Literature DB >> 35731258

A phase Ib study of Oraxol (oral paclitaxel and encequidar) in patients with advanced malignancies.

Wen Wee Ma1, Jenny J Li2, Nilofer S Azad3, Elaine T Lam4, Jennifer R Diamond4, Grace K Dy5, Mateusz Opyrchal6, Jay Zhi7, Douglas Kramer7, Wing-Kai Chan7, David Cutler7, Rudolf Kwan7, Alex A Adjei2, Antonio Jimeno4.   

Abstract

PURPOSE: Oraxol is an oral formulation of paclitaxel administered with a novel, minimally absorbed P-glycoprotein inhibitor encequidar (HM30181A). This phase Ib study was conducted to determine the maximum-tolerated dose (MTD) of Oraxol administered at a fixed dose for up to 5 consecutive days in patients with advanced malignancies.
METHODS: Part 1 of this study utilized a 3 + 3 dose-escalation design to determine the MTD of oral paclitaxel 270 mg plus oral encequidar 15 mg administered daily. Dose escalation was achieved by increasing the number of consecutive dosing days per week (from 2 to 5 days per week). Dosing occurred for 3 consecutive weeks out of a 4-week cycle. Part 2 treated additional patients at the MTD to determine tolerability and recommended phase II dose (RP2D). Adverse events, tumor responses, and pharmacokinetic profiles were assessed.
RESULTS: A total of 34 patients (n = 24 in Part 1, n = 10 in Part 2) received treatment. The MTD of Oraxol was determined to be 270 mg daily × 5 days per week per protocol definition and this was declared the RP2D. The most common treatment-related adverse events were fatigue, neutropenia, and nausea/vomiting. Hypersensitivity-type reactions were not observed. Of the 28 patients evaluable for response, 2 (7.1%) achieved partial response and 18 (64.3%) achieved stable disease. Pharmacokinetic analysis showed rapid absorption of paclitaxel when administered orally following encequidar. Paclitaxel daily exposure was comparable following 2-5 days dose levels.
CONCLUSION: The oral administration of encequidar with paclitaxel was safe, achieved clinically relevant paclitaxel levels, and showed evidence of anti-tumor activity.
© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.

Entities:  

Keywords:  Oral paclitaxel; Oraxol; Pharmacokinetics; Phase I

Mesh:

Substances:

Year:  2022        PMID: 35731258     DOI: 10.1007/s00280-022-04443-1

Source DB:  PubMed          Journal:  Cancer Chemother Pharmacol        ISSN: 0344-5704            Impact factor:   3.288


  19 in total

1.  Phase I and pharmacokinetic study of oral paclitaxel.

Authors:  M M Malingré; J M Terwogt; J H Beijnen; H Rosing; F J Koopman; O van Tellingen; K Duchin; W W Huinink; M Swart; J Lieverst; J H Schellens
Journal:  J Clin Oncol       Date:  2000-06       Impact factor: 44.544

2.  Limited oral bioavailability and active epithelial excretion of paclitaxel (Taxol) caused by P-glycoprotein in the intestine.

Authors:  A Sparreboom; J van Asperen; U Mayer; A H Schinkel; J W Smit; D K Meijer; P Borst; W J Nooijen; J H Beijnen; O van Tellingen
Journal:  Proc Natl Acad Sci U S A       Date:  1997-03-04       Impact factor: 11.205

Review 3.  Cremophor EL: the drawbacks and advantages of vehicle selection for drug formulation.

Authors:  H Gelderblom; J Verweij; K Nooter; A Sparreboom
Journal:  Eur J Cancer       Date:  2001-09       Impact factor: 9.162

4.  Phase II and pharmacologic study of weekly oral paclitaxel plus cyclosporine in patients with advanced non-small-cell lung cancer.

Authors:  C M F Kruijtzer; J H M Schellens; J Mezger; M E Scheulen; U Keilholz; J H Beijnen; H Rosing; R A A Mathôt; S Marcus; H van Tinteren; P Baas
Journal:  J Clin Oncol       Date:  2002-12-01       Impact factor: 44.544

5.  Phase I/II Study of Weekly Oraxol for the Second-Line Treatment of Patients With Metastatic or Recurrent Gastric Cancer.

Authors:  Keun-Wook Lee; Kyung Hee Lee; Dae Young Zang; Young Iee Park; Dong Bok Shin; Jin Won Kim; Seock-Ah Im; Sung Ae Koh; Kyung-Sang Yu; Joo-Youn Cho; Jin-A Jung; Yung-Jue Bang
Journal:  Oncologist       Date:  2015-06-25

6.  A phase I and pharmacokinetic study of bi-daily dosing of oral paclitaxel in combination with cyclosporin A.

Authors:  M M Malingré; J H Beijnen; H Rosing; F J Koopman; O van Tellingen; K Duchin; W W Ten Bokkel Huinink; M Swart; J Lieverst; J H Schellens
Journal:  Cancer Chemother Pharmacol       Date:  2001-04       Impact factor: 3.333

Review 7.  Paclitaxel and its formulations.

Authors:  Anil K Singla; Alka Garg; Deepika Aggarwal
Journal:  Int J Pharm       Date:  2002-03-20       Impact factor: 5.875

8.  Selective inhibition of MDR1 (ABCB1) by HM30181 increases oral bioavailability and therapeutic efficacy of paclitaxel.

Authors:  Jin-Oh Kwak; Sung Hee Lee; Gwan Sun Lee; Maeng Sup Kim; Young-Gil Ahn; Ji Hyun Lee; So Won Kim; Kyung Hwan Kim; Min Goo Lee
Journal:  Eur J Pharmacol       Date:  2009-11-10       Impact factor: 4.432

9.  New response evaluation criteria in solid tumours: revised RECIST guideline (version 1.1).

Authors:  E A Eisenhauer; P Therasse; J Bogaerts; L H Schwartz; D Sargent; R Ford; J Dancey; S Arbuck; S Gwyther; M Mooney; L Rubinstein; L Shankar; L Dodd; R Kaplan; D Lacombe; J Verweij
Journal:  Eur J Cancer       Date:  2009-01       Impact factor: 9.162

10.  A Phase I Study of Oral Paclitaxel with a Novel P-Glycoprotein Inhibitor, HM30181A, in Patients with Advanced Solid Cancer.

Authors:  Hyun Jung Lee; Dae-Seog Heo; Joo-Youn Cho; Sae-Won Han; Hye-Jung Chang; Hyeon-Gyu Yi; Tae-Eun Kim; Se-Hoon Lee; Do-Youn Oh; Seock-Ah Im; In-Jin Jang; Yung-Jue Bang
Journal:  Cancer Res Treat       Date:  2014-07-15       Impact factor: 4.679

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