Safety and enhanced immunostimulatory activity of the DRD2 antagonist ONC201 in advanced solid tumor patients with weekly oral administration
| Autor: | Praveen K. Bommareddy, Wafik S. El-Deiry, Tracie Saunders, Salvatore M. Aspromonte, Lorna Rodriguez, Rohinton Tarapore, Janice M. Mehnert, Steven K. Libutti, Nancy Chan, Ann W. Silk, Jenna H. Newman, Charles B. Chesson, Elayne Wesolowsky, Daniel J. Medina, Christian Gabel, Martin Stogniew, Shengguo Li, Joseph R. Bertino, Joshua E. Allen, Mark N. Stein, Evita Sadimin, Aparna Kareddula, Joseph Aisner, Sherrie Damare, Jyoti Malhotra, Wolfgang Oster, Varun V. Prabhu, Bruce G. Haffty, Andrew Zloza, Ricardo Estupinian, Tina M. Mayer, Melissa Frankel, Robert Aiken, Usha Malhotra |
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| Rok vydání: | 2018 |
| Předmět: |
0301 basic medicine
Oncology Adult Cancer Research medicine.medical_specialty medicine.medical_treatment Dopamine Immunology Administration Oral Antineoplastic Agents lcsh:RC254-282 03 medical and health sciences 0302 clinical medicine Pharmacokinetics Oral administration Internal medicine Neoplasms Solid tumors medicine Clinical endpoint Immunology and Allergy Humans Aged Cancer Pharmacology Aged 80 and over business.industry Receptors Dopamine D2 Standard treatment Endometrial cancer ONC201 Immunotherapy Immuno-oncology Middle Aged medicine.disease lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens 3. Good health 030104 developmental biology 030220 oncology & carcinogenesis Toxicity Molecular Medicine business Research Article |
| Zdroj: | Journal for Immunotherapy of Cancer Journal for ImmunoTherapy of Cancer, Vol 7, Iss 1, Pp 1-9 (2019) |
| ISSN: | 2051-1426 |
| Popis: | Background ONC201 is a small molecule antagonist of DRD2, a G protein-coupled receptor overexpressed in several malignancies, that has prolonged antitumor efficacy and immunomodulatory properties in preclinical models. The first-in-human trial of ONC201 previously established a recommended phase II dose (RP2D) of 625 mg once every three weeks. Here, we report the results of a phase I study that evaluated the safety, pharmacokinetics (PK), and pharmacodynamics (PD) of weekly ONC201. Methods Patients ≥ 18 years old with an advanced solid tumor refractory to standard treatment were enrolled. Dose escalation proceeded with a 3 + 3 design from 375 mg to 625 mg of ONC201. One cycle, also the dose-limiting toxicity (DLT) window, was 21 days. The primary endpoint was to determine the RP2D of weekly ONC201, which was confirmed in an 11-patient dose expansion cohort. Results Twenty patients were enrolled: three at 375 mg and 17 at 625 mg of ONC201. The RP2D was defined as 625 mg with no DLT, treatment discontinuation, or dose modifications due to drug-related toxicity. PK profiles were consistent with every-three-week dosing and similar between the first and fourth dose. Serum prolactin and caspase-cleaved cytokeratin-18 induction were detected, along with intratumoral integrated stress response activation and infiltration of granzyme B+ Natural Killer cells. Induction of immune cytokines and effectors was higher in patients who received ONC201 once weekly versus once every three weeks. Stable disease of > 6 months was observed in several prostate and endometrial cancer patients. Conclusions Weekly, oral ONC201 is well-tolerated and results in enhanced immunostimulatory activity that warrants further investigation. Trial registration NCT02250781 (Oral ONC201 in Treating Patients With Advanced Solid Tumors), NCT02324621 (Continuation of Oral ONC201 in Treating Patients With Advanced Solid Tumors). Electronic supplementary material The online version of this article (10.1186/s40425-019-0599-8) contains supplementary material, which is available to authorized users. |
| Databáze: | OpenAIRE |
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