A phase I trial to determine the safety, pharmacokinetics, and pharmacodynamics of intercalated BMS-690514 with paclitaxel/carboplatin (PC) in advanced or metastatic solid malignancies

• Published in: Cancer chemotherapy and pharmacology Vol. 71; no. 5; pp. 1273 - 1285
• Main Authors: Chow, Laura Q. M., Jonker, Derek I., Dy, Grace K., Nicholas, Garth, Fortin, Catherine, Patricia, Daniel, Adjei, Alex A., Belani, Chandra P., Gupta, Ashok, Park, Jong-Soon, Zhang, Steven, Sbar, Eric I., Laurie, Scott A.
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer-Verlag 01.05.2013; Springer; Springer Nature B.V
• Subjects: Antineoplastic agents; Antineoplastic Combined Chemotherapy Protocols - administration & dosage; Antineoplastic Combined Chemotherapy Protocols - adverse effects; Antineoplastic Combined Chemotherapy Protocols - pharmacokinetics; Area Under Curve; Biological and medical sciences; Cancer Research; Carboplatin; Dose-Response Relationship, Drug; Female; Humans; Male; Maximum Tolerated Dose; Medical sciences; Medicine; Medicine & Public Health; Middle Aged; Multiple tumors. Solid tumors. Tumors in childhood (general aspects); Neoplasm Metastasis; Neoplasms - drug therapy; Neoplasms - pathology; Oncology; Original Article; Paclitaxel - administration & dosage; Pharmacology. Drug treatments; Pharmacology/Toxicology; Piperidines - administration & dosage; Pyrroles - administration & dosage; Treatment Outcome; Triazines - administration & dosage; Tumors; Phase I; Paclitaxel/carboplatin; Tyrosine kinase inhibitor; VEGFR; Intercalated therapy; EGFR; BMS-690514; Solid malignancies; Antineoplastic agent; Pharmacokinetic pharmacodynamic relationship; Toxicity; Malignancy; Metastasis; Epidermal growth factor receptor; Vascular endothelium growth factor receptor; Taxane derivatives; Paclitaxel; Advanced stage; Antimitotic; Protein-tyrosine kinase; Platinum II Complexes; Human; Enzyme; Transferases; Enzyme inhibitor; Malignant tumor; Treatment; Carboplatin; Phase I trial; Pharmacokinetics; Cancer
• ISSN: 0344-5704; 1432-0843
• DOI: 10.1007/s00280-013-2126-9

Purpose A phase I dose escalation study was performed to determine the maximum tolerated dose (MTD) of intercalated dosing of BMS-690514, a reversible oral panHER/VEGF receptor inhibitor, combined with paclitaxel/carboplatin (PC) in advanced solid tumors. Secondary endpoints included safety, pharmacokinetics (PK), exploratory pharmacodynamics (PD), and preliminary efficacy. Experimental design Patients received fixed doses of P (200 mg/m 2 ) and C (AUC 6 mg/mL min) q21 days with intercalated BMS-690514 (Days 4–19) starting at 100 mg/day and increasing by 50 mg/day using a 3 + 3 dose escalation design until the MTD was reached. Twenty additional patients were enrolled in the expansion cohort at the recommended phase II dose (RP2D). Results The MTD was reached at 150 mg/day. DLTs included grade 3 thrombosis at 100 mg (1 patient) and grade 3 diarrhea at 150 mg (1 patient) and 200 mg (2 patients). Serious adverse events (AEs) occurring in 20/37 patients included neutropenia ( n  = 5), diarrhea ( n  = 4), pulmonary embolism ( n  = 3), and simultaneous dehydration, acute renal failure, and febrile neutropenia ( n  = 2). BMS-690514-related AEs included diarrhea (97 %), acneiform rash (60 %), fatigue (43 %), nausea (30 %), and anorexia (30 %). There were no treatment-related deaths. Sequential intermittent administration of PC did not affect the PK of BMS-690514. Of the 32 patients evaluable for efficacy, there were 12 partial responses including five patients with non-small-cell lung cancer and 12 patients with stable disease. Conclusions The MTD of intercalated BMS-609514 combined with PC was 150 mg/day. This approach was tolerable with manageable toxicities and antitumor activity in a variety of solid tumor types.