DOCSLIB.ORG

EGFR Mutant-Specific Inhibitor, in T790M+ NSCLC: #378 Efficacy and Safety at the RP2D

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
EGFR Mutant-Specific Inhibitor, in T790M+ NSCLC: #378 Efficacy and Safety at the RP2D Olmutinib (BI 1482694; HM61713), an EGFR mutant-specific inhibitor, in T790M+ NSCLC: #378 efficacy and safety at the RP2D Keunchil Park,1* Jong-Seok Lee,2 Ki Hyeong Lee,3 Joo-Hang Kim,4 Byoung Chul Cho,5 Young Joo Min,6 Jae Yong Cho,7 Ji-Youn Han,8 Bong-Seog Kim,9 Jin-Soo Kim,10 Dae Ho Lee,11 Jin Hyoung Kang,12 Eun Kyung Cho,13 Hoon-Gu Kim,14 Kyung Hee Lee,15 Hoon Kyo Kim,16 In-Jin Jang,17 Hyo-Yeon Kim,18 Jeewoong Son,18 Dong-Wan Kim17 1Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea; 2Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea; 3Chungbuk National University Hospital, Cheongju, North Chungcheong, South Korea; 4CHA Bundang Medical Center, CHA University, Gyeonggi-Do, South Korea; 5Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, South Korea; 6Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, South Korea; 7Gangnam Severance Hospital, Seoul, South Korea; 8Center for Lung Cancer, National Cancer Center, Goyang, South Korea; 9VHS Medical Center, Seoul, South Korea; 10Seoul National University, Boramae Medical Center, Seoul, South Korea; 11Asan Medical Center, Seoul, South Korea; 12Seoul St Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea; 13Gachon University Gil Medical Center, Incheon, South Korea; 14Gyeongsang National University Hospital, Jinju, South Gyeongsang, South Korea; 15Yeungnam University Medical Center, Gyeonsan, North Gyeongsang, South Korea; 16St. Vincent's Hospital, Suwon, South Korea; 17Seoul National University Hospital, Seoul, South Korea; 18Hanmi Pharmaceutical Co., Ltd., Seoul, South Korea INTRODUCTION RESULTS Table 2. Tumor response (independent assessment) • Across all patients (N=76), median treatment duration was 7.3 months Table 3. Drug-related AEs in >20% of patients (range 0.3–16.7) (Figure 4) Treated patients (N=76) Response, n (%) Evaluable for response (n=70) • A T790M mutation within exon 20 of the EGFR gene is the most common (~50% of Patients and treatment – As of February 29, 2016, 14 (18%) patients are continuing treatment, with a cases) mechanism of acquired resistance to first- and second-generation EGFR duration of over 16 months AE, n (%) All grades Grade ≥3 1–3 • Between August 2014 and April 2015 76 Korean patients with T790M+ NSCLC tyrosine kinase inhibitors (TKIs) OR (confirmed and unconfirmed) 43 (61) Diarrhea 45 (59) 0 commenced treatment with olmutinib 800 mg QD • Olmutinib (BI 1482694; HM61713) is an oral, third-generation TKI with EGFR Figure 4. Individual treatment duration (treated patients; N=76*) Pruritus 32 (42) 1 (1) mutant-specific activity against Del19, L858R, and T790M, that spares – Patient demographics and baseline characteristics are summarized in Table 1 4 wild-type EGFR Table 1. Baseline characteristics Disease control 63 (90) Rash 31 (41) 4 (5) • The safety, tolerability, pharmacokinetics, and preliminary activity of olmutinib Confirmed OR 38 (54) Nausea 30 (39) 0 were evaluated in a Phase I/II trial in Korean patients with EGFR TKI Characteristic Patients (N=76) SD / unconfirmed PR 20 (29) / 5 (7) pre-treated NSCLC5,6 Palmar-plantar erythrodysesthesia syndrome 23 (30) 3 (4) • In Phase I, the recommended Phase II dose (RP2D) was 800 mg once daily (QD), Gender, n (%) and 76 patients with T790M+ NSCLC were enrolled at this dose in a Phase II part Female 44 (58) PD 3 (4) Best response by independent review* Decreased appetite 23 (30) 0 PR (n=43) – The preliminary safety and efficacy results at 800 mg QD (as of June 2015) were SD (n=20) Dry skin 21 (28) 1 (1) 6 Median age, years (range) 60 (32–85) presented previously NE 4 (6) NE (n=10) PD (n=3) Skin exfoliation 20 (26) 1 (1) – Here we present updated efficacy and safety findings as of February 29, 2016 NE, not evaluable; PD, progressive disease; SD, stable disease ECOG PS, n (%) Onset of response 0 / 1 / 2 5 (7) / 56 (74) / 15 (20) Confirmed PR (n=38) METHODS Figure 2. Duration of response (independent assessment) Unconfirmed PR (n=5) CONCLUSIONS Identified patient ongoing (n=14) Study design Smoking history, n (%) Never / former / current 53 (70) / 21 (28) / 2 (3) 1.0 • At the RP2D of 800 mg QD, olmutinib showed meaningful clinical activity with a • Phase I/II, open-label, multicenter study (NCT01588145) 0.9 OR rate 0 10 20 30 40 50 60 70 80 favorable safety profile in Korean patients with T790M+ NSCLC progressing on • Phase II part enrolled patients with centrally confirmed T790M+ NSCLC (Figure 1) 0.8 95% CI initial EGFR TKI therapy Previous lines of systemic treatment*, n (%) Censored Treatment duration (weeks) 0.7 • Tumors were assessed every 6 weeks by investigator and independent review 1 / 2 / ≥3 19 (25) / 27 (36) / 30 (39) *6 patients were not evaluable for independent response assessment and were included in those • Confirmed ORs by independent review were observed in 38 (54%) patients, with a according to RECIST v1.1 0.6 classified as best response, NE median duration of response of 8.3 months (5.7–9.7) 0.5 • Treatment continued until disease progression, unacceptable toxicity, or other Previous EGFR TKI†, n (%) • The most common drug-related AEs were typically mild-to-moderate in intensity and 0.4 stopping criteria Gefitinib 58 (76) • Evidence of the anti-tumor activity of olmutinib on CNS metastases was observed in included gastrointestinal and dermatologic disorders 0.3 Probability of OR Probability a 62-year-old male patient enrolled in April 2015. The patient achieved complete Erlotinib 21 (28) • An ongoing global Phase II trial, ELUXA 1 (NCT02485652), is further assessing the Figure 1. Study design and expansion cohort 0.2 response (CR) in the brain by August 2015 (Cycle 6), which was sustained until efficacy and safety of olmutinib in patients with T790M+ NSCLC7 Afatinib 11 (14) 0.1 October 2015 (Cycle 9), when the patient came off treatment due to an adverse 5 Dose escalation (N=66) Poziotinib 2 (3) 0 event (AE) of neuropathy (Figure 5) 0 5 Time (months) 10 15 T790M+ or -negative REFERENCES EGFRm+ NSCLC Median interval from last EGFR TKI, days 61 Figure 5. CR in the brain lesion in a patient at 800 mg QD Progression on ≥2 prior Expansion/Phase II 1. Arcila ME, et al. Clin Cancer Res 2011;17:1169–80 (N=76; ongoing) T790M mutation, n (%) Figure 3. Individual tumor change (independent assessment) Baseline, March 2015 Cycle 5, July 2015 Cycle 6, August 2015 therapies, including EGFR TKI 1200 mg 2. Nguyen KS, et al. Clin Cancer Res 2009;10:281–9 Positive (local test) 76 (100) 800 mg T790M positive Evaluable patients (n=70) 3. Wu SG, et al. Oncotarget 2016;7:12404–13 650 mg Progression on ≥1 prior EGFR TKI Positive (central test) 73 (96) 20 4. Lee K-O, et al. Cancer Res 2014;74:LB-100 No symptomatic or uncontrolled 500 mg 5. Park K, et al. J Clin Oncol 2015;33(Suppl.15) (abstract 8084) CNS metastases † 0 400 mg *Including EGFR TKIs; Patients may have received more than one EGFR TKI 6. Park K, et al. APLCC 2016;poster #PA27 ECOG PS, Eastern Cooperative Oncology Group performance status 300 mg 7. Park K, et al. J Thorac Oncol 2016;11(Suppl 4):S139 (abstract 190TiP) –30 250 mg * * * * * * * Efficacy –50 * * * * * * 200 mg * * * * * * ACKNOWLEDGMENTS • 70 patients were evaluable for response by independent review. Table 2 summarizes volume change (%) PR (n=43) * * 150 mg * * * * * * * Confirmed PR (n=38) * * the best response as of February 29, 2016 * * * * 100 mg SD (n=20) * This study was funded by Hanmi Pharmaceutical Co., Ltd. The authors were fully 75 mg • Figures 2 and 3 show duration of response and individual tumor change Tumor NE (n=4) Safety responsible for all content and editorial decisions, were involved at all stages of poster –100 * • 43 (61%) patients experienced tumor shrinkage qualifying for OR PD (n=3) * * • The most common drug-related AEs (all/grade ≥3) were diarrhea (59%/0%), pruritus development, and approved the final version CNS, central nervous system; EGFRm+, EGFR mutation-positive (42%/1%), rash (41%/5%), and nausea (39%/0%) (Table 3) – In the majority of patients (36/43 [84%]), onset of tumor response occurred by the Medical writing assistance, supported financially by Boehringer Endpoints and assessments in Phase II Week 6 (Cycle 2) scan (Figure 4) • 4 (5%) patients discontinued due to drug-related AEs (upper abdominal pain and Ingelheim, was provided by Fiona Scott, PhD, of GeoMed, an • Median PFS among all treated patients (n=76) by independent review was 6.9 vomiting [n=1], interstitial lung disease [n=1], peripheral neuropathy [n=1], and skin • The primary endpoint was objective response (OR) by independent assessment; • 38 (54%) patients had confirmed partial response (PR), with a median duration of Ashfield company, part of UDG Healthcare plc, during the QR months (95% confidence interval [CI]: 5.36, 9.49) exfoliation [n=1]) secondary endpoints included duration of response, progression-free survival response of 8.3 months (range 5.7–9.7) preparation of this poster (PFS), and safety – Median PFS was 8.8 months (95% CI: 3.98, 11.07) in patients with one prior • 11 (14%) patients had serious drug-related AEs Copies of this poster obtained through Quick Response (QR) Code are for code – 13 of 38 confirmed responders continue on treatment at data cut-off systemic treatment (n=19) and 6.8 months (95% CI: 4.21, 8.35) in patients with personal use only and may not be reproduced without permission from • Patients were required to undergo a baseline and at least one post-baseline tumor • There were no AEs of QT prolongation or hyperglycemia and no drug-related deaths assessment to be evaluable for independent response assessment • 63 (90%) patients experienced disease control (PR + SD) two or more prior regimens (n=57) ASCO® and the author of this poster American Society of Clinical Oncology (ASCO) Annual Meeting, Chicago, IL, USA, June 3–7, 2016 *Corresponding author email address: [email protected].
Load more

Recommended publications
  • YH25448, an Irreversible EGFR-TKI with Potent Intracranial Activity in EGFR Mutant Non-Small- Cell Lung Cancer
    Author Manuscript Published OnlineFirst on January 22, 2019; DOI: 10.1158/1078-0432.CCR-18-2906 Author manuscripts have been peer reviewed and accepted for publication but have not yet been edited. YH25448, an irreversible EGFR-TKI with Potent Intracranial Activity in EGFR mutant non-small- cell lung cancer Jiyeon Yun1*, Min Hee Hong1,2*, Seok-Young Kim1, Chae-Won Park1, Soyoung Kim1, Mi Ran Yun1,3, Han Na Kang1,3, Kyoung-Ho Pyo1, Sung Sook Lee4, Jong Sung Koh5, Ho-Juhn Song5, Dong Kyun Kim6, Young-Sung Lee6, Se-Woong Oh6, Soongyu Choi6, Hye Ryun Kim1,2#, and Byoung Chul Cho1,2,3# 1Yonsei Cancer Research Institute, Yonsei University College of Medicine, Seoul, Republic of Korea. 2Division of Medical Oncology, Department of Internal Medicine, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Korea. 3JE-UK Institute for Cancer Research, JEUK Co. Ltd., Gumi-City, Kyungbuk, Republic of Korea. 4Department of Hematology-Oncology Inje University Haeundae Paik Hospital, Busan, Korea, 5Genosco Inc., Cambridge, MA. 6Yuhan R&D Institute, Yuhan Corporation, Seoul, Korea * These authors contributed equally to this work and should be considered co-first authors # These authors contributed equally to this work and should be considered co-corresponding authors Corresponding Author: Byoung Chul Cho, Yonsei Cancer Center, Division of Medical Oncology, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul 120-752, Korea. Phone: 82-2-2228-8126; Fax: 82-2-393-3562; E-mail: [email protected]; Hye Ryun Kim, M.D., Ph.D. Yonsei Cancer Center, Division of Medical Oncology, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul 120-752, Korea.
    [Show full text]
  • Structural Insights Into Characterizing Binding Sites in EGFR Kinase Mutants
    Structural insights into characterizing binding sites in EGFR kinase mutants Zheng Zhao1, Lei Xie2,3 and Philip E. Bourne*,1,4 1. Department of Biomedical Engineering, University of Virginia, Charlottesville, Virginia 22904, United States of America 2. Department of Computer Science, Hunter College, The City University of New York, New York, New York 10065, United States of America 3.The Graduate Center, The City University of New York, New York, New York 10016, United States of America 4. Data Science Institute, University of Virginia, Charlottesville, Virginia 22904, United States of America *Corresponding author Philip E. Bourne: phone, (434) 924-6867; e-mail, [email protected] 1 Abstract Over the last two decades epidermal growth factor receptor (EGFR) kinase has become an important target to treat non-small cell lung cancer (NSCLC). Currently, three generations of EGFR kinase-targeted small molecule drugs have been FDA approved. They nominally produce a response at the start of treatment and lead to a substantial survival benefit for patients. However, long-term treatment results in acquired drug resistance and further vulnerability to NSCLC. Therefore, novel EGFR kinase inhibitors that specially overcome acquired mutations are urgently needed. To this end, we carried out a comprehensive study of different EGFR kinase mutants using a structural systems pharmacology strategy. Our analysis shows that both wild-type and mutated structures exhibit multiple conformational states that have not been observed in solved crystal structures. We show that this conformational flexibility accommodates diverse types of ligands with multiple types of binding modes. These results provide insights for designing a new- generation of EGFR kinase inhibitor that combats acquired drug-resistant mutations through a multi-conformation-based drug design strategy.
    [Show full text]
  • Receptor Tyrosine Kinase-Targeted Cancer Therapy
    International Journal of Molecular Sciences Review Receptor Tyrosine Kinase-Targeted Cancer Therapy Toshimitsu Yamaoka 1,* , Sojiro Kusumoto 2, Koichi Ando 2, Motoi Ohba 1 and Tohru Ohmori 2 1 Advanced Cancer Translational Research Institute (Formerly, Institute of Molecular Oncology), Showa University, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo 142-8555, Japan; [email protected] 2 Division of Allergology and Respiratory Medicine, Department of Medicine, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo 142-8555, Japan; [email protected] (S.K.); [email protected] (K.A.); [email protected] (T.O.) * Correspondence: [email protected]; Tel.: +81-3-3784-8146 Received: 25 September 2018; Accepted: 2 November 2018; Published: 6 November 2018 Abstract: In the past two decades, several molecular targeted inhibitors have been developed and evaluated clinically to improve the survival of patients with cancer. Molecular targeted inhibitors inhibit the activities of pathogenic tyrosine kinases. Particularly, aberrant receptor tyrosine kinase (RTK) activation is a potential therapeutic target. An increased understanding of genetics, cellular biology and structural biology has led to the development of numerous important therapeutics. Pathogenic RTK mutations, deletions, translocations and amplification/over-expressions have been identified and are currently being examined for their roles in cancers. Therapies targeting RTKs are categorized as small-molecule inhibitors and monoclonal antibodies. Studies are underway to explore abnormalities in 20 types of RTK subfamilies in patients with cancer or other diseases. In this review, we describe representative RTKs important for developing cancer therapeutics and predicting or evaluated resistance mechanisms.
    [Show full text]
  • Osimertinib in EGFR T790M Mutation–Positive Non–Small Cell Lung Cancer Ferdinandos Skoulidis and Vassiliki A
    Published OnlineFirst November 7, 2016; DOI: 10.1158/1078-0432.CCR-15-2815 CCR Drug Updates Clinical Cancer Research Targeting the Gatekeeper: Osimertinib in EGFR T790M Mutation–Positive Non–Small Cell Lung Cancer Ferdinandos Skoulidis and Vassiliki A. Papadimitrakopoulou Abstract In 2015, the FDA approved an unprecedented number of new patients with metastatic EGFR T790M mutation–positive NSCLC, therapies for non–small cell lung cancer (NSCLC), among them as detected by an FDA-approved test, who have progressed on or therapies addressing specific genomic tumor subsets in the setting after EGFR tyrosine kinase inhibitor therapy. It received break- of development of resistance to first-line targeted therapy. Osimer- through therapy designation, priority review status, and accelerated tinib (Tagrisso, formerly AZD9291; AstraZeneca) is indicated for approval from the FDA. Clin Cancer Res; 23(3); 618–22. Ó2016 AACR. Introduction clinical doses required to effectively inhibit T790M in vivo. In a phase Ib clinical trial, afatinib in combination with the chimeric The treatment of non–small cell lung cancer (NSCLC) bearing monoclonal anti-EGFR antibody cetuximab in patients with activating mutations in EGFR with EGFR tyrosine kinase inhibi- acquired resistance to erlotinib or gefitinib resulted in a meaning- tors (TKI) represents a paradigm of science-driven personalized ful 32% objective response rate [ORR; 95% confidence interval cancer therapy. For patients bearing EGFR TKI–sensitizing muta- (CI), 21.8–44.5] and 4.6-month median progression-free survival tions, most commonly in-frame microdeletions in exon 19 (PFS) in EGFR T790-mutant patients, but it was associated with a (Ex19del) and point mutations in exon 21 (leading to L858R or 46% rate of grade 3/4 adverse events, mostly rash and diarrhea L861Q amino acid substitutions) or exon 18 (G719X), treatment (11).
    [Show full text]
  • Kinase Drug Discovery 20 Years After Imatinib: Progress and Future Directions
    REVIEWS Kinase drug discovery 20 years after imatinib: progress and future directions Philip Cohen 1 ✉ , Darren Cross 2 ✉ and Pasi A. Jänne 3 ✉ Abstract | Protein kinases regulate nearly all aspects of cell life, and alterations in their expression, or mutations in their genes, cause cancer and other diseases. Here, we review the remarkable progress made over the past 20 years in improving the potency and specificity of small-molecule inhibitors of protein and lipid kinases, resulting in the approval of more than 70 new drugs since imatinib was approved in 2001. These compounds have had a significant impact on the way in which we now treat cancers and non- cancerous conditions. We discuss how the challenge of drug resistance to kinase inhibitors is being met and the future of kinase drug discovery. Protein kinases In 2001, the first kinase inhibitor, imatinib, received FDA entered clinical trials in 1998, changed the perception Enzymes that catalyse transfer approval, providing the catalyst for an article with the of protein kinases as drug targets, which had previously of the γ- phosphate of ATP provocative title ‘Protein kinases — the major drug tar- received scepticism from many pharmaceutical com- to amino acid side chains in gets of the twenty- first century?’1. Imatinib inhibits the panies. Since then, hundreds of protein kinase inhibi- substrate proteins, such as serine, threonine and tyrosine Abelson (ABL) tyrosine kinase, which is expressed as a tors have been developed and tested in humans and, at residues. deregulated fusion protein, termed BCR–ABL, in nearly the time of writing, 76 have been approved for clinical all cases of chronic myeloid leukaemia (CML)2 and is use, mainly for the treatment of various cancers (FiG.
    [Show full text]
  • Novel Third-Generation EGFR Tyrosine Kinase Inhibitors And
    Published OnlineFirst February 4, 2019; DOI: 10.1158/0008-5472.CAN-18-1281 Cancer Review Research Novel Third-Generation EGFR Tyrosine Kinase Inhibitors and Strategies to Overcome Therapeutic Resistance in Lung Cancer Ayesha Murtuza, Ajaz Bulbul, John Paul Shen, Parissa Keshavarzian, Brian D. Woodward, Fernando J. Lopez-Diaz, Scott M. Lippman, and Hatim Husain Abstract EGFR-activating mutations are observed in approximately (PF-0647775), and AC0010. However, therapeutic resistance 15% to 20% of patients with non–small cell lung cancer. after the administration of third-generation inhibitors is com- Tyrosine kinase inhibitors have provided an illustrative exam- plex and not fully understood, with significant intertumoral ple of the successes in targeting oncogene addiction in cancer and intratumoral heterogeneity. Repeat tissue and plasma and the role of tumor-specific adaptations conferring thera- analyses on therapy have revealed insights into multiple peutic resistance. The compound osimertinib is a third- mechanisms of resistance, including novel second site generation tyrosine kinase inhibitor, which was granted full EGFR mutations, activated bypass pathways such as MET FDA approval in March 2017 based on targeting EGFR T790M amplification, HER2 amplification, RAS mutations, BRAF resistance. The compound has received additional FDA mutations, PIK3CA mutations, and novel fusion events. approval as first-line therapy with improvement in progres- Strategies to understand and predict patterns of mutagenesis sion-free survival by suppressing the activating mutation are still in their infancy; however, technologies to under- and preventing the rise of the dominant resistance clone. stand synthetically lethal dependencies and track cancer Drug development has been breathtaking in this space with evolution through therapy are being explored.
    [Show full text]
  • B1218-5,25 Olmutinib
    BioVision 010/16 RELATED PRODUCTS: PRODUCT: Olmutinib A 83-01 (Cat. No. 1725-1) ABT-869 (Cat. No. 1615-1,5) ALTERNATE NAME: N-(3-((2-((4-(4-methylpiperazin-1-yl)phenyl)amino)thieno[3,2- Axitinib (Cat. No. 1581-5, 25) d]pyrimidin-4-yl)oxy)phenyl)acrylamide; HM61713; BI1482694 BIBW2992 (Cat. No. 1616-1,5) BMS-599626 (Cat. No. 1614-1,5) CATALOG #: B1218-5,25 Bosutinib (Cat. No. 1584-5, 25) Canertinib (Cat. No. 1617-5) AMOUNT: 5 mg, 25 mg Cediranib (Cat. No. 1613-1,5) CP-690550 (Cat. No. 1622-5,25) Dasatinib (Cat. No. 1586-25, 100) STRUCTURE: Emodin (Cat. No. 1875-25, 100) Enzastaurin (LY317615) (Cat. No. 1619-1,5) Erlotinib, Hydrochloride Salt (Cat. No. 1588-100,1000) EZSolution™ Staurosporine (Cat. No. 1745-01) Gefitinib (Cat. No. 1589-5,25) MOLECULAR FORMULA: C26H26N6O2S Genistein (Cat. No. 1533-10, 100) Go 6976 (Cat. No. 1711-500) MOLECULAR WEIGHT: 486.59 Imatinib Mesylate (Cat. No. 1625-100, 1000) Lapatinib Ditosylate (Cat. No. 1624-25,100) CAS NUMBER: 1353550-13-6 Nilotinib (Cat. No. 1750-25, 100) Olmutinib (Cat. No. B1218-5,25) PD 153035, Hydrochloride (Cat. No. 1656-2) APPEARANCE: Pale yellow solid PD173074 (Cat. No. 1675-1) SOLUBILITY: DMSO (>40 mg/ml) Saracatinib (Cat. No. 1582-5, 25) SB-431542 (Cat. No. 1674-1) PURITY: 98% by HPLC Sorafenib (Cat. No. 1594-5, 25) Staurosporine (Cat. No. 1048-01,1) Tamoxifen Citrate (Cat. No. 1551-1000) STORAGE: Store at -20℃. Protect from air and light. SU 1498 (Cat. No. 1836-1,5) SU-5402 (Cat.
    [Show full text]
  • Dabrafenib in Patients with BRAF-Mutated Non-Small Cell Lung Cancer
    Commentary Dabrafenib in patients with BRAF-mutated non-small cell lung cancer Takahisa Kawamura, Haruyasu Murakami Division of Thoracic Oncology, Shizuoka Cancer Center, Shizuoka 411-8777, Japan Correspondence to: Haruyasu Murakami, MD, PhD. Division of Thoracic Oncology, Shizuoka Cancer Center, 1007 Shimonagakubo, Nagaizumi-cho, Sunto-gun, Shizuoka 411-8777, Japan. Email: [email protected]. Comment on: Planchard D, Kim TM, Mazieres J, et al. Dabrafenib in patients with BRAF(V600E)-positive advanced non-small-cell lung cancer: a single- arm, multicentre, open-label, phase 2 trial. Lancet Oncol 2016;17:642-50. Submitted Jun 30, 2016. Accepted for publication Jul 14, 2016. doi: 10.21037/tcr.2016.07.41 View this article at: http://dx.doi.org/10.21037/tcr.2016.07.41 Lung cancer is the leading cause of cancer death worldwide phase III trials (2,3). Dabrafenib significantly improved and non-small cell lung cancer (NSCLC) accounts for more progression-free survival compared with dacarbazine, and than 85% of all cases of lung cancer. Molecular targeted dabrafenib plus trametinib, as compared with dabrafenib drugs, which specifically inhibit a particular molecular plus placebo, significantly improved overall survival in target, have been developed actively and have contributed patients with BRAF-mutated melanoma. BRAF mutation to improved outcomes of advanced NSCLC patients. is a targetable oncogene in melanoma, but not in all non- Epidermal growth factor receptor (EGFR) tyrosine kinase melanoma cancers. The therapeutic efficacy of vemurafenib, inhibitors (TKIs) (e.g., gefitinib, erlotinib, icotinib, afatinib, an adenosine triphosphate-competitive BRAF inhibitor, in olmutinib and osimertinib) and anaplastic lymphoma BRAF-mutated colorectal cancer was disappointing (4).
    [Show full text]
  • Investigation of the Metabolic Stability of Olmutinib by Validated LC-MS/MS: Quantification in Human Cite This: RSC Adv.,2018,8,40387 Plasma
    RSC Advances View Article Online PAPER View Journal | View Issue Investigation of the metabolic stability of olmutinib by validated LC-MS/MS: quantification in human Cite this: RSC Adv.,2018,8,40387 plasma Mohamed W. Attwa, a Adnan A. Kadi,a Hany W. Darwish*ab and Ali S. Abdelhameeda Olmutinib (OTB, Olita™) is an orally available third-generation epidermal growth factor receptor tyrosine kinase inhibitor (EGFR TKI). It was developed by Boehringer Ingelheim and Hanmi Pharmaceutical Co. Ltd for the cure of non-small cell lung cancer (NSCLC). In May 2016, OTB was approved in South Korea for the treatment of patients suffering from metastatic or locally advanced EGFR T790M mutation-positive NSCLC. A LC-MS/MS methodology was validated for OTB quantification in human plasma. An extended application for this validated LC-MS/MS is OTB metabolic stability evaluation. Chromatographic separation of OTB and ponatinib (PNT, IS) was attained using a reversed phase with isocratic elution. The linearity of the developed LC-MS/MS method ranged from 5.00 to 500.00 ng mLÀ1 with r2 $ 0.9999 in À1 Creative Commons Attribution 3.0 Unported Licence. human plasma. LOD and LOQ were 1.12 and 3.39 ng mL , respectively. The intra-day and inter-day Received 2nd October 2018 precision and accuracy were 1.17 to 2.75% and 97.86 to 101.48%, respectively. The intrinsic clearance Accepted 15th November 2018 À1 À1 (CLint) was 2.71 mL min kg and the in vitro half-life (t1/2) was 48.80 min. A review of the literature DOI: 10.1039/c8ra08161a revealed that there are no previous articles about the quantification of OTB in human plasma using LC- rsc.li/rsc-advances MS/MS or its metabolic stability assessment.
    [Show full text]
  • Patient-Derived Cells to Guide Targeted Therapy for Advanced
    www.nature.com/scientificreports OPEN Patient-Derived Cells to Guide Targeted Therapy for Advanced Lung Adenocarcinoma Seok-Young Kim1,2, Ji Yeon Lee2, Dong Hwi Kim1,2, Hyeong -Seok Joo1,2, Mi Ran Yun1,2, Dongmin Jung3, Jiyeon Yun2, Seong Gu Heo2, Beung -Chul Ahn2, Chae Won Park2, Kyoung Ho Pyo2, You Jin Chun2, Min Hee Hong 2, Hye Ryun Kim 2* & Byoung Chul Cho2* Adequate preclinical model and model establishment procedure are required to accelerate translational research in lung cancer. We streamlined a protocol for establishing patient-derived cells (PDC) and identifed efective targeted therapies and novel resistance mechanisms using PDCs. We generated 23 PDCs from 96 malignant efusions of 77 patients with advanced lung adenocarcinoma. Clinical and experimental factors were reviewed to identify determinants for PDC establishment. PDCs were characterized by driver mutations and in vitro sensitivity to targeted therapies. Seven PDCs were analyzed by whole-exome sequencing. PDCs were established at a success rate of 24.0%. Utilizing cytological diagnosis and tumor colony formation can improve the success rate upto 48.8%. In vitro response to a tyrosine kinase inhibitor (TKI) in PDC refected patient treatment response and contributed to identifying efective therapies. Combination of dabrafenib and trametinib was potent against a rare BRAF K601E mutation. Afatinib was the most potent EGFR-TKI against uncommon EGFR mutations including L861Q, G719C/S768I, and D770_N771insG. Aurora kinase A (AURKA) was identifed as a novel resistance mechanism to olmutinib, a mutant-selective, third-generation EGFR-TKI, and inhibition of AURKA overcame the resistance. We presented an efcient protocol for establishing PDCs.
    [Show full text]
  • Olmutinib Induced Lichen Planus Like Eruption Pissn 1013-9087ㆍeissn 2005-3894 Ann Dermatol Vol
    Olmutinib Induced Lichen Planus Like Eruption pISSN 1013-9087ㆍeISSN 2005-3894 Ann Dermatol Vol. 30, No. 4, 2018 https://doi.org/10.5021/ad.2018.30.4.451 CASE REPORT Olmutinib Induced Lichen Planus Like Eruption Seung Hwan Oh, Hyun Jeong Byun, Se Jin Oh, Ji-Young Jun, Ji-Hye Park, Jong Hee Lee, Dong-Youn Lee, Joo-Heung Lee, Jun-Mo Yang Department of Dermatology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea Drug induced lichen planus like eruption is an uncommon INTRODUCTION cutaneous adverse effect of several drugs. This appears sym- metric eruption of erythematous or violaceous plaques re- Olmutinib is an oral, third-generation epidermal growth sembling lichen planus on the trunk and extremities. A factor receptor-tyrosine kinase inhibitor (EGFR-TKI) for lo- 50-year-old male presented with scaly, violaceous plaques cally advanced or metastatic EGFR T790M mutation-pos- and dusky brown macules on whole body. For four months, itive non-small cell lung cancer. This received its first the patient was treated with olmutinib, an oral, third-gen- global approval in South Korea in May 20161. We present eration epidermal growth factor receptor-tyrosine kinase a case of lichen planus (LP) like eruption in a man after ol- inhibitor. In May 2016, olmutinib received its first global ap- mutinib treatment. To our knowledge, this is the first re- proval in South Korea for the treatment of patients with lo- ported case of olmutinib induced LP like eruption. cally advanced or metastatic epidermal growth factor re- ceptor T790M mutation-positive non-small cell lung cancer.
    [Show full text]
  • Potentiating Therapeutic Effects of Epidermal Growth Factor Receptor Inhibition in Triple-Negative Breast Cancer
    pharmaceuticals Review Potentiating Therapeutic Effects of Epidermal Growth Factor Receptor Inhibition in Triple-Negative Breast Cancer Kyu Sic You 1,2,† , Yong Weon Yi 3,† , Jeonghee Cho 3 , Jeong-Soo Park 1,* and Yeon-Sun Seong 1,2,3,* 1 Department of Biochemistry, College of Medicine, Dankook University, Cheonan 31116, Chungcheongnam-do, Korea; [email protected] 2 Graduate School of Convergence Medical Science, Dankook University, Cheonan 3116, Chungcheongnam-do, Korea 3 Department of Nanobiomedical Science, Dankook University, Cheonan 31116, Chungcheongnam-do, Korea; [email protected] (Y.W.Y.); [email protected] (J.C.) * Correspondence: [email protected] (J.-S.P.); [email protected] (Y.-S.S.); Tel.: +82-41-550-3876 (J.-S.P.); +82-41-550-3875 (Y.-S.S.) † These authors contributed equally to this work. Abstract: Triple-negative breast cancer (TNBC) is a subset of breast cancer with aggressive charac- teristics and few therapeutic options. The lack of an appropriate therapeutic target is a challenging issue in treating TNBC. Although a high level expression of epidermal growth factor receptor (EGFR) has been associated with a poor prognosis among patients with TNBC, targeted anti-EGFR therapies have demonstrated limited efficacy for TNBC treatment in both clinical and preclinical settings. However, with the advantage of a number of clinically approved EGFR inhibitors (EGFRis), combi- nation strategies have been explored as a promising approach to overcome the intrinsic resistance of TNBC to EGFRis. In this review, we analyzed the literature on the combination of EGFRis with Citation: You, K.S.; Yi, Y.W.; Cho, J.; other molecularly targeted therapeutics or conventional chemotherapeutics to understand the current Park, J.-S.; Seong, Y.-S.
    [Show full text]