Evolution of early phase clinical trials in oncology

被引:11
作者
Bui, Nam Q. [1 ]
Kummar, Shivaani [1 ]
机构
[1] Stanford Univ, Sch Med, Div Med Oncol, 780 Welch Rd,CJ250L, Palo Alto, CA 94305 USA
来源
JOURNAL OF MOLECULAR MEDICINE-JMM | 2018年 / 96卷 / 01期
关键词
Phase; 1; trials; Drug development; Basket trials; Umbrella trials; CELL LUNG-CANCER; PD-1; BLOCKADE; OPEN-LABEL; PEMBROLIZUMAB; ANTI-PD-1; SAFETY; MULTICENTER; INHIBITION; EFFICACY; ANTIBODY;
D O I
10.1007/s00109-017-1612-7
中图分类号
Q3 [遗传学];
学科分类号
071007 ; 090102 ;
摘要
The therapeutic armamentarium for the treatment of cancer has rapidly evolved with the advent of molecularly targeted and immuno-oncology agents. Dramatic and prolonged responses observed in patients with advanced cancers have created excitement and promise for expedited development of effective new treatments. However, this has also necessitated a rethinking of our early phase clinical trial designs and the process of optimally developing a novel agent. In this review, we discuss the current state and future directions of phase I clinical trials in oncology. Firstly, we cover the statistical methodologies behind rules and model-based dose escalation designs, and what the future holds for optimal dose selection beyond targeting the maximum tolerated dose. Next, we discuss the recent adoption of seamless expansion strategies to expedite drug development timelines, highlighted by the pembrolizumab KEYNOTE-001 trial, and potential pitfalls with this approach. Finally, we delve into the concepts behind genomic matching trials, including early success stories and the challenges that lie ahead.
引用
收藏
页码:31 / 38
页数:8
相关论文
共 38 条
[1]  
[Anonymous], FDA APPR PEMBR
[2]   Immune related adverse events associated with anti-CTLA-4 antibodies: systematic review and meta-analysis [J].
Bertrand, Anne ;
Kostine, Marie ;
Barnetche, Thomas ;
Truchetet, Marie-Elise ;
Schaeverbeke, Thierry .
BMC MEDICINE, 2015, 13
[3]   Improved Survival with Vemurafenib in Melanoma with BRAF V600E Mutation [J].
Chapman, Paul B. ;
Hauschild, Axel ;
Robert, Caroline ;
Haanen, John B. ;
Ascierto, Paolo ;
Larkin, James ;
Dummer, Reinhard ;
Garbe, Claus ;
Testori, Alessandro ;
Maio, Michele ;
Hogg, David ;
Lorigan, Paul ;
Lebbe, Celeste ;
Jouary, Thomas ;
Schadendorf, Dirk ;
Ribas, Antoni ;
O'Day, Steven J. ;
Sosman, Jeffrey A. ;
Kirkwood, John M. ;
Eggermont, Alexander M. M. ;
Dreno, Brigitte ;
Nolop, Keith ;
Li, Jiang ;
Nelson, Betty ;
Hou, Jeannie ;
Lee, Richard J. ;
Flaherty, Keith T. ;
McArthur, Grant A. .
NEW ENGLAND JOURNAL OF MEDICINE, 2011, 364 (26) :2507-2516
[4]   NCI-molecular analysis for therapy choice (NCI-MATCH) clinical trial: interim analysis [J].
Conley, Barbara A. ;
Gray, Robert ;
Chen, Alice ;
O'Dwyer, Peter ;
Arteaga, Carlos ;
Coffey, Brent ;
Patton, David ;
Li, Shuli ;
McShane, Lisa M. ;
Rubinstein, Larry ;
Connis, Robert ;
Abrams, Jeffrey ;
Williams, Paul M. ;
Lih, Chih-Jian ;
Hamilton, Stanley ;
Mitchell, Edith ;
Zwiebel, James ;
Flaherty, Keith .
CANCER RESEARCH, 2016, 76
[5]   Evaluation of Statistical Designs in Phase I Expansion Cohorts: The Dana-Farber/Harvard Cancer Center Experience [J].
Dahlberg, Suzanne E. ;
Shapiro, Geoffrey I. ;
Clark, Jeffrey W. ;
Johnson, Bruce E. .
JNCI-JOURNAL OF THE NATIONAL CANCER INSTITUTE, 2014, 106 (07)
[6]   Immune-Related Adverse Events Associated with Immune Checkpoint Inhibitors [J].
Day, Daphne ;
Hansen, Aaron R. .
BIODRUGS, 2016, 30 (06) :571-584
[7]   Efficacy and safety of imatinib mesylate in advanced gastrointestinal stromal tumors [J].
Demetri, GD ;
von Mehren, M ;
Blanke, CD ;
Van den Abbeele, AD ;
Eisenberg, B ;
Roberts, PJ ;
Heinrich, MC ;
Tuveson, DA ;
Singer, S ;
Janicek, M ;
Fletcher, JA ;
Silverman, SG ;
Silberman, SL ;
Capdeville, R ;
Kiese, B ;
Peng, B ;
Dimitrijevic, S ;
Druker, BJ ;
Corless, C ;
Fletcher, CDM ;
Joensuu, H .
NEW ENGLAND JOURNAL OF MEDICINE, 2002, 347 (07) :472-480
[8]   Efficacy and safety of a specific inhibitor of the BCR-ABL tyrosine kinase in chronic myeloid leukemia. [J].
Druker, BJ ;
Talpaz, M ;
Resta, DJ ;
Peng, B ;
Buchdunger, E ;
Ford, JM ;
Lydon, NB ;
Kantarjian, H ;
Capdeville, R ;
Ohno-Jones, S ;
Sawyers, CL .
NEW ENGLAND JOURNAL OF MEDICINE, 2001, 344 (14) :1031-1037
[9]  
Elassaiss-Schaap J, 2017, CPT-PHARMACOMET SYST, V6, P21, DOI 10.1002/psp4.12132
[10]   Pembrolizumab for the Treatment of Non-Small-Cell Lung Cancer [J].
Garon, Edward B. ;
Rizvi, Naiyer A. ;
Hui, Rina ;
Leighl, Natasha ;
Balmanoukian, Ani S. ;
Eder, Joseph Paul ;
Patnaik, Amita ;
Aggarwal, Charu ;
Gubens, Matthew ;
Horn, Leora ;
Carcereny, Enric ;
Ahn, Myung-Ju ;
Felip, Enriqueta ;
Lee, Jong-Seok ;
Hellmann, Matthew D. ;
Hamid, Omid ;
Goldman, Jonathan W. ;
Soria, Jean-Charles ;
Dolled-Filhart, Marisa ;
Rutledge, Ruth Z. ;
Zhang, Jin ;
Lunceford, Jared K. ;
Rangwala, Reshma ;
Lubiniecki, Gregory M. ;
Roach, Charlotte ;
Emancipator, Kenneth ;
Gandhi, Leena .
NEW ENGLAND JOURNAL OF MEDICINE, 2015, 372 (21) :2018-2028