Dose escalation and expansion cohort study for DS-8895a in patients with advanced solid tumors.

Authors

Taroh Satoh

Taroh Satoh

Department of Frontier Science for Cancer and Chemotherapy Osaka University Graduate School of Medicine, Osaka, Japan

Taroh Satoh , Kohei Shitara , Satoru Iwasa , Kensei Yamaguchi , Kei Muro , Yoshito Komatsu , Tomohiro Nishina , Taito Esaki , Jun Hasegawa , Yasuyuki Kakurai , Emi Kamiyama , Tomoko Nakata , Kota Nakamura , Ichinosuke Hyodo

Organizations

Department of Frontier Science for Cancer and Chemotherapy Osaka University Graduate School of Medicine, Osaka, Japan, National Cancer Center Hospital East, Kashiwa, Chiba, Japan, National Cancer Center Hospital, Department of Experimental Therapeutics, Tokyo, Japan, The Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan, Department of Clinical Oncology, Aichi Cancer Center Hospital, Nagoya, Japan, Department of Cancer Chemotherapy, Hokkaido University Hospital Cancer Center, Sapporo, Japan, National Hospital Organization Shikoku Cancer Center, Matsuyama, Japan, Department of Gastrointestinal and Medical Oncology, National Kyushu Cancer Center, Fukuoka, Japan, Daiichi Sankyo Co., Ltd., Tokyo, Japan, Division of Gastroenterology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan

Research Funding

Pharmaceutical/Biotech Company

Background: Erythropoietin-producing hepatocellular receptor A2 (EPHA2) is overexpressed on the cell surface of many tumors and is associated with poor prognosis, suggesting EPHA2 as a target for cancer therapy. DS-8895a is an afucosylated, humanized anti-EPHA2 IgG1 monoclonal antibody with potent cytotoxicity. We report results from a phase I clinical trial to determine safety, tolerability, and pharmacokinetics (PK) of DS-8895a in Japanese patients with advanced solid tumors (NCT02004717). Methods: Step 1 (dose escalation cohort) had patients with advanced solid tumors and comprised of six dose levels (0.1–20 mg/mL, intravenous infusion, every 2 weeks [Q2W]) with a 28-day dose limiting toxicity (DLT) evaluation period. Step 2 (expansion cohort) patients had gastric or esophageal cancer confirmed to be EPHA2 positive by immunohistochemistry. Dose level in Step 2 was determined based on results obtained in Step 1. We evaluated safety, PK, potential biomarkers including circulating NK cells and cytokines, and tumor response. Results: Maximum tolerated dose was not reached in Step 1 (n = 22). DS-8895a was administered at 20 mg/kg Q2W in Step 2 (n = 15). Among 37 patients in the safety analysis set, adverse events (AEs) were reported in 97.3% (64.9% drug-related); 35.1% presented grade ≥ 3 AEs (8.1% drug-related). Dose delay and study discontinuation due to AEs (treatment related: grade 4 platelet decrease, hypoesthesia, hypotension, peripheral coldness, nausea, and vomiting) were observed in one and four patients (20 mg/kg), respectively. Infusion-related reactions occurred in 51.4% of patients resulting in 10 dose interruptions with one discontinuation. Serum inflammatory cytokines were transiently increased 4 h from the end of infusion drug administration. Serum DS-8895a maximum and trough concentrations increased dose-dependently. Biomarkers had no apparent relationship to best overall response. Seven patients in Step 1 achieved stable disease; in Step 2, six patients achieved stable disease and one patient achieved partial response. Conclusions: DS-8895a was safe and well tolerated up to 20 mg/kg. The PK of DS-8895a was dose-dependent as expected. Clinical trial information: NCT02004717

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Abstract Details

Meeting

2019 Gastrointestinal Cancers Symposium

Session Type

Poster Session

Session Title

Poster Session A: Cancers of the Esophagus and Stomach

Track

Cancers of the Esophagus and Stomach

Sub Track

Multidisciplinary Treatment

Clinical Trial Registration Number

NCT02004717

Citation

J Clin Oncol 37, 2019 (suppl 4; abstr 99)

DOI

10.1200/JCO.2019.37.4_suppl.99

Abstract #

99

Poster Bd #

J9

Abstract Disclosures