A Phase I First-in-Human Trial of Bardoxolone Methyl in Patients with Advanced Solid Tumors and Lymphomas

被引：209

作者：

Hong, David S. ^{[10
]}

Kurzrock, Razelle ^{[10
]}

Supko, Jeffrey G.

He, Xiaoying

Naing, Aung ^{[10
]}

Wheler, Jennifer ^{[10
]}

Lawrence, Donald ^{[7
]}

Eder, Joseph Paul ^{[6
]}

Meyer, Colin J. ^{[4
]}

Ferguson, Deborah A. ^{[4
]}

Mier, James ^{[5
]}

Konopleva, Marina ^{[1
]}

Konoplev, Sergej ^{[2
]}

Andreeff, Michael ^{[3
]}

Kufe, Donald

Lazarus, Hillard ^{[8
]}

Shapiro, Geoffrey I. ^{[6
]}

Dezube, Bruce J. ^{[9
]}

机构：

[1] Univ Texas MD Anderson Canc Ctr, Div Canc Med, Dept Leukemia, Houston, TX 77030 USA

[2] Univ Texas MD Anderson Canc Ctr, Dept Hematopathol, Houston, TX 77030 USA

[3] Univ Texas MD Anderson Canc Ctr, Dept Mol Hematol Therapy, Dept Stem Cell Transplantat & Cellular Therapy, Houston, TX 77030 USA

[4] Reata Pharmaceut Inc, Irving, TX USA

[5] Harvard Univ, Beth Israel Deaconess Med Ctr, Sch Med, Dana Farber Harvard Canc Ctr, Boston, MA 02215 USA

[6] Harvard Univ, Sch Med, Dana Farber Canc Inst, Early Drug Dev Ctr,Dept Med Oncol, Boston, MA 02115 USA

[7] Harvard Univ, Massachusetts Gen Hosp, Sch Med, Div Hematol Oncol, Boston, MA USA

[8] Univ Hosp Case Med Ctr, Dept Med, Cleveland, OH USA

[9] Harvard Univ, Beth Israel Deaconess Med Ctr, Sch Med, Dept Hematol & Oncol, Boston, MA 02215 USA

[10] Univ Texas MD Anderson Canc Ctr, Phase Clin Trials Program 1, Dept Invest Canc Therapeut, Houston, TX 77030 USA

来源：

CLINICAL CANCER RESEARCH | 2012年 / 18卷 / 12期

关键词：

NF-KAPPA-B; TRITERPENOID CDDO-ME; LUNG-CANCER CELLS; INFLAMMATORY RESPONSE; APOPTOTIC ACTIVITY; DIRECT INHIBITION; OXIDATIVE STRESS; KIDNEY-FUNCTION; ESTER; EXPRESSION;

D O I：

10.1158/1078-0432.CCR-11-2703

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Purpose: Bardoxolone methyl, a novel synthetic triterpenoid and antioxidant inflammation modulator, potently induces Nrf2 and inhibits NF-kappa B and Janus-activated kinase/STAT signaling. This first-in-human phase I clinical trial aimed to determine the dose-limiting toxicities (DLT), maximum tolerated dose (MTD), and appropriate dose for phase II studies; characterize pharmacokinetic and pharmacodynamic parameters; and assess antitumor activity. Experimental Design: Bardoxolone methyl was administered orally once daily for 21 days of a 28-day cycle. An accelerated titration design was employed until a grade 2-related adverse event occurred. A standard 3 + 3 dose escalation was then employed until the MTD was reached. Single dose and steady-state plasma pharmacokinetics of the drug were characterized. Assessment of Nrf2 activation was examined in peripheral blood mononuclear cells (PBMC) by measuring NAD(P) H: quinone oxidoreductase (NQO1) mRNA levels. Immunohistochemical assessment of markers of inflammation, cell cycle, and apoptosis was carried out on tumor biopsies. Results: The DLTs were grade 3 reversible liver transaminase elevations. The MTD was established as 900 mg/d. A complete tumor response occurred in a mantle cell lymphoma patient, and a partial response was observed in an anaplastic thyroid carcinoma patient. NQO1 mRNA levels increased in PBMCs, and NF-kappa B and cyclin D1 levels decreased in tumor biopsies. Estimated glomerular filtration rate (eGFR) was also increased. Conclusions: Bardoxolone methyl was well tolerated with an MTD of 900 mg/d. The increase in eGFR suggests that bardoxolone methyl might be beneficial in chronic kidney disease. Objective tumor responses and pharmacodynamic effects were observed, supporting continued development of other synthetic triterpenoids in cancer. Clin Cancer Res; 18(12); 3396-406. (C) 2012 AACR.

引用

页码：3396 / 3406

页数：11

共 40 条

[1] Triterpenoid CDDO-methyl ester inhibits the janus-activated kinase-1 (JAK1)→Signal transducer and activator of transcription-3 (STAT3) pathway by direct inhibition of JAK1 and STAT3 [J].