastrointestinal cancers.
PURPOSE:Paclitaxel injection concentrate for nano-dispersion (PICN) is a Cremophor-free, nanotechnology-driven paclitaxel formulation. This phase I study examined the safety, tolerability, pharmacokinetics and maximum tolerated dose (MTD) of PICN alone and in combination with carboplatin. Its early efficacy in unresectable biliary tract cancers (BTCs) was also evaluated. METHODS: This multi-center study comprised two parts. Part A contained a dose-escalation cohort following "3 + 3" design using PICN monotherapy in advanced solid tumors (Part A1); Part A2 dose-expansion cohort was then conducted in advanced BTCs due to observed efficacy in Part A1. Part B1 and B2 evaluated escalating dose of PICN with carboplatin in advanced solid tumors. PICN was administered as a 30 min-infusion every 3 weeks without pre-medications for hypersensitivity reactions. RESULTS: Thirty-six patients received PICN monotherapy in Part A and 21 received PICN plus carboplatin in Part B. The MTD of PICN was determined to be 295 mg/m2 both as a monotherapy and in combination with carboplatin at AUC 5. Dose-proportional exposure in paclitaxel Cmax and AUC was observed overdose range from 175 to 325 mg/m2 for PICN monotherapy and its combination with carboplatin. Carboplatin did not alter PICN exposure. Clinically significant toxicities mainly include neutropenia and peripheral neuropathy. PICN monotherapy yielded a response rate of 20% in unresectable BTCs. CONCLUSION: This study demonstrated the safety and stable pharmacokinetics of PICN as a monotherapy and in combination with carboplatin. Single-agent PICN showed promising antitumor activity in advanced BTCs, warranting further studies to investigate its role in gastrointestinal cancers.
Entities:
Keywords:
Biliary tract cancer; Carboplatin; Paclitaxel; Pharmacokinetics; Phase I
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