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Title:
Pharmacokinetic, pharmacodynamic and biomarker evaluation of transforming growth factor-β receptor I kinase inhibitor, galunisertib, in phase 1 study in patients with advanced cancer | Investigational New Drugs
Description:
Purpose Transforming growth factor-beta (TGF-β) signaling plays a key role in epithelial-mesenchymal transition (EMT) of tumors, including malignant glioma. Small molecule inhibitors (SMI) blocking TGF-β signaling reverse EMT and arrest tumor progression. Several SMIs were developed, but currently only LY2157299 monohydrate (galunisertib) was advanced to clinical investigation. Design The first-in-human dose study had three parts (Part A, dose escalation, nâ=â39; Part B, safety combination with lomustine, nâ=â26; Part C, relative bioavailability study, nâ=â14). Results A preclinical pharmacokinetic/pharmacodynamic (PK/PD) model predicted a therapeutic window up to 300 mg/day and was confirmed in Part A after continuous PK/PD. PK was not affected by co-medications such as enzyme-inducing anti-epileptic drugs or proton pump inhibitors. Changes in pSMAD2 levels in peripheral blood mononuclear cells were associated with exposure indicating target-related pharmacological activity of galunisertib. Twelve (12/79; 15 %) patients with refractory/relapsed malignant glioma had durable stable disease (SD) for 6 or more cycles, partial responses (PR), or complete responses (CR). These patients with clinical benefit had high plasma baseline levels of MDC/CCL22 and low protein expression of pSMAD2 in their tumors. Of the 5 patients with IDH1/2 mutation, 4 patients had a clinical benefit as defined by CR/PR and SD âĽ6 cycles. Galunisertib had a favorable toxicity profile and no cardiac adverse events. Conclusion Based on the PK, PD, and biomarker evaluations, the intermittent administration of galunisertib at 300 mg/day is safe for future clinical investigation.
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Keywords {đ}
patients, galunisertib, part, psmad, study, glioma, article, cohort, cycles, pubmed, google, scholar, cas, mgday, treatment, panel, cell, clinical, cells, plasma, baseline, cancer, tgfβ, tumor, dose, expression, growth, levels, benefit, idh, received, glioblastoma, fig, lomustine, table, observed, inhibition, treated, receptor, inhibitor, signaling, bid, samples, results, tissue, response, day, transforming, combination, assessed,
Topics {âď¸}
tgf-beta signalling-related markers full size image nonenzyme-inducing anti-epileptic drugs eiae enzyme-inducing anti-epileptic enzyme-inducing anti-epileptic drugs targeted therapy cd4+cd25+cd127â/lofoxp3+ cells epidermal growth factor monitoring anti-tgfbetar therapy article download pdf specific receptor tgf-βri observed tgf-β-stimulated psmad2 heteroaryl-substituted pyrazole inhibitors cd4+cd25+ cd127â/lofoxp3+ tgf-beta2-dependent regulation tgf-beta receptor proton pump inhibitors profound long-lasting depletion ipilimumab-induced severe enterocolitis enzyme-inducing antiepileptic drugs making tgf-β signaling johns hopkins university tgf-β-stimulated tsmad2 [ promote epithelial-mesenchymal transition pre-existing medical conditions cytotoxic t-lymphocyte antigen-4 minimum post-baseline values oligonucleotide-based microarray analysis tgf-beta signaling multi-analyte immunoassay panel standard temozolomide-based radiochemotherapy refractory/relapsed malignant glioma tgf-beta2 inhibitor trabedersen patients receiving enzyme-inducing integrated genomic analysis tgf-β inhibitors [10] small molecule inhibitors full access minimum post-dose psmad2 glioma-initiating cell population anti-tumor activity luis paz-ares intended pharmacological activity receptor kinase domain related subjects suggests dose-proportional pk phase 1b study pre-dose normalized psmad2 kinase inhibitor ly2109761 privacy choices/manage cookies
Questions {â}
- Nancey S, Boschetti G, Cotte E, Ruel K, Almeras T, Chauvenet M et al (2012) Blockade of cytotoxic T-lymphocyte antigen-4 by ipilimumab is associated with a profound long-lasting depletion of Foxp3+ regulatory T cells: a mechanistic explanation for ipilimumab-induced severe enterocolitis?
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headline:Pharmacokinetic, pharmacodynamic and biomarker evaluation of transforming growth factor-β receptor I kinase inhibitor, galunisertib, in phase 1 study in patients with advanced cancer
description:
Purpose Transforming growth factor-beta (TGF-β) signaling plays a key role in epithelial-mesenchymal transition (EMT) of tumors, including malignant glioma. Small molecule inhibitors (SMI) blocking TGF-β signaling reverse EMT and arrest tumor progression. Several SMIs were developed, but currently only LY2157299 monohydrate (galunisertib) was advanced to clinical investigation. Design The first-in-human dose study had three parts (Part A, dose escalation, nâ=â39; Part B, safety combination with lomustine, nâ=â26; Part C, relative bioavailability study, nâ=â14). Results A preclinical pharmacokinetic/pharmacodynamic (PK/PD) model predicted a therapeutic window up to 300 mg/day and was confirmed in Part A after continuous PK/PD. PK was not affected by co-medications such as enzyme-inducing anti-epileptic drugs or proton pump inhibitors. Changes in pSMAD2 levels in peripheral blood mononuclear cells were associated with exposure indicating target-related pharmacological activity of galunisertib. Twelve (12/79; 15 %) patients with refractory/relapsed malignant glioma had durable stable disease (SD) for 6 or more cycles, partial responses (PR), or complete responses (CR). These patients with clinical benefit had high plasma baseline levels of MDC/CCL22 and low protein expression of pSMAD2 in their tumors. Of the 5 patients with IDH1/2 mutation, 4 patients had a clinical benefit as defined by CR/PR and SD âĽ6 cycles. Galunisertib had a favorable toxicity profile and no cardiac adverse events. Conclusion Based on the PK, PD, and biomarker evaluations, the intermittent administration of galunisertib at 300 mg/day is safe for future clinical investigation.
datePublished:2014-12-23T00:00:00Z
dateModified:2014-12-23T00:00:00Z
pageStart:357
pageEnd:370
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TGF-β inhibitor
Galunisertib
First-in-Human Dose
Glioma
Pharmacokinetics
Pharmacodynamics
Oncology
Pharmacology/Toxicology
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headline:Pharmacokinetic, pharmacodynamic and biomarker evaluation of transforming growth factor-β receptor I kinase inhibitor, galunisertib, in phase 1 study in patients with advanced cancer
description:
Purpose Transforming growth factor-beta (TGF-β) signaling plays a key role in epithelial-mesenchymal transition (EMT) of tumors, including malignant glioma. Small molecule inhibitors (SMI) blocking TGF-β signaling reverse EMT and arrest tumor progression. Several SMIs were developed, but currently only LY2157299 monohydrate (galunisertib) was advanced to clinical investigation. Design The first-in-human dose study had three parts (Part A, dose escalation, nâ=â39; Part B, safety combination with lomustine, nâ=â26; Part C, relative bioavailability study, nâ=â14). Results A preclinical pharmacokinetic/pharmacodynamic (PK/PD) model predicted a therapeutic window up to 300 mg/day and was confirmed in Part A after continuous PK/PD. PK was not affected by co-medications such as enzyme-inducing anti-epileptic drugs or proton pump inhibitors. Changes in pSMAD2 levels in peripheral blood mononuclear cells were associated with exposure indicating target-related pharmacological activity of galunisertib. Twelve (12/79; 15 %) patients with refractory/relapsed malignant glioma had durable stable disease (SD) for 6 or more cycles, partial responses (PR), or complete responses (CR). These patients with clinical benefit had high plasma baseline levels of MDC/CCL22 and low protein expression of pSMAD2 in their tumors. Of the 5 patients with IDH1/2 mutation, 4 patients had a clinical benefit as defined by CR/PR and SD âĽ6 cycles. Galunisertib had a favorable toxicity profile and no cardiac adverse events. Conclusion Based on the PK, PD, and biomarker evaluations, the intermittent administration of galunisertib at 300 mg/day is safe for future clinical investigation.
datePublished:2014-12-23T00:00:00Z
dateModified:2014-12-23T00:00:00Z
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TGF-β inhibitor
Galunisertib
First-in-Human Dose
Glioma
Pharmacokinetics
Pharmacodynamics
Oncology
Pharmacology/Toxicology
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name:Shawn T. Estrem
affiliation:
name:Eli Lilly and Company
address:
name:Eli Lilly and Company, Indianapolis, USA
type:PostalAddress
type:Organization
name:Luis Paz-Ares
affiliation:
name:Hospital Virgen del RocĂo
address:
name:Hospital Virgen del RocĂo, Sevilla, Spain
type:PostalAddress
type:Organization
name:Matthias Holdhoff
affiliation:
name:Johns Hopkins Kimmel Cancer Center
address:
name:Johns Hopkins Kimmel Cancer Center, Baltimore, USA
type:PostalAddress
type:Organization
name:Jaishri Blakeley
affiliation:
name:Johns Hopkins University
address:
name:Neurology/Neurosurgery/and Oncology, Johns Hopkins University, Baltimore, USA
type:PostalAddress
type:Organization
name:Michael M. Lahn
affiliation:
name:Eli Lilly and Company
address:
name:Eli Lilly and Company, Indianapolis, USA
type:PostalAddress
type:Organization
name:Jose Baselga
affiliation:
name:Vall dâHebron University Hospital and Universitat Autonoma de Barcelona
address:
name:Medical Oncology, Vall dâHebron University Hospital and Universitat Autonoma de Barcelona, Barcelona, Spain
type:PostalAddress
type:Organization
PostalAddress:
name:Medical Oncology, Vall dâHebron University Hospital and Universitat Autonoma de Barcelona, Barcelona, Spain
name:Servei dâOncologia Medica, Hospital Universitari Vall dâHebron, Vall dâHebron Institute of Oncology (V.H.I.O.), Barcelona, Spain
name:Johns Hopkins Kimmel Cancer Center, Baltimore, USA
name:Hospital Universitario 12 de Octubre, Madrid, Spain
name:Medical Oncology, Vall dâHebron University Hospital and Universitat Autonoma de Barcelona, Barcelona, Spain
name:Medical Oncology, Vall dâHebron University Hospital and Universitat Autonoma de Barcelona, Barcelona, Spain
name:START Madrid, Centro Integral OncolĂłgico Clara Campal, Madrid, Spain
name:Medical Oncology, Vall dâHebron University Hospital and Universitat Autonoma de Barcelona, Barcelona, Spain
name:Medical Oncology, Vall dâHebron University Hospital and Universitat Autonoma de Barcelona, Barcelona, Spain
name:Medical Oncology, Vall dâHebron University Hospital and Universitat Autonoma de Barcelona, Barcelona, Spain
name:Eli Lilly and Company, Erl Wood, UK
name:Eli Lilly and Company, Erl Wood, UK
name:Eli Lilly and Company, Indianapolis, USA
name:Eli Lilly and Company, Indianapolis, USA
name:Eli Lilly and Company, Indianapolis, USA
name:Hospital Virgen del RocĂo, Sevilla, Spain
name:Johns Hopkins Kimmel Cancer Center, Baltimore, USA
name:Neurology/Neurosurgery/and Oncology, Johns Hopkins University, Baltimore, USA
name:Eli Lilly and Company, Indianapolis, USA
name:Medical Oncology, Vall dâHebron University Hospital and Universitat Autonoma de Barcelona, Barcelona, Spain
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