A phase 1 clinical trial of the selective BTK inhibitor ONO/GS-4059 in relapsed and refractory mature B-cell malignancies

Autor: Tomoya Ohno, Claire V. Hutchinson, John Sharpe, Guillaume Cartron, Gilles Salles, Simon Rule, Franck Morschhauser, Hideyuki Honda, Bruno Cazin, Virginia Jamieson, Shin-ichiro Abe, Lionel Karlin, Toshio Yoshizawa, Harriet S. Walter, Akihisa Nishimura, Philippe Quittet, Martin J. S. Dyer, Kevin J. Duffy, Nimish Shah, Joseph Birkett, Ceri Jones, Christopher Fegan, Nigel Courtenay-Luck
Přispěvatelé: Centre Hospitalier Lyon Sud [CHU - HCL] (CHLS), Hospices Civils de Lyon (HCL), Dynamique des interactions membranaires normales et pathologiques (DIMNP), Université Montpellier 1 (UM1)-Université Montpellier 2 - Sciences et Techniques (UM2)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Service d’Hématologie [Centre Hospitalier Lyon Sud - HCL], Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL), Centre de Recherche en Cancérologie de Lyon (UNICANCER/CRCL), Centre Léon Bérard [Lyon]-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM)-Université Montpellier 2 - Sciences et Techniques (UM2)-Université Montpellier 1 (UM1)
Jazyk: angličtina
Rok vydání: 2016
Předmět:
0301 basic medicine
Male
Lymphocytosis
Lymphoma
Clinical Trials and Observations
Chronic lymphocytic leukemia
Phases of clinical research
Lymphoma
Mantle-Cell

Biochemistry
Gastroenterology
Cohort Studies
0302 clinical medicine
hemic and lymphatic diseases
London
Agammaglobulinaemia Tyrosine Kinase
80 and over
Medicine
Chronic
ComputingMilieux_MISCELLANEOUS
Aged
80 and over

B-Lymphocytes
Hematoma
Leukemia
Imidazoles
Hematology
Middle Aged
Protein-Tyrosine Kinases
Diffuse
Lymphocytic
3. Good health
drug therapy
Local
030220 oncology & carcinogenesis
Female
Lymphoma
Large B-Cell
Diffuse

France
medicine.symptom
Adult
Diarrhea
medicine.medical_specialty
Patients
Immunology
[SDV.CAN]Life Sciences [q-bio]/Cancer
03 medical and health sciences
Refractory
blood
Internal medicine
Large B-Cell
Humans
Adverse effect
Protein Kinase Inhibitors
Aged
therapy
business.industry
B-Cell
toxicity
Cell Biology
Mantle-Cell
medicine.disease
Leukemia
Lymphocytic
Chronic
B-Cell

Surgery
030104 developmental biology
Neoplasm Recurrence
Pyrimidines
antagonists & inhibitors
therapeutic use
drug effects
adverse effects
Mantle cell lymphoma
pathology
Neoplasm Recurrence
Local

business
Progressive disease
Zdroj: Blood
Blood, American Society of Hematology, 2016, 127 (4), pp.411-419. ⟨10.1182/blood-2015-08-664086⟩
ISSN: 0006-4971
1528-0020
Popis: We report the results of a multicenter phase 1 dose-escalation study of the selective Bruton tyrosine kinase (BTK) inhibitor ONO/GS-4059 in 90 patients with relapsed/refractory B-cell malignancies. There were 9 dose-escalation cohorts ranging from 20 mg to 600 mg once daily with twice-daily regimens of 240 mg and 300 mg. Twenty-four of 25 evaluable chronic lymphocytic leukemia (CLL) patients (96%) responded to ONO/GS-4059, with a median treatment duration of 80 weeks; 21 CLL patients remain on treatment. Lymph node responses were rapid and associated with a concurrent lymphocytosis. Eleven of 12 evaluable patients with mantle cell lymphoma (92%) responded (median treatment duration, 40 weeks). Eleven of 31 non-germinal center B-cell diffuse large B-cell lymphoma patients (35%) responded but median treatment duration was 12 weeks due to development of progressive disease. ONO/GS-4059 was very well tolerated with 75% of adverse events (AEs) being Common Toxicity Criteria for Adverse Events version 4.0 grade 1 or grade 2. Grade 3/4 AEs were mainly hematologic and recovered spontaneously during therapy. One CLL patient experienced a grade 3 treatment-related bleeding event (spontaneous muscle hematoma) but no clinically significant diarrhea, cardiac dysrhythmias, or arthralgia were observed. No maximal tolerated dose (MTD) was reached in the CLL cohort. In the non-Hodgkin lymphoma cohort, 4 patients developed a dose-limiting toxicity, yielding an MTD of 480 mg once daily. ONO/GS-4059 has significant activity in relapsed/refractory B-cell malignancies without major drug-related toxicity. The selectivity of ONO/GS-4059 should confer advantages in combination therapies. This trial was registered at www.clinicaltrials.gov as #NCT01659255.
Databáze: OpenAIRE