A phase I dose-escalation study of volasertib (BI 6727) combined with nintedanib (BIBF 1120) in advanced solid tumors.

Authors

null

Filippo G. De Braud

Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy

Filippo G. De Braud , Stefano Cascinu , Gianluca Spitaleri , Korinna Pilz , Laura Clementi , Dan Liu , Patricia Glomb , Tommaso De Pas

Organizations

Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy, Department of Medical Oncology, Polytechnic University of the Marche Region, Ancona, Italy, Medical Oncology Unit of Respiratory Tract and Sarcomas, New Drugs Development Division, European Institute of Oncology, Milan, Italy, Boehringer Ingelheim GmbH, Biberach, Germany, Boehringer Ingelheim Italia S.p.A., Milan, Italy, Division of Thoracic Oncology, European Institute of Oncology, Milan, Italy

Research Funding

Pharmaceutical/Biotech Company

Background: Volasertib (V) is a potent and selective cell cycle kinase inhibitor that induces mitotic arrest and apoptosis by targeting Polo-like kinases. Nintedanib (N) is a triple angiokinase inhibitor of VEGF, PDGF, and FGF receptors. Both have shown clinical activity with a manageable safety profile in patients (pts) with advanced solid tumors. This study was designed to determine the maximum tolerated dose (MTD) of V combined with N in these pts. Methods: Cohorts of 3–6 pts received V (100–450 mg IV Q3W) + oral standard dose N (200 mg BID continuously, except V infusion day). Treatment continued until clinical progression. Up to 12 pts were treated at the MTD for additional safety data. Primary endpoint was the MTD; secondary endpoints were pharmacokinetics (PK), overall safety, and preliminary efficacy. Results: 30 pts were treated (median age, 56.5 yr; ECOG PS 0/1/2, 33%/60%/7%; ≥3 prior therapies, 87%). At V doses >200 mg, 7 pts experienced 13 dose-limiting toxicities (DLTs) during cycle 1: increased alanine aminotransferase [ALT] or aspartate aminotransferase [AST], neutropenia and thrombocytopenia. The MTD was V 300 mg (Table). At the MTD, the most common all grade (Gr) adverse events (AEs) were neutropenia (69%), asthenia and thrombocytopenia (62% each), increased ALT, increased AST and diarrhea (54% each). Median (range) duration on treatment was 4 (1–18) cycles. Treatment was discontinued due to progressive disease (80%), DLT (3%) and other non-AE related reasons (17%). 2 objective responses were observed (1 complete [breast cancer] and 1 partial [NSCLC]), both with the 300 mg dose. 6 pts had SD for ≥ 6 mo. PK data will be presented at the meeting. Conclusions: MTD of V + standard dose N (200 mg BID) was determined to be 300 mg Q3W (the same as the recommended phase II single agent dose of V in solid tumors). This combination had a manageable safety profile without unexpected or overlapping toxicities and showed preliminary antitumor activity. Clinical trial information: NCT01022853.

Cycle 1 DLTs.
V (mg) Pts Pts with DLTs DLTs (n of pts)
100 3 0
200 4 0
300 13 3 Gr 4 neutropenia (1);
Gr 3 ALT increase (3);
Gr 3 AST increase (2)
350 8 2 Gr 4 neutropenia (2);
Gr 4 thrombocytopenia (1);
Gr 3 ALT increase (1)
400 2 2 Gr 4 thrombocytopenia (2);
Gr 4 neutropenia (1)

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Abstract Details

Meeting

2013 ASCO Annual Meeting

Session Type

Poster Session

Session Title

Developmental Therapeutics - Clinical Pharmacology and Experimental Therapeutics

Track

Developmental Therapeutics

Sub Track

Cytotoxic and Other Novel Agents

Clinical Trial Registration Number

NCT01022853

Citation

J Clin Oncol 31, 2013 (suppl; abstr 2556)

DOI

10.1200/jco.2013.31.15_suppl.2556

Abstract #

2556

Poster Bd #

3H

Abstract Disclosures