A first in human phase I study of AZD8186, a potent and selective inhibitor of PI3K in patients with advanced solid tumours as monotherapy and in combination with the dual mTORC1/2 inhibitor vistusertib (AZD2014) or abiraterone acetate.

Authors

Aaron Richard Hansen

Aaron Richard Hansen

Princess Margaret Cancer Centre, Toronto, ON, Canada

Aaron Richard Hansen , Geoffrey Shapiro , Khanh T Do , Rajiv Kumar , Juan Martin-Liberal , Celestia S. Higano , Kari Braun Wisinski , Emma Jane Dean , Elisabeth I. Heath , Dana E. Rathkopf , Mark David Linch , Simon T Barry , Wolfram Brugger , Elza De Bruin , Steve Colebrook , Teresa Klinowska , Patrick D Mitchell , Ganesh Moorthy , Johann S. De Bono , Lillian L. Siu

Organizations

Princess Margaret Cancer Centre, Toronto, ON, Canada, Dana-Farber Cancer Institute, Boston, MA, Royal Marsden Hospital, Surrey, United Kingdom, Medical Oncology Department, Vall d'Hebron University Hospital, Molecular Therapeutics Research Group, Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain, University of Washington Fred Hutchinson Cancer Center, Seattle, WA, University of Wisconsin School of Medicine and Public Health, Madison, WI, University of Manchester and The Christie NHS Foundation Trust, Manchester, United Kingdom, Barbara Ann Karmanos Cancer Institute, Wayne State University, Detroit, MI, Memorial Sloan-Kettering Cancer Center, New York, NY, Royal Marsden Hospital, Kingston, United Kingdom, AstraZeneca, Cambridge, United Kingdom, AstraZeneca, Waltham, MA, The Institute of Cancer Research and The Royal Marsden Hospital, London, United Kingdom

Research Funding

Pharmaceutical/Biotech Company

Background: Loss of PTEN function leads to increased PI3Kβ signalling. AZD8186 (AZD) exhibits significant anti-tumour activity in PTEN-deficient preclinical models, particularly when combined with anti-androgens or the dual mTORC1/2 inhibitor vistusertib (AZD2014). Here we report on the dose-finding part of this Phase 1 study. Methods: AZD single agent was administered twice daily (BD) in 3 different schedules (5 days on/ 2 days off, 2 days on/ 5 days off and continuous). Escalating doses of AZD were evaluated in cohorts of 3-6 patients treated until progression, unacceptable toxicity, or consent withdrawal. Accrual is ongoing in the combination arms with vistusertib or abiraterone acetate. Results: As of 16 Jan 2017, 87 patients have received AZD at doses of 30–360 mg BD, with 28 confirmed as PTEN deficient (IHC). The selected RP2D for the 5 days on/2 days off monotherapy schedule is 60 mg BD. PK parameters show that systemic exposures to AZD and its major active metabolite increase in a dose proportional manner. 69 serious adverse events (SAEs) were reported in 31 patients on AZD monotherapy with 23 SAEs considered possibly related to AZD. In the 5/2 schedule: 5 dose limiting toxicities (G3 rash with ≥G2 fever and/or chills) were observed in 5 patients at doses of 120-360mg. Adverse events ≥G1 in > 20% included diarrhoea, nausea, fatigue, LFT elevations and decreased appetite. 20 patients remained on study for > 100 days. Dose-dependent target inhibition has been demonstrated in surrogate tissue (platelets). Evaluation of direct tumour target engagement in paired biopsies is currently ongoing. Preliminary efficacy: Confirmed PRs seen in a CRPC patient (BRCA2 and androgen receptor mutant) treated in combination with vistusertib (on study for 411 days) and in one ongoing monotherapy PTEN-deficient colorectal cancer patient (on study > 329 days). Updated data will be presented. Conclusions: AZD has potential for treatment of PTEN-deficient tumours. Investigation of the safety/tolerability and preliminary efficacy in combination with vistusertib or abiraterone acetate is continuing. Clinical trial information: NCT01884285

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Abstract Details

Meeting

2017 ASCO Annual Meeting

Session Type

Poster Session

Session Title

Developmental Therapeutics—Clinical Pharmacology and Experimental Therapeutics

Track

Developmental Therapeutics and Translational Research

Sub Track

Small Molecules

Clinical Trial Registration Number

NCT01884285

Citation

J Clin Oncol 35, 2017 (suppl; abstr 2570)

DOI

10.1200/JCO.2017.35.15_suppl.2570

Abstract #

2570

Poster Bd #

62

Abstract Disclosures

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