A multicenter, phase I, dose-escalation study to assess the safety, tolerability, and pharmacokinetics of etirinotecan pegol in patients with refractory solid tumors

Gayle S. Jameson, John T. Hamm, Glen J. Weiss, Carlos Alemany, Stephen Anthony, Michele Basche, Ramesk K Ramanathan, Mitesh J Borad, Raoul Tibes, Allen Cohn, Ioana Hinshaw, Robert Jotte, Lee S. Rosen, Ute Hoch, Michael A. Eldon, Robert Medve, Katrina Schroeder, Erica White, Daniel D. Von Hoff

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Abstract

Purpose: This study was designed to establish the maximum tolerated dose (MTD) and to evaluate tolerability, pharmacokinetics, and antitumor activity of etirinotecan pegol. Experimental Design: Patients with refractory solid malignancies were enrolled and assigned to escalating-dose cohorts. Patients received 1 infusion of etirinotecan pegol weekly 3 times every 4 weeks (w x 3q4w), or every 14 days (q14d), or every 21 days (q21d), with MTD as the primary end point using a standard 3 + 3 design. Results: Seventy-six patients were entered onto 3 dosing schedules (58-245 mg/m2). The MTD was 115 mg/m2 for the w x 3q4w schedule and 145 mg/m2 for both the q14d and q21d schedules. Most adverse events related to study drug were gastrointestinal disorders and were more frequent at higher doses of etirinotecan pegol. Late onset diarrhea was observed in some patients, the frequency of which generally correlated with dose density. Cholinergic diarrhea commonly seen with irinotecan treatment did not occur in patients treated with etirinotecan pegol. Etirinotecan pegol administration resulted in sustained and controlled systemic exposure to SN-38, which had a mean half-life of approximately 50 days. Overall, the pharmacokinetics of etirinotecan pegol are predictable and do not require complex dosing adjustments. Confirmed partial responses were observed in 8 patients with breast, colon, lung (small and squamous cell), bladder, cervical, and neuroendocrine cancer. Conclusion: Etirinotecan pegol showed substantial antitumor activity in patients with various solid tumors and a somewhat different safety profile compared with the irinotecan historical profile. The MTD recommended for phase II clinical trials is 145 mg/m2 q14d or q21d.

Original languageEnglish (US)
Pages (from-to)268-278
Number of pages11
JournalClinical Cancer Research
Volume19
Issue number1
DOIs
StatePublished - Jan 1 2013

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irinotecan
Pharmacokinetics
Maximum Tolerated Dose
Safety
Neoplasms
Appointments and Schedules
Diarrhea
Gastrointestinal Agents
Phase II Clinical Trials
etirinotecan pegol
Uterine Cervical Neoplasms
Cholinergic Agents
Half-Life
Colon
Urinary Bladder
Breast
Research Design
Epithelial Cells
Lung

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

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A multicenter, phase I, dose-escalation study to assess the safety, tolerability, and pharmacokinetics of etirinotecan pegol in patients with refractory solid tumors. / Jameson, Gayle S.; Hamm, John T.; Weiss, Glen J.; Alemany, Carlos; Anthony, Stephen; Basche, Michele; Ramanathan, Ramesk K; Borad, Mitesh J; Tibes, Raoul; Cohn, Allen; Hinshaw, Ioana; Jotte, Robert; Rosen, Lee S.; Hoch, Ute; Eldon, Michael A.; Medve, Robert; Schroeder, Katrina; White, Erica; Von Hoff, Daniel D.

In: Clinical Cancer Research, Vol. 19, No. 1, 01.01.2013, p. 268-278.

Research output: Contribution to journalArticle

Jameson, GS, Hamm, JT, Weiss, GJ, Alemany, C, Anthony, S, Basche, M, Ramanathan, RK, Borad, MJ, Tibes, R, Cohn, A, Hinshaw, I, Jotte, R, Rosen, LS, Hoch, U, Eldon, MA, Medve, R, Schroeder, K, White, E & Von Hoff, DD 2013, 'A multicenter, phase I, dose-escalation study to assess the safety, tolerability, and pharmacokinetics of etirinotecan pegol in patients with refractory solid tumors', Clinical Cancer Research, vol. 19, no. 1, pp. 268-278. https://doi.org/10.1158/1078-0432.CCR-12-1201
Jameson, Gayle S. ; Hamm, John T. ; Weiss, Glen J. ; Alemany, Carlos ; Anthony, Stephen ; Basche, Michele ; Ramanathan, Ramesk K ; Borad, Mitesh J ; Tibes, Raoul ; Cohn, Allen ; Hinshaw, Ioana ; Jotte, Robert ; Rosen, Lee S. ; Hoch, Ute ; Eldon, Michael A. ; Medve, Robert ; Schroeder, Katrina ; White, Erica ; Von Hoff, Daniel D. / A multicenter, phase I, dose-escalation study to assess the safety, tolerability, and pharmacokinetics of etirinotecan pegol in patients with refractory solid tumors. In: Clinical Cancer Research. 2013 ; Vol. 19, No. 1. pp. 268-278.
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abstract = "Purpose: This study was designed to establish the maximum tolerated dose (MTD) and to evaluate tolerability, pharmacokinetics, and antitumor activity of etirinotecan pegol. Experimental Design: Patients with refractory solid malignancies were enrolled and assigned to escalating-dose cohorts. Patients received 1 infusion of etirinotecan pegol weekly 3 times every 4 weeks (w x 3q4w), or every 14 days (q14d), or every 21 days (q21d), with MTD as the primary end point using a standard 3 + 3 design. Results: Seventy-six patients were entered onto 3 dosing schedules (58-245 mg/m2). The MTD was 115 mg/m2 for the w x 3q4w schedule and 145 mg/m2 for both the q14d and q21d schedules. Most adverse events related to study drug were gastrointestinal disorders and were more frequent at higher doses of etirinotecan pegol. Late onset diarrhea was observed in some patients, the frequency of which generally correlated with dose density. Cholinergic diarrhea commonly seen with irinotecan treatment did not occur in patients treated with etirinotecan pegol. Etirinotecan pegol administration resulted in sustained and controlled systemic exposure to SN-38, which had a mean half-life of approximately 50 days. Overall, the pharmacokinetics of etirinotecan pegol are predictable and do not require complex dosing adjustments. Confirmed partial responses were observed in 8 patients with breast, colon, lung (small and squamous cell), bladder, cervical, and neuroendocrine cancer. Conclusion: Etirinotecan pegol showed substantial antitumor activity in patients with various solid tumors and a somewhat different safety profile compared with the irinotecan historical profile. The MTD recommended for phase II clinical trials is 145 mg/m2 q14d or q21d.",
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T1 - A multicenter, phase I, dose-escalation study to assess the safety, tolerability, and pharmacokinetics of etirinotecan pegol in patients with refractory solid tumors

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AU - Hamm, John T.

AU - Weiss, Glen J.

AU - Alemany, Carlos

AU - Anthony, Stephen

AU - Basche, Michele

AU - Ramanathan, Ramesk K

AU - Borad, Mitesh J

AU - Tibes, Raoul

AU - Cohn, Allen

AU - Hinshaw, Ioana

AU - Jotte, Robert

AU - Rosen, Lee S.

AU - Hoch, Ute

AU - Eldon, Michael A.

AU - Medve, Robert

AU - Schroeder, Katrina

AU - White, Erica

AU - Von Hoff, Daniel D.

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N2 - Purpose: This study was designed to establish the maximum tolerated dose (MTD) and to evaluate tolerability, pharmacokinetics, and antitumor activity of etirinotecan pegol. Experimental Design: Patients with refractory solid malignancies were enrolled and assigned to escalating-dose cohorts. Patients received 1 infusion of etirinotecan pegol weekly 3 times every 4 weeks (w x 3q4w), or every 14 days (q14d), or every 21 days (q21d), with MTD as the primary end point using a standard 3 + 3 design. Results: Seventy-six patients were entered onto 3 dosing schedules (58-245 mg/m2). The MTD was 115 mg/m2 for the w x 3q4w schedule and 145 mg/m2 for both the q14d and q21d schedules. Most adverse events related to study drug were gastrointestinal disorders and were more frequent at higher doses of etirinotecan pegol. Late onset diarrhea was observed in some patients, the frequency of which generally correlated with dose density. Cholinergic diarrhea commonly seen with irinotecan treatment did not occur in patients treated with etirinotecan pegol. Etirinotecan pegol administration resulted in sustained and controlled systemic exposure to SN-38, which had a mean half-life of approximately 50 days. Overall, the pharmacokinetics of etirinotecan pegol are predictable and do not require complex dosing adjustments. Confirmed partial responses were observed in 8 patients with breast, colon, lung (small and squamous cell), bladder, cervical, and neuroendocrine cancer. Conclusion: Etirinotecan pegol showed substantial antitumor activity in patients with various solid tumors and a somewhat different safety profile compared with the irinotecan historical profile. The MTD recommended for phase II clinical trials is 145 mg/m2 q14d or q21d.

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