First-in-human phase i trial of two schedules of OSI-930, a novel multikinase inhibitor, incorporating translational proof-of-mechanism studies

Timothy A. Yap, Hendrik Tobias Arkenau, D. Ross Camidge, Suzanne George, Natalie J. Serkova, Stephen J. Gwyther, Jennifer L. Spratlin, Rohit Lal, James Spicer, Nandita M. Desouza, Martin O. Leach, Jon Chick, Srinivasu Poondru, Ramesh Boinpally, Richard Gedrich, Katie Brock, Andrew Stephens, S. Gail Eckhardt, Stan B. Kaye, George DemetriMichelle Scurr

Research output: Contribution to journalArticlepeer-review

23 Scopus citations

Abstract

Purpose: OSI-930 is a novel, potent, oral small-molecule receptor tyrosine kinase inhibitor, predominantly against VEGF receptors (VEGFR), c-Kit, and platelet-derived growth factor receptors. A phase I trial was undertaken to determine safety, maximum-tolerated dose (MTD), pharmacokinetics, pharmacodynamics, and antitumor activity of OSI-930 in patients with advanced solid tumors. Experimental Design: OSI-930 was administered once or twice a day using a modified accelerated titration design. Pharmacokinetics and plasma soluble VEGFR2 (sVEGFR2) studies were undertaken. Dynamic contrast-enhanced MRI (DCE-MRI) and 2[18F]fluoro-2-deoxy-D-glucose-positron emission tomography (FDG-PET) MTD expansion cohorts were conducted. Results: Fifty-eight patients received OSI-930 in 2 schedules; once a day schedule: 12 patients at doses up to 1, 600 mg without reaching MTD; twice a day schedule: 46 patients at 400 mg (n = 7), 500 mg (n = 31), and 600mg(n=8). Dose-limiting toxicities were observed at 600mgtwice a day (n=3):G3rash (n=2) and G4 g-glutamyltransferase, establishing the MTD at 500 mg twice a day. Common G1-2 toxicities included fatigue, diarrhea, nausea, and rash. Antitumor responses were seen in 2 patients with advanced ovarian cancer [Response Evaluation Criteria in Solid Tumors (RECIST) partial response (PR) (n=1); GCIG CA125 response (n = 1)]. Eleven of 19 heavily pretreated imatinib-resistant patients with gastrointestinal stromal tumors achieved RECIST stable disease (median duration: 126 days), with FDG-PET scans showing PRs in 4 of 9 patients. OSI-930 exposure increased with dose; substantial decreases in sVEGFR levels were observed with OSI-930 twice a day doses ≥400 mg, while DCE-MRI responses were shown in 4 of 6 patients. Conclusions: OSI-930 is safe and well tolerated, with pharmacokinetic- pharmacodynamic data supporting proof-of-mechanism with clinically relevant antitumor activity.

Original languageEnglish (US)
Pages (from-to)909-919
Number of pages11
JournalClinical Cancer Research
Volume19
Issue number4
DOIs
StatePublished - Feb 15 2013
Externally publishedYes

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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