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Erschienen in: Cancer Chemotherapy and Pharmacology 6/2014

01.06.2014 | Original Article

Phase 1 dose escalation and pharmacokinetic evaluation of oral gemcitabine prodrug (LY2334737) in combination with docetaxel in patients with advanced solid tumors

verfasst von: Ramon Salazar, Serafin Morales, Marta Gil-Martín, Elena Aguirre, Ana Oaknin, Margarita Garcia, Sophie Callies, Enaksha R. Wickremsinhe, Karim A. Benhadji, Antonio Llombart

Erschienen in: Cancer Chemotherapy and Pharmacology | Ausgabe 6/2014

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Abstract

Purpose

This Phase 1 study aimed to determine the recommended Phase 2 dose of LY2334737, an oral gemcitabine prodrug, when combined with standard dose docetaxel treatment in patients with advanced solid tumors. Pharmacokinetics (PK) and antitumor activity were additionally evaluated.

Methods

Patients with advanced/metastatic solid tumors received escalating doses of LY2334737 once daily (QD) for 14 days, followed by a 7-day drug-free period. Docetaxel was given at 75 mg/m2 every 3 weeks (q3w). Cycles were repeated until progressive disease (PD) or unacceptable toxicity.

Results

Of 22 patients recruited, all Caucasian, 7 received an LY2334737 dose of 10 mg/day, 10 received 20 mg/day, 5 received 30 mg/day. Nineteen patients discontinued due to PD, 2 due to adverse events, 1 due to investigator decision. Dose-limiting toxicities: 2× febrile neutropenia (G3), 2× fatigue (1× G2, 1× G3), 1× neutropenia (G4). The maximum tolerated dose (MTD) was identified to be 10 mg/day. Two patients achieved partial response, 10 patients stable disease. Enrollment was stopped after unexpected hepatic toxicities were observed with LY2334737 QD for 14 days per cycle in another study of Japanese patients. PK data were consistent with the first-in-man study of LY2334737 and did not reveal any drug–drug interaction between LY2334737 and docetaxel.

Conclusions

Combination of LY2334737 at doses up to 30 mg/day QD for 14 days per cycle with docetaxel 75 mg/m2 q3w resulted in an undesirable toxicity profile and a low MTD of 10 mg/day. Alternative treatment schedules of LY2334737 should be explored.
Literatur
2.
Zurück zum Zitat Yu Y, Xu X, Du Z, Shi M (2012) Non-platinum regimens of gemcitabine plus docetaxel versus platinum-based regimens in first-line treatment of advanced non-small cell lung cancer: a meta-analysis on 9 randomized controlled trials. Cancer Chemother Pharmacol 69:1265–1275PubMedCrossRef Yu Y, Xu X, Du Z, Shi M (2012) Non-platinum regimens of gemcitabine plus docetaxel versus platinum-based regimens in first-line treatment of advanced non-small cell lung cancer: a meta-analysis on 9 randomized controlled trials. Cancer Chemother Pharmacol 69:1265–1275PubMedCrossRef
3.
Zurück zum Zitat Nielsen DL, Bjerre KD, Jakobsen EH, Cold S, Stenbygaard L, Sørensen PG, Kamby C, Møller S, Jørgensen CL, Andersson M (2011) Gemcitabine plus docetaxel versus docetaxel in patients with predominantly human epidermal growth factor receptor 2-negative locally advanced or metastatic breast cancer: a randomized, phase III study by the Danish Breast Cancer Cooperative Group. J Clin Oncol 29:4748–4754PubMedCrossRef Nielsen DL, Bjerre KD, Jakobsen EH, Cold S, Stenbygaard L, Sørensen PG, Kamby C, Møller S, Jørgensen CL, Andersson M (2011) Gemcitabine plus docetaxel versus docetaxel in patients with predominantly human epidermal growth factor receptor 2-negative locally advanced or metastatic breast cancer: a randomized, phase III study by the Danish Breast Cancer Cooperative Group. J Clin Oncol 29:4748–4754PubMedCrossRef
4.
Zurück zum Zitat Chan S, Romieu G, Huober J, Delozier T, Tubiana-Hulin M, Schneeweiss A, Lluch A, Llombart A, du Bois A, Kreienberg R, Mayordomo JI, Antón A, Harrison M, Jones A, Carrasco E, Vaury AT, Frimodt-Moller B, Fumoleau P (2009) Phase III study of gemcitabine plus docetaxel compared with capecitabine plus docetaxel for anthracycline-pretreated patients with metastatic breast cancer. J Clin Oncol 27:1753–1760PubMedCrossRef Chan S, Romieu G, Huober J, Delozier T, Tubiana-Hulin M, Schneeweiss A, Lluch A, Llombart A, du Bois A, Kreienberg R, Mayordomo JI, Antón A, Harrison M, Jones A, Carrasco E, Vaury AT, Frimodt-Moller B, Fumoleau P (2009) Phase III study of gemcitabine plus docetaxel compared with capecitabine plus docetaxel for anthracycline-pretreated patients with metastatic breast cancer. J Clin Oncol 27:1753–1760PubMedCrossRef
5.
Zurück zum Zitat Maki RG, Wathen JK, Patel SR, Priebat DA, Okuno SH, Samuels B, Fanucchi M, Harmon DC, Schuetze SM, Reinke D, Thall PF, Benjamin RS, Baker LH, Hensley ML (2007) Randomized phase II study of gemcitabine and docetaxel compared with gemcitabine alone in patients with metastatic soft tissue sarcomas: results of sarcoma alliance for research through collaboration study 002 [corrected]. J Clin Oncol 25:2755–2763PubMedCrossRef Maki RG, Wathen JK, Patel SR, Priebat DA, Okuno SH, Samuels B, Fanucchi M, Harmon DC, Schuetze SM, Reinke D, Thall PF, Benjamin RS, Baker LH, Hensley ML (2007) Randomized phase II study of gemcitabine and docetaxel compared with gemcitabine alone in patients with metastatic soft tissue sarcomas: results of sarcoma alliance for research through collaboration study 002 [corrected]. J Clin Oncol 25:2755–2763PubMedCrossRef
6.
Zurück zum Zitat Huang P, Chubb S, Hertel LW, Grindey GB, Plunkett W (1991) Action of 2′,2′-difluorodeoxycytidine on DNA synthesis. Cancer Res 51:6110–6117PubMed Huang P, Chubb S, Hertel LW, Grindey GB, Plunkett W (1991) Action of 2′,2′-difluorodeoxycytidine on DNA synthesis. Cancer Res 51:6110–6117PubMed
7.
Zurück zum Zitat Ruiz van Haperen VW, Veerman G, Vermorken JB, Peters GJ (1993) 2′,2′-Difluoro-deoxycytidine (gemcitabine) incorporation into RNA and DNA of tumour cell lines. Biochem Pharmacol 46:762–766PubMedCrossRef Ruiz van Haperen VW, Veerman G, Vermorken JB, Peters GJ (1993) 2′,2′-Difluoro-deoxycytidine (gemcitabine) incorporation into RNA and DNA of tumour cell lines. Biochem Pharmacol 46:762–766PubMedCrossRef
8.
Zurück zum Zitat Kroep JR, Giaccone G, Voorn DA, Smit EF, Beijnen JH, Rosing H, van Moorsel CJ, van Groeningen CJ, Postmus PE, Pinedo HM, Peters GJ (1999) Gemcitabine and paclitaxel: pharmacokinetic and pharmacodynamic interactions in patients with Non-Small-Cell Lung Cancer. J Clin Oncol 17:2190–2197PubMed Kroep JR, Giaccone G, Voorn DA, Smit EF, Beijnen JH, Rosing H, van Moorsel CJ, van Groeningen CJ, Postmus PE, Pinedo HM, Peters GJ (1999) Gemcitabine and paclitaxel: pharmacokinetic and pharmacodynamic interactions in patients with Non-Small-Cell Lung Cancer. J Clin Oncol 17:2190–2197PubMed
9.
Zurück zum Zitat Oliveras-Ferraros C, Vazquez-Martin A, Colomer R, De Llorens R, Brunet J, Menendez JA (2008) Sequence-dependent synergism and antagonism between paclitaxel and gemcitabine in breast cancer cells: the importance of scheduling. Int J Oncol 32:113–120PubMed Oliveras-Ferraros C, Vazquez-Martin A, Colomer R, De Llorens R, Brunet J, Menendez JA (2008) Sequence-dependent synergism and antagonism between paclitaxel and gemcitabine in breast cancer cells: the importance of scheduling. Int J Oncol 32:113–120PubMed
10.
Zurück zum Zitat Lavelle F, Bissery MC, Combeau C, Riou JF, Vrignaud P, André S (1995) Preclinical evaluation of docetaxel (Taxotere). Semin Oncol 22(2 Suppl 4):3–16 Lavelle F, Bissery MC, Combeau C, Riou JF, Vrignaud P, André S (1995) Preclinical evaluation of docetaxel (Taxotere). Semin Oncol 22(2 Suppl 4):3–16
11.
Zurück zum Zitat Moysan E, Bastiat G, Benoit JP (2013) Gemcitabine versus Modified Gemcitabine: A Review of Several Promising Chemical Modifications. Mol Pharm 10:430–444PubMedCrossRef Moysan E, Bastiat G, Benoit JP (2013) Gemcitabine versus Modified Gemcitabine: A Review of Several Promising Chemical Modifications. Mol Pharm 10:430–444PubMedCrossRef
12.
Zurück zum Zitat Bender DM, Bao J, Dantzig AH, Diseroad WD, Law KL, Magnus NA, Peterson JA, Perkins EJ, Pu YJ, Reutzel-Edens SM, Remick DM, Starling JJ, Stephenson GA, Vaid RK, Zhang D, McCarthy JR (2009) Synthesis, crystallization, and biological evaluation of an orally active prodrug of gemcitabine. J Med Chem 52:6958–6961PubMedCrossRef Bender DM, Bao J, Dantzig AH, Diseroad WD, Law KL, Magnus NA, Peterson JA, Perkins EJ, Pu YJ, Reutzel-Edens SM, Remick DM, Starling JJ, Stephenson GA, Vaid RK, Zhang D, McCarthy JR (2009) Synthesis, crystallization, and biological evaluation of an orally active prodrug of gemcitabine. J Med Chem 52:6958–6961PubMedCrossRef
13.
Zurück zum Zitat Pratt SE, Durland-Busbice S, Shepard RL, Heinz-Taheny K, Iversen PW, Dantzig AH (2013) Human carboxylesterase 2 hydrolyzes the prodrug of gemcitabine (LY2334737) and confers prodrug sensitivity to cancer cells. Clin Cancer Res 19:1159–1168PubMedCrossRef Pratt SE, Durland-Busbice S, Shepard RL, Heinz-Taheny K, Iversen PW, Dantzig AH (2013) Human carboxylesterase 2 hydrolyzes the prodrug of gemcitabine (LY2334737) and confers prodrug sensitivity to cancer cells. Clin Cancer Res 19:1159–1168PubMedCrossRef
14.
Zurück zum Zitat Pratt SE, Durland-Busbice S, Shepard RL, Donoho GP, Starling JJ, Wickremsinhe ER, Perkins EJ, Dantzig AH (2013) Efficacy of low-dose oral metronomic dosing of the prodrug of gemcitabine, LY2334737, in human tumor xenografts. Mol Cancer Ther 12:481–490PubMedCrossRef Pratt SE, Durland-Busbice S, Shepard RL, Donoho GP, Starling JJ, Wickremsinhe ER, Perkins EJ, Dantzig AH (2013) Efficacy of low-dose oral metronomic dosing of the prodrug of gemcitabine, LY2334737, in human tumor xenografts. Mol Cancer Ther 12:481–490PubMedCrossRef
15.
Zurück zum Zitat Koolen SLW, Witteveen PO, Jansen RS, Langenberg MH, Kronemeijer RH, Nol A, Garcia-Ribas I, Callies S, Benhadji KA, Slapak CA, Beijnen JH, Voest EE, Schellens JH (2011) Phase I study of oral gemcitabine prodrug (LY2334737) alone and in combination with erlotinib in patients with advanced solid tumors. Clin Cancer Res 17:6071–6082PubMedCrossRef Koolen SLW, Witteveen PO, Jansen RS, Langenberg MH, Kronemeijer RH, Nol A, Garcia-Ribas I, Callies S, Benhadji KA, Slapak CA, Beijnen JH, Voest EE, Schellens JH (2011) Phase I study of oral gemcitabine prodrug (LY2334737) alone and in combination with erlotinib in patients with advanced solid tumors. Clin Cancer Res 17:6071–6082PubMedCrossRef
17.
Zurück zum Zitat Yamamoto N, Nokihara H, Yamada Y, Uenaka K, Sekiguchi R, Makiuchi T, Slapak CA, Benhadji KA, Tamura T (2013) Phase I study of oral gemcitabine prodrug (LY2334737) in Japanese patients with advanced solid tumors. Cancer Chemother Pharmacol 71:1645–1655PubMedCrossRef Yamamoto N, Nokihara H, Yamada Y, Uenaka K, Sekiguchi R, Makiuchi T, Slapak CA, Benhadji KA, Tamura T (2013) Phase I study of oral gemcitabine prodrug (LY2334737) in Japanese patients with advanced solid tumors. Cancer Chemother Pharmacol 71:1645–1655PubMedCrossRef
18.
Zurück zum Zitat Therasse P, Arbuck SG, Eisenhauer EA, Wanders J, Kaplan RS, Rubinstein L, Verweij J, Van Glabbeke M, van Oosterom AT, Christian MC, Gwyther SG (2000) New guidelines to evaluate the response to treatment in solid tumors European Organization for Research and Treatment of Cancer, National Cancer Institute of the United States, National Cancer Institute of Canada. J Natl Cancer Inst 92:205–216PubMedCrossRef Therasse P, Arbuck SG, Eisenhauer EA, Wanders J, Kaplan RS, Rubinstein L, Verweij J, Van Glabbeke M, van Oosterom AT, Christian MC, Gwyther SG (2000) New guidelines to evaluate the response to treatment in solid tumors European Organization for Research and Treatment of Cancer, National Cancer Institute of the United States, National Cancer Institute of Canada. J Natl Cancer Inst 92:205–216PubMedCrossRef
19.
Zurück zum Zitat Wickremsinhe ER, Lutzke BS, Jones BR, Schultz GA, Freeman AB, Pratt SE, Bones AM, Ackermann BL (2010) Quantification of gemcitabine incorporation into human DNA by LC/MS/MS as a surrogate measure for target engagement. Anal Chem 82:6576–6583PubMedCrossRef Wickremsinhe ER, Lutzke BS, Jones BR, Schultz GA, Freeman AB, Pratt SE, Bones AM, Ackermann BL (2010) Quantification of gemcitabine incorporation into human DNA by LC/MS/MS as a surrogate measure for target engagement. Anal Chem 82:6576–6583PubMedCrossRef
20.
Zurück zum Zitat Dumez H, Louwerens M, Pawinsky A, Planting AS, de Jonge MJ, Van Oosterom AT, Highley M, Guetens G, Mantel M, de Boeck G, de Bruijn E, Verweij J (2002) The impact of drug administration sequence and pharmacokinetic interaction in a phase I study of the combination of docetaxel and gemcitabine in patients with advanced solid tumors. Anticancer Drugs 13:583–593PubMedCrossRef Dumez H, Louwerens M, Pawinsky A, Planting AS, de Jonge MJ, Van Oosterom AT, Highley M, Guetens G, Mantel M, de Boeck G, de Bruijn E, Verweij J (2002) The impact of drug administration sequence and pharmacokinetic interaction in a phase I study of the combination of docetaxel and gemcitabine in patients with advanced solid tumors. Anticancer Drugs 13:583–593PubMedCrossRef
21.
Zurück zum Zitat Bhargava P, Marshall JL, Fried K, Williams M, Lefebvre P, Dahut W, Hanfelt J, Gehan E, Figuera M, Hawkins MJ, Rizvi NA (2001) Phase I and pharmacokinetic study of two sequences of gemcitabine and docetaxel administered weekly to patients with advanced cancer. Cancer Chemother Pharmacol 48:95–103PubMedCrossRef Bhargava P, Marshall JL, Fried K, Williams M, Lefebvre P, Dahut W, Hanfelt J, Gehan E, Figuera M, Hawkins MJ, Rizvi NA (2001) Phase I and pharmacokinetic study of two sequences of gemcitabine and docetaxel administered weekly to patients with advanced cancer. Cancer Chemother Pharmacol 48:95–103PubMedCrossRef
22.
Zurück zum Zitat Grunewald R, Kantarjian H, Keating MJ, Abbruzzese J, Tarassoff P, Plunkett W (1990) Pharmacologically directed design of the dose rate and schedule of 2′,2′-difluorodeoxycytidine (Gemcitabine) administration in leukemia. Cancer Res 50:6823–6826PubMed Grunewald R, Kantarjian H, Keating MJ, Abbruzzese J, Tarassoff P, Plunkett W (1990) Pharmacologically directed design of the dose rate and schedule of 2′,2′-difluorodeoxycytidine (Gemcitabine) administration in leukemia. Cancer Res 50:6823–6826PubMed
23.
Zurück zum Zitat Patel SR, Gandhi V, Jenkins J, Papadopolous N, Burgess MA, Plager C, Plunkett W, Benjamin RS (2001) Phase II clinical investigation of gemcitabine in advanced soft tissue sarcomas and window evaluation of dose rate on gemcitabine triphosphate accumulation. J Clin Oncol 19:3483–3489PubMed Patel SR, Gandhi V, Jenkins J, Papadopolous N, Burgess MA, Plager C, Plunkett W, Benjamin RS (2001) Phase II clinical investigation of gemcitabine in advanced soft tissue sarcomas and window evaluation of dose rate on gemcitabine triphosphate accumulation. J Clin Oncol 19:3483–3489PubMed
24.
Zurück zum Zitat Tempero M, Plunkett W, Ruiz Van Haperen V, Hainsworth J, Hochster H, Lenzi R, Abbruzzese J (2003) Randomized phase II comparison of dose-intense gemcitabine: thirty-minute infusion and fixed dose rate infusion in patients with pancreatic adenocarcinoma. J Clin Oncol 21:3402–3408PubMedCrossRef Tempero M, Plunkett W, Ruiz Van Haperen V, Hainsworth J, Hochster H, Lenzi R, Abbruzzese J (2003) Randomized phase II comparison of dose-intense gemcitabine: thirty-minute infusion and fixed dose rate infusion in patients with pancreatic adenocarcinoma. J Clin Oncol 21:3402–3408PubMedCrossRef
25.
Zurück zum Zitat Faivre SJ, Olszanski AJ, Weigang-Koehler K, Riess H, Peng G, Callies S, Benhadji KA, Raymond E (2012) Phase I and pharmacokinetic (PK)/pharmacodynamic (PD) study of LY2334737, an oral gemcitabine prodrug, in patients (pts) with advanced solid tumors. Abstract. J Clin Oncol 30(suppl):abstr 2554 Faivre SJ, Olszanski AJ, Weigang-Koehler K, Riess H, Peng G, Callies S, Benhadji KA, Raymond E (2012) Phase I and pharmacokinetic (PK)/pharmacodynamic (PD) study of LY2334737, an oral gemcitabine prodrug, in patients (pts) with advanced solid tumors. Abstract. J Clin Oncol 30(suppl):abstr 2554
Metadaten
Titel
Phase 1 dose escalation and pharmacokinetic evaluation of oral gemcitabine prodrug (LY2334737) in combination with docetaxel in patients with advanced solid tumors
verfasst von
Ramon Salazar
Serafin Morales
Marta Gil-Martín
Elena Aguirre
Ana Oaknin
Margarita Garcia
Sophie Callies
Enaksha R. Wickremsinhe
Karim A. Benhadji
Antonio Llombart
Publikationsdatum
01.06.2014
Verlag
Springer Berlin Heidelberg
Erschienen in
Cancer Chemotherapy and Pharmacology / Ausgabe 6/2014
Print ISSN: 0344-5704
Elektronische ISSN: 1432-0843
DOI
https://doi.org/10.1007/s00280-014-2457-1

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