Phase I study of cabazitaxel (Cbz) plus cisplatin (Cis) in patients (pts) with advanced solid tumors: Substudy to evaluate the impact of a strong CYP3A inhibitor (ketoconazole; K) or inducer (rifampicin; R) on the pharmacokinetics (PK) of Cbz.

Authors

null

Alain C. Mita

Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA

Alain C. Mita , Albert C. Lockhart , James Lloyd Wade , John Charles Morris , Olivier Rixe , Jean-François Dedieu , Claudine Wack , Laurent Kassalow , John Sarantopoulos

Organizations

Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA, Siteman Cancer Center, Washington University School of Medicine, St. Louis, MO, Cancer Care Center of Decatur, Decatur, IL, University of Cincinnati Cancer Institute, Cincinnati, OH, Georgia Regents University, Augusta, GA, Sanofi, Chilly-Mazarin, France, Sanofi-Aventis, Bridgewater, NJ, Institute for Drug Development, University of Texas Health Science Center, San Antonio, TX

Research Funding

Pharmaceutical/Biotech Company

Background: Cbz is approved for treatment of pts with hormone-refractory metastatic prostate cancer after progression on a docetaxel-containing regimen. The dose-escalation part of this Phase I study (NCT00925743) found the maximum tolerated dose (MTD) of Cbz/Cis to be 15/75 mg/m2. No Cbz–Cis PK interactions were seen. As Cbz is mainly metabolized by CYP3A, the study also evaluated the impact of a strong CYP3A inhibitor (K; study part 3) or strong CYP3A inducer (R; study part 4) on the PK of Cbz in combination with Cis. Methods: The study included pts with metastatic or unresectable solid tumors for which Cis-based therapy was considered appropriate. Pts received Cbz/Cis every 3 weeks at MTD, with K 400 mg (part 3) or R 600 mg (part 4) administered orally once daily prior to, on, and after Cycle 2 Day 1 for a total of 10 (K) or 14 (R) days. In part 3, the Cbz/Cis dose was 5/75 mg/m2 in Cycles 1 and 2 to provide a safety margin to the MTD. Effects on Cbz PK were assessed with a linear mixed-effects model. The primary endpoint was Cbz clearance (CL). Safety assessments included adverse events (AEs) and laboratory abnormalities. Results: The PK population included 23 pts (part 3) and 21 pts (part 4). Repeated administration of K resulted in a 20% decrease in Cbz CL (L/h/m2) (geometric mean ratio [GMR]: 0.80; 90% confidence interval [CI]: 0.55, 1.15; n = 18), corresponding to a 25% increase in AUC (ng*h/mL/mg/m2) (GMR: 1.25; 90% CI: 0.86, 1.81; n = 18). Repeated administration of R resulted in a 21% increase in Cbz CL (L/h/m2) (GMR: 1.21; 90% CI: 0.95, 1.53; n = 20), corresponding to a 17% decrease in AUC (ng*h/mL/mg/m2) (GMR: 0.83; 90% CI: 0.65, 1.05; n = 20). The GMR of AUC0–24was 1.09 (90% CI: 0.9, 1.33; n = 21), suggesting a low impact of R during the initial phases of Cbz elimination. The most frequent AEs included nausea (part 3: 68%; part 4: 74%), vomiting (part 3: 68%; part 4: 74%) and fatigue (part 3: 52%; part 4: 70%). Conclusions: The CL of Cbz was decreased by 20% by co-administration with K and increased by 21% by co-administration with R. Safety results were consistent with prior findings for this Cbz/Cis combination. Clinical trial information: NCT00925743.

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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

NCT00925743

Citation

J Clin Oncol 31, 2013 (suppl; abstr 2560)

DOI

10.1200/jco.2013.31.15_suppl.2560

Abstract #

2560

Poster Bd #

4D

Abstract Disclosures