- Authors
- Weiss, Glen J.; Chao, Joseph; Neidhart, Jeffrey D.; Ramanathan, Ramesh K.; Bassett, Dawn; Neidhart, James A.; Choi, Chung Hang J.; Chow, Warren; Chung, Vincent; Forman, Stephen J.; Garmey, Edward; Hwang, Jungyeon; Kalinoski, D. Lynn; Koczywas, Marianna; Longmate, Jeffrey; Melton, Roger J.; Morgan, Robert; Oliver, Jamie; Peterkin, Joanna J.; Ryan, John L.; Schluep, Thomas; Synold, Timothy W.; Twardowski, Przemyslaw; Davis, Mark E.; Yen, Yun
- Part of
- Investigational new drugs, 2013-08, Vol.31 (4), p.986-1000
- Abstract
-
- Summary
Patients with advanced solid malignancies were enrolled to an open-label, single-arm, dose-escalation study, in which CRLX101 was administered intravenously over 60 min among two dosing schedules, initially weekly at 6, 12, and 18 mg/m
2
and later bi-weekly at 12, 15, and 18 mg/m
2
. The maximum tolerated dose (MTD) was determined at 15 mg/m
2
bi-weekly, and an expansion phase 2a study was completed. Patient samples were obtained for pharmacokinetic (PK) and pharmacodynamic (PD) assessments. Response was evaluated per RECIST criteria v1.0 every 8 weeks. Sixty-two patients (31 male; median age 63 years, range 39–79) received treatment. Bi-weekly dosing was generally well tolerated with myelosuppression being the dose-limiting toxicity. Among all phase 1/2a patients receiving the MTD (
n
= 44), most common grade 3/4 adverse events were neutropenia and fatigue. Evidence of systemic plasma exposure to both the polymer-conjugated and unconjugated CPT was observed in all treated patients. Mean elimination unconjugated CPT T
max
values ranged from 17.7 to 24.5 h, and maximum plasma concentrations and areas under the curve were generally proportional to dose for both polymer-conjugated and unconjugated CPT. Best overall response was stable disease in 28 patients (64 %) treated at the MTD and 16 (73 %) of a subset of NSCLC patients. Median progression-free survival (PFS) for patients treated at the MTD was 3.7 months and for the subset of NSCLC patients was 4.4 months. These combined phase 1/2a data demonstrate encouraging safety, pharmacokinetic, and efficacy results. Multinational phase 2 clinical development of CRLX101 across multiple tumor types is ongoing.
- Subjects
- Adult; Aged; Antineoplastic agents; Area Under Curve; Biological and medical sciences; Biopsy; Camptothecin - adverse effects; Camptothecin - blood; Camptothecin - pharmacokinetics; Camptothecin - therapeutic use; Cancer therapies; Cellulose - adverse effects; Cellulose - blood; Cellulose - pharmacokinetics; Cellulose - therapeutic use; Chemotherapy; Clinical trials; Cyclodextrins - adverse effects; Cyclodextrins - blood; Cyclodextrins - pharmacokinetics; Cyclodextrins - therapeutic use; Demography; Disease-Free Survival; Dose-Response Relationship, Drug; Drug dosages; Drug therapy; Female; General aspects; Humans; Immunohistochemistry; Male; Maximum Tolerated Dose; Medical sciences; Medicine; Medicine & Public Health; Middle Aged; Multiple tumors. Solid tumors. Tumors in childhood (general aspects); Nanoparticles; Nanoparticles - adverse effects; Nanoparticles - therapeutic use; Neoplasm Staging; Neoplasms - diagnostic imaging; Neoplasms - drug therapy; Neoplasms - pathology; Oncology; Ovarian cancer; Patients; Permeability; Pharmaceutical sciences; Pharmacodynamics; Pharmacokinetics; Pharmacology. Drug treatments; Pharmacology/Toxicology; Phase II Studies; Plasma; Polymers; Studies; Tomography, X-Ray Computed; Treatment Outcome; Tumors