A Phase 1B Clinical Study of Combretastatin A1 Diphosphate (OXi4503) and Cytarabine (ARA-C) in Combination (OXA) for Patients with Relapsed or Refractory Acute Myeloid Leukemia
Combretastatin A1 (OXi4503) is a dual-function drug with vascular disrupting and cytotoxic properties that has exhibited single-agent anti-leukemia activity in murine xenograft models of acute myeloid leukemia (AML) and in a prior Phase 1A clinical study for relapsed/refractory (R/R) AML. The purpos...
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Published in | Cancers Vol. 12; no. 1; p. 74 |
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Main Authors | , , , , , , |
Format | Journal Article |
Language | English |
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Abstract | Combretastatin A1 (OXi4503) is a dual-function drug with vascular disrupting and cytotoxic properties that has exhibited single-agent anti-leukemia activity in murine xenograft models of acute myeloid leukemia (AML) and in a prior Phase 1A clinical study for relapsed/refractory (R/R) AML. The purpose of the present multicenter Phase 1B study was to define the maximum tolerated dose (MTD) and safety profile of OXi4503 and cytarabine (ARA-C) administered in combination (OXA). At four centers, 29 patients with R/R AML or myelodysplastic syndrome (MDS) were treated with OXA. The most common grade 3/4 treatment-emergent adverse events (AEs) were febrile neutropenia (28%), hypertension (17%), thrombocytopenia (17%), and anemia (14%). There were no treatment-emergent grade 5 AEs. Drug-related serious adverse events (SAEs) developed in 4/29 patients (14%) and included febrile neutropenia (
= 2), pneumonia/acute respiratory failure (
= 1), and hypotension (
= 1). 9.76 mg/m
was defined as the MTD of OXi4503 when administered in combination with 1 g/m
ARA-C. In 26 evaluable AML patients, there were 2 complete remissions (CR), 2 complete remissions with incomplete count recovery (CRi) and one partial response (PR), for an overall response rate (ORR) of 19%. The median overall survival (OS) time for the four patients who achieved a CR/CRi was 528 days (95% CI: 434-NA), which was significantly longer than the median OS time of 113 days (95% CI: 77-172) for the remaining 22 patients who did not achieve a CR/CRi (Log Rank Chi Square = 11.8,
-value = 0.0006). The safety and early evidence of efficacy of the OXA regimen in R/R AML patients warrant further investigation in a Phase 2 clinical study. |
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AbstractList | Combretastatin A1 (OXi4503) is a dual-function drug with vascular disrupting and cytotoxic properties that has exhibited single-agent anti-leukemia activity in murine xenograft models of acute myeloid leukemia (AML) and in a prior Phase 1A clinical study for relapsed/refractory (R/R) AML. The purpose of the present multicenter Phase 1B study was to define the maximum tolerated dose (MTD) and safety profile of OXi4503 and cytarabine (ARA-C) administered in combination (OXA). At four centers, 29 patients with R/R AML or myelodysplastic syndrome (MDS) were treated with OXA. The most common grade 3/4 treatment-emergent adverse events (AEs) were febrile neutropenia (28%), hypertension (17%), thrombocytopenia (17%), and anemia (14%). There were no treatment-emergent grade 5 AEs. Drug-related serious adverse events (SAEs) developed in 4/29 patients (14%) and included febrile neutropenia (N = 2), pneumonia/acute respiratory failure (N = 1), and hypotension (N = 1). 9.76 mg/m2 was defined as the MTD of OXi4503 when administered in combination with 1 g/m2 ARA-C. In 26 evaluable AML patients, there were 2 complete remissions (CR), 2 complete remissions with incomplete count recovery (CRi) and one partial response (PR), for an overall response rate (ORR) of 19%. The median overall survival (OS) time for the four patients who achieved a CR/CRi was 528 days (95% CI: 434–NA), which was significantly longer than the median OS time of 113 days (95% CI: 77–172) for the remaining 22 patients who did not achieve a CR/CRi (Log Rank Chi Square = 11.8, p-value = 0.0006). The safety and early evidence of efficacy of the OXA regimen in R/R AML patients warrant further investigation in a Phase 2 clinical study. Combretastatin A1 (OXi4503) is a dual-function drug with vascular disrupting and cytotoxic properties that has exhibited single-agent anti-leukemia activity in murine xenograft models of acute myeloid leukemia (AML) and in a prior Phase 1A clinical study for relapsed/refractory (R/R) AML. The purpose of the present multicenter Phase 1B study was to define the maximum tolerated dose (MTD) and safety profile of OXi4503 and cytarabine (ARA-C) administered in combination (OXA). At four centers, 29 patients with R/R AML or myelodysplastic syndrome (MDS) were treated with OXA. The most common grade 3/4 treatment-emergent adverse events (AEs) were febrile neutropenia (28%), hypertension (17%), thrombocytopenia (17%), and anemia (14%). There were no treatment-emergent grade 5 AEs. Drug-related serious adverse events (SAEs) developed in 4/29 patients (14%) and included febrile neutropenia ( = 2), pneumonia/acute respiratory failure ( = 1), and hypotension ( = 1). 9.76 mg/m was defined as the MTD of OXi4503 when administered in combination with 1 g/m ARA-C. In 26 evaluable AML patients, there were 2 complete remissions (CR), 2 complete remissions with incomplete count recovery (CRi) and one partial response (PR), for an overall response rate (ORR) of 19%. The median overall survival (OS) time for the four patients who achieved a CR/CRi was 528 days (95% CI: 434-NA), which was significantly longer than the median OS time of 113 days (95% CI: 77-172) for the remaining 22 patients who did not achieve a CR/CRi (Log Rank Chi Square = 11.8, -value = 0.0006). The safety and early evidence of efficacy of the OXA regimen in R/R AML patients warrant further investigation in a Phase 2 clinical study. Combretastatin A1 (OXi4503) is a dual-function drug with vascular disrupting and cytotoxic properties that has exhibited single-agent anti-leukemia activity in murine xenograft models of acute myeloid leukemia (AML) and in a prior Phase 1A clinical study for relapsed/refractory (R/R) AML. The purpose of the present multicenter Phase 1B study was to define the maximum tolerated dose (MTD) and safety profile of OXi4503 and cytarabine (ARA-C) administered in combination (OXA). At four centers, 29 patients with R/R AML or myelodysplastic syndrome (MDS) were treated with OXA. The most common grade 3/4 treatment-emergent adverse events (AEs) were febrile neutropenia (28%), hypertension (17%), thrombocytopenia (17%), and anemia (14%). There were no treatment-emergent grade 5 AEs. Drug-related serious adverse events (SAEs) developed in 4/29 patients (14%) and included febrile neutropenia (N = 2), pneumonia/acute respiratory failure (N = 1), and hypotension (N = 1). 9.76 mg/m2 was defined as the MTD of OXi4503 when administered in combination with 1 g/m2 ARA-C. In 26 evaluable AML patients, there were 2 complete remissions (CR), 2 complete remissions with incomplete count recovery (CRi) and one partial response (PR), for an overall response rate (ORR) of 19%. The median overall survival (OS) time for the four patients who achieved a CR/CRi was 528 days (95% CI: 434−NA), which was significantly longer than the median OS time of 113 days (95% CI: 77−172) for the remaining 22 patients who did not achieve a CR/CRi (Log Rank Chi Square = 11.8, p-value = 0.0006). The safety and early evidence of efficacy of the OXA regimen in R/R AML patients warrant further investigation in a Phase 2 clinical study. Combretastatin A1 (OXi4503) is a dual-function drug with vascular disrupting and cytotoxic properties that has exhibited single-agent anti-leukemia activity in murine xenograft models of acute myeloid leukemia (AML) and in a prior Phase 1A clinical study for relapsed/refractory (R/R) AML. The purpose of the present multicenter Phase 1B study was to define the maximum tolerated dose (MTD) and safety profile of OXi4503 and cytarabine (ARA-C) administered in combination (OXA). At four centers, 29 patients with R/R AML or myelodysplastic syndrome (MDS) were treated with OXA. The most common grade 3/4 treatment-emergent adverse events (AEs) were febrile neutropenia (28%), hypertension (17%), thrombocytopenia (17%), and anemia (14%). There were no treatment-emergent grade 5 AEs. Drug-related serious adverse events (SAEs) developed in 4/29 patients (14%) and included febrile neutropenia ( N = 2), pneumonia/acute respiratory failure ( N = 1), and hypotension ( N = 1). 9.76 mg/m 2 was defined as the MTD of OXi4503 when administered in combination with 1 g/m 2 ARA-C. In 26 evaluable AML patients, there were 2 complete remissions (CR), 2 complete remissions with incomplete count recovery (CRi) and one partial response (PR), for an overall response rate (ORR) of 19%. The median overall survival (OS) time for the four patients who achieved a CR/CRi was 528 days (95% CI: 434–NA), which was significantly longer than the median OS time of 113 days (95% CI: 77–172) for the remaining 22 patients who did not achieve a CR/CRi (Log Rank Chi Square = 11.8, p -value = 0.0006). The safety and early evidence of efficacy of the OXA regimen in R/R AML patients warrant further investigation in a Phase 2 clinical study. |
Author | Cogle, Christopher R Uckun, Fatih M Trieu, Vuong N Lin, Tara L Watts, Justin M Qazi, Sanjive Schiller, Gary |
AuthorAffiliation | 4 Division of Hematologic Malignancies and Cellular Therapeutics, Department of Internal Medicine, University of Kansas Medical Center, University of Kansas Cancer Center and Medical Pavillon, Westwood, KS 66205, USA 3 Division of Hematology and Oncology, Department of Medicine, College of Medicine & University of Florida Health Cancer Center, University of Florida, Gainesville, FL 32610, USA 2 Ares Pharmaceuticals, St. Paul, MN 55110, USA 1 Immuno-Oncology Program, Mateon Therapeutics, Agoura Hills, CA 91301, USA 5 Bioinformatics Program and Department of Biology, Gustavus Adolphus College, St Peter, MN 56082, USA 7 Department of Medicine, Division of Hematology/Oncology Miller School of Medicine, University of Miami Sylvester Comprehensive Cancer Center, Miami, FL 33136, USA 6 Bone Marrow/Stem Cell Transplantation, Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA 90095, USA |
AuthorAffiliation_xml | – name: 3 Division of Hematology and Oncology, Department of Medicine, College of Medicine & University of Florida Health Cancer Center, University of Florida, Gainesville, FL 32610, USA – name: 2 Ares Pharmaceuticals, St. Paul, MN 55110, USA – name: 1 Immuno-Oncology Program, Mateon Therapeutics, Agoura Hills, CA 91301, USA – name: 5 Bioinformatics Program and Department of Biology, Gustavus Adolphus College, St Peter, MN 56082, USA – name: 4 Division of Hematologic Malignancies and Cellular Therapeutics, Department of Internal Medicine, University of Kansas Medical Center, University of Kansas Cancer Center and Medical Pavillon, Westwood, KS 66205, USA – name: 7 Department of Medicine, Division of Hematology/Oncology Miller School of Medicine, University of Miami Sylvester Comprehensive Cancer Center, Miami, FL 33136, USA – name: 6 Bone Marrow/Stem Cell Transplantation, Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA 90095, USA |
Author_xml | – sequence: 1 givenname: Fatih M surname: Uckun fullname: Uckun, Fatih M organization: Ares Pharmaceuticals, St. Paul, MN 55110, USA – sequence: 2 givenname: Christopher R orcidid: 0000-0001-5422-6863 surname: Cogle fullname: Cogle, Christopher R organization: Division of Hematology and Oncology, Department of Medicine, College of Medicine & University of Florida Health Cancer Center, University of Florida, Gainesville, FL 32610, USA – sequence: 3 givenname: Tara L orcidid: 0000-0002-0242-6449 surname: Lin fullname: Lin, Tara L organization: Division of Hematologic Malignancies and Cellular Therapeutics, Department of Internal Medicine, University of Kansas Medical Center, University of Kansas Cancer Center and Medical Pavillon, Westwood, KS 66205, USA – sequence: 4 givenname: Sanjive surname: Qazi fullname: Qazi, Sanjive organization: Bioinformatics Program and Department of Biology, Gustavus Adolphus College, St Peter, MN 56082, USA – sequence: 5 givenname: Vuong N surname: Trieu fullname: Trieu, Vuong N organization: Immuno-Oncology Program, Mateon Therapeutics, Agoura Hills, CA 91301, USA – sequence: 6 givenname: Gary surname: Schiller fullname: Schiller, Gary organization: Bone Marrow/Stem Cell Transplantation, Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA 90095, USA – sequence: 7 givenname: Justin M surname: Watts fullname: Watts, Justin M organization: Department of Medicine, Division of Hematology/Oncology Miller School of Medicine, University of Miami Sylvester Comprehensive Cancer Center, Miami, FL 33136, USA |
BackLink | https://www.ncbi.nlm.nih.gov/pubmed/31888052$$D View this record in MEDLINE/PubMed |
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ContentType | Journal Article |
Copyright | 2019 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. 2019 by the authors. 2019 |
Copyright_xml | – notice: 2019 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. – notice: 2019 by the authors. 2019 |
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Keywords | AML clinical study combretastatin leukemia OXA |
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SubjectTerms | Acute myeloid leukemia Adverse events aml Animal models Antitumor activity Binding sites Bone marrow clinical study combretastatin Cytarabine Cytotoxicity Drug dosages Hypertension Hypotension Leukemia Medical prognosis Myelodysplastic syndrome Myeloid leukemia Neutropenia oxa Patients Pneumonia Thrombocytopenia Xenografts |
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Title | A Phase 1B Clinical Study of Combretastatin A1 Diphosphate (OXi4503) and Cytarabine (ARA-C) in Combination (OXA) for Patients with Relapsed or Refractory Acute Myeloid Leukemia |
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