baVenugopal, B., Baird, R., Kristeleit, R. S., Plummer, R., Cowan, R., Stewart, A., Fourneau, N., Hellemans, P., Elsayed, Y., McClue, S., Smit, J. W., Forslund, A., Phelps, C., Camm, J., Evans, T. R. J., de Bono, J. S., Banerji, U. (2013) A Phase I Study of Quisinostat (JNJ-26481585), an Oral Hydroxamate Histone Deacetylase Inhibitor with Evidence of Target Modulation and Antitumor Activity, in Patients with Advanced Solid Tumors. CLINICAL CANCER RESEARCH, 19 (15). pp. 4262-4272. ISSN 1078-0432

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Abstract

Purpose: To determine the maximum-tolerated dose (MTD), dose-limiting toxicities (DLT), and pharmacokinetic and pharmacodynamic profile of quisinostat, a novel hydroxamate, pan-histone deacetylase inhibitor (HDACi). Experimental Design: In this first-in-human phase I study, quisinostat was administered orally, once daily in three weekly cycles to patients with advanced malignancies, using a two-stage accelerated titration design. Three intermittent schedules were subsequently explored: four days on/three days off; every Monday, Wednesday, Friday (MWF); and every Monday and Thursday (M-Th). Toxicity, pharmacokinetics, pharmacodynamics, and clinical efficacy were evaluated at each schedule. Results: Ninety-two patients were treated in continuous daily (2-12 mg) and three intermittent dosing schedules (6-19 mg). Treatment-emergent adverse events included: fatigue, nausea, decreased appetite, lethargy, and vomiting. DLTs observed were predominantly cardiovascular, including nonsustained ventricular tachycardia, ST/T-wave abnormalities, and other tachyarhythmias. Noncardiac DLTs were fatigue and abnormal liver function tests. The maximum plasma concentration (C-max) and area under the plasma concentration-time curve (AUC) of quisinostat increased proportionally with dose. Pharmacodynamic evaluation showed increased acetylated histone 3 in hair follicles, skin and tumor biopsies, and in peripheral blood mononuclear cells as well as decreased Ki67 in skin and tumor biopsies. A partial response lasting five months was seen in one patient with melanoma. Stable disease was seen in eight patients (duration 4-10.5 months). Conclusions: The adverse event profile of quisinostat was comparable with that of other HDACi. Intermittent schedules were better tolerated than continuous schedules. On the basis of tolerability, pharmacokinetic predictions, and pharmacodynamic effects, the recommended dose for phase II studies is 12 mg on the MWF schedule. (C) 2013 AACR.

Item Type:	Article
Authors (ICR Faculty only):	Banerji, udai and De Bono, Johann
All Authors:	baVenugopal, B., Baird, R., Kristeleit, R. S., Plummer, R., Cowan, R., Stewart, A., Fourneau, N., Hellemans, P., Elsayed, Y., McClue, S., Smit, J. W., Forslund, A., Phelps, C., Camm, J., Evans, T. R. J., de Bono, J. S., Banerji, U.
Additional Information:	Venugopal, Balaji Baird, Richard Kristeleit, Rebecca S. Plummer, Ruth Cowan, Richard Stewart, Adam Fourneau, Nele Hellemans, Peter Elsayed, Yusri Mcclue, Steve Smit, Johan W. Forslund, Ann Phelps, Charles Camm, John Evans, T. R. Jeffry de Bono, Johann S. Banerji, Udai
Research teams:	ICR divisions > Cancer Therapeutics > Cancer Biomarkers ICR divisions > Clinical Studies > Cancer Biomarkers ICR divisions > Clinical Studies > Clinical Pharmacology – Adaptive Therapy ICR divisions > Cancer Therapeutics > Clinical Pharmacology – Adaptive Therapy ICR divisions > Clinical Studies > Prostate Cancer Targeted Therapy Group
Depositing User:	Users 11 not found.
Date Deposited:	02 Sep 2013 11:18
Last Modified:	20 Mar 2018 14:57
URI:	http://publications.icr.ac.uk/id/eprint/12684

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